Hi everyone, thank you for allowing me to join your group. I was recently diagnosed with PsA, but am still in that denial/are they really right about this? stage. I’ve had a bottle of methotrexate sitting on my counter for more than a month… I’m still afraid to start it. My symptoms are on the mild end… I have joint pain, but mostly tendon and muscle pain. But one thing that I have daily is foot pain… heel and toe pain, and a little bit of swelling in my achilles tendon and in one toe. But I really have minimal swelling if any at all. I wake up every morning with burning hot, red toes that are stiff and achy. After a few minutes of walking around they get better. But I also get cold blue toes! Does all of this sound like PsA? You can see my ugly feet in the picture. They were the inspiration for my user name lol.
Sounds like you might have a touch of Raynaud’s syndrome along with the PsA. They can go hand in hand (and foot in foot). I have it and it can be painful, both the burning and the cold. Do mention it to your doctor. There are generic medications that can be prescribed to keep it controlled.
(Medication in the cupboard and painful joints) = (permanent damage) THAT IS NOT mild disease.
I’ve never had any swelling on my feet. Ankles yes, feet no. Was recently told while having an ultrasound that every joint in my feet is damaged. Yet I can walk, at the moment. My feet are often hot, often painful. The Mtx is in my tummy once a week, I want to keep walking.
And don’t be too hard on those feet. Mine are vile to look at, but I’m full of admiration for the little troopers.
Hiya … I want to call you by your screen name, but I.just.cant … LOL. Anyway, I’m glad you joined us. I see tntlamb has introduced himself to you already. He can sometimes come across as a gruff so-n-so, but we’ve learned here that he’s almost always right. Very annoying, that. 
When I see anything about feet, I have the irresistible urge to jump right in. (The regulars are now rolling their eyes!) Doctors shrugged my complaints off for years before I was diagnosed (like you, I had a lot of muscle and tendon pain, which helped make a diagnosis difficult). Once I was diagnosed, my now-ex-rheumatologist seriously underestimated the severity of my disease. The result was serious foot damage to the point that I cannot stand or walk for more than about ten minutes because of the excruciating pain. My mobility scooter is my best friend.
What turned my disease around was listening to tntlamb and getting out there and finding a rheumatologist who took my disease seriously. Since taking tnt’s advice, I’ve had virtually no more damage, and I have my life back.
Welcome to our clubhouse, UF! We’re glad that you’ve joined us, and we hope that you will be too.
Thank you for the replies everyone… it’s nice to be able to ask questions of such knowledgeable people. Seenie… you can call me Penny (or uglyfeet… it’s kind of growing on me lol). Question for tntlamb… are you saying that what I’m dealing with is not mild disease? I’ve always been so healthy that it’s very difficult for me to admit there is something wrong that requires medication. And I have a lot of stomach issues (celiac), so I’m terrified of anything that causes GI distress. It can take me weeks to recover.
Hello Penny! (Phew, that’s a relief!).
Not wanting to speak for the venerable @tntlamb, but what your feet look like (the redness) isn’t normal. Any of us with a PsA diagnosis whose feet looked so red would be off quick to the rheumatologist asking for help. It’s not possible to diagnose you–nor is it our purpose as a support site–but from our collective experience we can certainly say it looks like you need some medical intervention. And not all medicines are a burden on the gut.
Well Penny keeping in mind what Sennie said and that I’m only looking at a photo, and I’m not a Rheumie. I’d say what you have is NOT mild disease. Sure it might be Raynauds but aside from a name whats going on is you have varying levels of inflammation in your feet.(the worst BTW is when they get cold) In the PsA world where there is uncontrolled inflammation DAMAGE follows.
The adage around here is fear the Disease NOT the meds. Side effects? Damn the side effects. I have tendency to drink. (not alcoholic drinking) I make and collect wine. I have a LARGE collection of Single Malt Whiskeys and participate in several tasting clubs. I have been known to wake up after a “meeting” or bottling day with some side effects on occasion bad enough I have asked my wife to shoot me. On occasion she has been more likley than Not (especially on a Las Vegas trip where I learned Chardonnay was low carb and free. I had a particularly good streak going on the Roulette Table. You can drink a lot of free Chardonnay in 8 hours. I side effects that hadn’t had since High School (close to 50 years ago) I still drink because of the enjoyment I have. That and I have never had a permanent hang over. NO ONE does.
