Frustrated with Doctor


I was diagnosed with PsA in August 2011. I have been taking methotrexate for 10 weeks now. I have noticed a reduction in some of my foot pain, primarily the morning stiffness. However I have noticed an increase in my shin pain. I am no longer able to run without pain, and struggling with some exercise that I used to find ok.. When I saw my Rhemy he just said that the shin pain is not related to the PsA, however that was my first symptom..

I am not sure where to go from here.. Any suggestions??


Hi Samc, It can be frustrating when you feel like your doctor isn't listening to you. If that is a chronic issue with your doc, you might want to find a new one, if insurance and location allow it. You need to have a good working relationship with your Rheumy as PsA is a life-long issue. PsA is challenging enough without adding an inattentive doctor in the mix!

Since you are physically active, you might want to see about getting a referral to a physical therapist to address the shin pain and the other exercises you are struggling with. A good PT should be able to help you either find a work-around for the difficulties or may be able to help you address the shin pain, whatever the underlying cause. Massage therapy, ultrasonic wand-thingy (getting really technical there!), and heat/cold therapy are all possibilities that a PT can help you with.

Here's hoping that your shins settle down!

I must agree with Andrea…find a doctor who will listen to you. I wasted 2 years with a doctor that never listened while my health continued to detoriate. I have a rhuemetogolist now that listens, open to anything I want to discuss, and is willing to “experiment” with my care. It is really too bad he cannot be my primary doctor. I have the upmost trust in his advise. You need to have that trust because this IS YOUR life, not the doctors’. I do want to tell you that I take methotrexate each week and when I first went on it, I did not see the benefit from it; only the sickness I felt. I have been taking it for almost 6 years; there is good from it but we must give these medications time to work. I wish you good luck and the best things for you to come.

As far as the shin pain I’ve had the same thing, and it’s totally related!! Cmon! I went to a lot of physical therapy for my feet and they determined that my hip flexors were not strong enough to support my legs correctly, and I had plantar fascitis. Both things were causing other muscles to work overtime like my shins, and caused increased pain. Simple physical therapy for a few weeks greatly improved my feet and legs. I have given up running since then, as I am convinced it sped up the need for foot surgery. Maybe consider other forms of exercise? I know you don’t want to hear that, because runners love running.

I, too, have been on MTX for almost three months with no apparent improvement, and it is totally frustrating. In fact, my skin is much worse than before I began the drug. I do not think the drug caused this, but I was hoping it would help more. When a drug has the potential side effects of MTX, you really want it to be working to justify the risk of being on it!

I must agree that a physical therapist may be the one who could help you figure out how to exercise so that your pain is not so aggravated. My PT actually has an athletic trainer that works in his office to help with just your kind of issues. Could be a good place to start for answers.

Hope you can get some good advice and get back to moving without pain!

I just started on MTX 4 weeks ago, and Enbrel yesterday. In the past weeks, I've noticed that my shins hurt sometimes. Maybe the MTX is related. I usually attribute it to working out too hard or something else. My shins would hurt while lying in bed on my stomach typing on the laptop. They would almost cramp. They get better if I walk a bit. A couple days before though I had stressed myself in a fairly hard workout, so I'm not sure what to think. I'll bug my rhum next time I see her.

Could the shin pain just be do to using your legs more now that you feel better? Same with me maybe.

Shin pain is most definitely related to this. Mine get very painful and lumps form along the affected tendons. This goes away when the medication works.

I would also agree that it is related. My feet and hands are the worst, and I definitely have shin pain, and terrible pain on the top of my foot where it meets the ankle. I walk A LOT...always have, and I wear very good shoes. Now most days its VERY rare if I don't have pain. I agree with hamishead - this disease is horrible on the tendons. Definitely find a Dr that Anne Marie I wasted a number of years with a Rheum that constantly dismissed my claims of pain.....because I never seem to have a lot of swelling.....not everyone with PsA has swelling. now with my new Rheum we have discovered severe bone erosion (via MRI) and I often wonder if my first Dr would have listened if maybe that erosion could have been slowed down or prevented. I'll never know, but I definitely speak up and do a lot of research on my own and document how I feel each day to see if there are any patterns.

As you may know this condition causes inflammation in the synovial fluid of the tendon sheaths and bone joints.

I started getting a numbness in my left foot about 12 years ago. I now have a strange mixture of numbness or 'woodeness' combined with excrutiating, burning pain if I knock or even rub any part of the toes, knuckles at the toe /foot joint, the major joint in the middle of the foot, the ankles, the shins and, now, around my knee prothesis's. (I lost both knees before PsA was diagnosed) Both feet are affected and some fairly high level of pain is always present. The pain is reduced by medication such as enbrel, humira, methotrexate but never goes away for even a minute. If the medication isn't working I cannot stand even a bed sheet touching them. I am now getting the same symptoms starting in my fingers with the index finger of the left hand very painful and the top knuckle completely destroyed.

I'm writing this because I think it is beneficial to any person new to this disease to quickly realise the sort of areas and pain it causes so that they don't become concerned that they have some other disease or physical problem as well as PsA and so they can bring it to their Doctor's attention. Over the last 12 months I have pain and swelling in the tendon between two ribs! In the early days I would have been worried I had some other disease but the type of pain makes it clear what it is. And my current doctor agrees. And this helps my mental state a lot.

I encourage anyone starting to have this to do anything you can to try to slow the progression down. However I have been unable to find any doctor or physio etc that has had any idea of what to do other than the medications. I had physio when it first started but with little result other than short term but I now cannot bear anyone to touch them. It took years before I found a doctor who would even acknowledge that I could have such strange mixed symptoms and that it was PsA.

The more I read peoples stories the more I feel a data base of symptoms and where they occur is needed both for sufferers and doctors to help them and the doctors quickly identify what the new pain a person is feeling is and any treatment found to help. So many doctors including rheumo's seem to have limited knowledge and although I think my current one is really trying I always feel the progression of my condition is ahead of his knowledge. But he is always keen to listen to me accepts that my knowledge of my disease is important. If your doctor won't even do that find one that does for your sake.

Initially I thought medication would stop all pain but for me the best would be a 60% reduction and then only for 12 months at the most. Each time a medication fails the pain levels and areas affected grow permanently

This rant is definitely linked to the discussion title! I hope it helps newcomers know what they may face with out causing fear because we all seem to suffer in our own unique way.