Our meds are very much the same. The side effects because they are powerful do happen from time to time. Incidentally its less than 25% of the time ANYONE has the side effects. people who don’t have them just don’t show up on the internet to bitch.
What is going on with your feet is a sign of bad stuff happening. Your doc knows it, he told you so when he prescribed the meds (he doesn’t get commission for prescriptions or extra pay for taking the time to write them - he’d much sooner save the 15 minutes and get to the next patient and another $300.00 bucks trust me on that)
Has bad stuff happened? prolly not. (but those middle toes concern me, have they always been bent? The big question is DO YOU WANT BAD STUFF TO HAPPEN? Take the meds IF you have some side effects think about the hangover. I have two grandaughters living with me. BOTH of whom take these meds. We look forward to Tuesday nights when we all three inject. As Tana says it make Wed. suck sometimes. BUT it makes the weekend GREAT!!!
As far as the GI stress goes, inject. Also keep in mind these are the same meds that are used to treat most Autoimmune GI issues (Yeah doesn’t make sense BUT what causes issues with cleliac is INFLAMMATION)
Penny! Yes, that’s better. I’m completely with janeatiu. One of the things I’ve learned to do in the last few years is question my doctors’ assessments. Not in an aggressive fashion, but from the point of view of checking what the docs are saying with my gut. My gut was always the part that I didn’t trust. I learned the hard way that, above all else, THAT is the part that I need to trust.
About your gut. I had terrible gut problems for years, attributed to IBS, or maybe food sensitivities, or maybe … blah blah blah, you know it happens, cut back on fat and gluten and … blah blah blah. When my PsA was finally diagnosed properly (it was severe, not mild as the first rheum thought) and controlled, the gut problems disappeared like snow in the sun.
So something to think about. Hang in there, Penny.
You guys are awesome, thank you so much…for the kind welcome, the information, and the hard reality check. I really needed to hear these things and I am listening. I told my husband last night that I will start the meds. tntlamb… my second toes have always been slightly crooked but have gotten much worse. X-rays showed nothing though… everything was normal. Although that was a year ago… before I started having the hot red feet. My inflammation markers are always normal too (sed rate and crp)… is normal blood work common? On a side note… my dad was just diagnosed with RA, and guess who’s giving him a hard time about starting his meds? 
Penny, we’re so glad that you are finding being here helpful. We’re nice, but we will subject you to a reality check too: many of us have been to the PsA rodeo too many times.
I complained of sore feet for a long time. A couple of years, maybe more than a couple. It was always “get better shoes” and “orthotic time”. None of that did much good. Repeated X-rays showed nothing was wrong, until one day they did. And then the damage was already done.
Here’s the thing. Inflammation does not show on x-rays, however if you can get your rheum to do an MRI or specialized ultrasound, you might see it on those.
The normal blood work thing is one of things that trips doctors up all the time. Something like 51% of PsA patients have blood work in the normal range. (That fact comes from Dr. Daphna Gladman, the great godmother of PsA research.)
Another newbie article: Inflammatory Markers in PsA
Mine was always normal, so the doc thought nothing was wrong with me. (Well no, that’s not true. She thought I was a whingeing, whining, complaining, depressed and snivelling menopausal woman, that’s what she thought was wrong with me.) For Pete’s sake, my CRP&ESR were normal the whole time PsA was destroying my right hip, and it finished that job in the space of twelve months. What a claim to fame!
Psoriatic Arthritis is a tricky disease to diagnose correctly and to assess accurately. Listen to your docs, and listen to your gut. Fear the disease, not the treatment. And accept the most aggressive therapy that your rheumatologist is prepared to give you.
JMHO
I do actually remember my dr saying “normal blood work lends itself to a PsA diagnosis.” I forgot that he said that, but it makes sense!