What it is about feet? It seems that all members have big problems with their feet!

I don't remember having feet that were normal, honestly I don't . So reading so many comments on here about everyones feet is jaw dropping to me really.

I hear people comment about their feet during my daily life for instance if they have been walking all day or have worn the wrong shoes etc, just all normal stuff.

I have often felt a bit isolated at times with mine being so chronic. I think its the fact that it won't go away, so I have to accept it. But again, just wondering why the feet ?

Indeed, why the feet? It’s just one of the body parts that PsA like to pick on, I guess. Feet also happen to be something that most GPs are pretty clueless about. Come to think of it, the sports medicine lady I once saw got the diagnosis pretty wrong too. And really, what are they going to do? Tell you to get good shoes, lose some weight and get new orthotics.

Feet get ignored and shrugged off. When I was with my specialist PsA rheumie for a check up, I witnessed a teaching moment with the resident du jour. Dr. PsA commented that when children have sore feet, wverybody gets all concerned. But adults tend to get ignored when they complain that their feet hurt. “And this,” he said, pointing to my feet,“is what can happen if you ignore the complaints for long enough. Don’t let this happen to any of your patients.” The resident looked very serious.

Yes, there are plenty of foot problems here. I even blogged about mine –
http://discussion.livingwithpsoriaticarthritis.org/profiles/blogs/listen-up-take-notes

It's the small joints. My feet and hands are fairly equally affected, although the damage to my hands so far has been worse. I would be very happy if I didn't have problems with my feet, but there it is. I wear good shoes most of the time, and have and wear my orthotics.

Haha! I like this post! I'm not too keen on my feet though because ... guess what? I can't remember ever having normal feet either. Though maybe early adolescence was their heyday!

The damn things have an awful lot of bones in them & therefore a lot of joints. And of course PsA picks on joints. Add to that the fact that they bear our entire weight and it's hardly surprising that they tend to be, even at best, a right pair of divas.

Funny how things turn out though. My feet brought me & my husband together. I got talking to him in a pub - a stranger then - about how big & ugly my feet were. And he said that he'd always felt that his were too small for his build. In retrospect it's tragic how awful our chat-up lines were but worked for us!

I do wish docs would take more notice of feet. I'm sure the state of them can be an early indication of PsA.

Naaaah, NanaL, I’m just a drama queen! LOL To see me on the street (for less than ten minutes, that is) you’d think there was nothing wrong with me. LOL … just ask some of my friends here.



A biologic is a very specialized, genetically-engineered medication which, for some people, provides near-miraculous relief. For others, not so much. But generally, they are regarded as the gold standard of inflalmmatory arthritis treatment. They are hair-raisingly expensive, and therefore not generally available until you have turned over every other treatment stone.



Sounds like you had fun in Liverpool. A great city, isn’t it? Did you take the Feeeeerry Across the Meeersey?

Best pickup line I’ve heard for a long time.



Sybil said:

Funny how things turn out though. My feet brought me & my husband together. I got talking to him in a pub - a stranger then - about how big & ugly my feet were. And he said that he’d always felt that his were too small for his build. In retrospect it’s tragic how awful our chat-up lines were but worked for us!

I do wish docs would take more notice of feet. I’m sure the state of them can be an early indication of PsA.

Also, if you're interested in the criteria UK patients have to meet to be prescribed biologics you could join the group we have here for UK members 'Cuppa House' and see Jules' post on the NICE guidelines. Basically you 'need' to fail 2 DMARDs and have a certain number of swollen / tender joints. I think this information is somewhere else on the site as well.

Cuppa House doesn't get much traffic, probably because we're well served on the main site, but it definitely has potential. The small number of posts means whatever UK specific info. you're looking for is very easy to find.

Sybil, you crack me up!!! That is hilarious. Omg, but I can so relate–that’s not how I met my husband, but I do have big, ugly feet. Except, now I think those feet are getting back at me for always complaining about how big and ugly they are. Actually, the rest of me in my older age is catching up to being just as big and/or ugly as my feet have always been! Haha



Sybil said:

Funny how things turn out though. My feet brought me & my husband together. I got talking to him in a pub - a stranger then - about how big & ugly my feet were. And he said that he’d always felt that his were too small for his build. In retrospect it’s tragic how awful our chat-up lines were but worked for us!

I do wish docs would take more notice of feet. I’m sure the state of them can be an early indication of PsA.

Since I can’t reach my toes and feet, I go for a pedicure. Not just any salon works. The salons run by Vietnamese are the best! I go in once a month. The Vietnamese know more about the feet than anyone. They massage the feet for a long time. Very deep massage. When I’m done my feet feel awesome! If I could afford it every week, would do it.

When I go to bed is usually when the fun starts (and that's not some kind of corny innuendo). It all sounds rather familiar to me.

If I were you I'd get this down to a concise list for your rheumy. You feel sickly tired and have widespread intermittent pain: feet, hand, forearm, lower legs, thumb, knees. Burning sensation on heel. Unpleasant sensations and cramp(?) in feet and toes.

Well, that's what I'd do anyway .... write a list like that and then do a few more such lists before your appointment, then go through, weed out anything that was a one-off or not too bad and put the symptoms into categories. I tend to start with systemic symptoms - those that badly affect how I feel overall such as fatigue or generally feeling very unwell. Then I go on to things the doctor will be able to see - that's usually swelling. Then I say where I've had pain or weird sensations and how bad it has been.

A good doctor will ask all the right questions and give you a thorough physical examination. Sleep tight I hope!

P.S. my rheumy got a bit upset the one and only time I produced a list. So I memorise it and keep it in my bag just in case.

NanaL, I find that having my legs slightly elevated on a pillow helps with my back, knee and foot pain in bed. I started off with the pillow underneath my knees but then when the heel pain of resting on the mattress became intolerable I swung the pillow lengthways so my heels hang off the end. If I turn on my side I keep the pillow between my legs. I have a nice soft but firm memory foam pillow which is 'just the job'. Took me a while to find just the right pillow support (I have one either side for my arms/shoulders as well) but they are my best chance of some comfort.

Ha, ha NanaL .... I didn't like the memory foam pillow under my head either :-)

Definitely try a pillow between your knees, it also helps keep your hips/pelvis in alignment and that in itself relieves strain and pain. I hate all the weird sensations, I find cold helps them the most either an ice pack or even rubbing in something like Flexall Cooling Gel/BioFreeze and my favourite is 4Head Stick .... yeah, I know it was designed for tension headaches ...... it is only a waxy levomenthol stick so great for a cooling effect on the forehead, neck and elsewhere without the mess of a gel/cream and fab if you're out and about. It's also great for hot flushes/night sweats for us ladies of a certain age.

I had "traveling" pain a lot, too, before I went on Enbrel. I think it's typical with PsA. I would tell my rheumy about the worst stuff, which was tendonitis in my shoulders, wrists, stiffness and pain in my back, hands, feet, and then mention I had aches and pains that seemed to travel. He understood. He seemed to know enough about PsA to tell me he wouldn't let his mom or sister suffer like that and he'd make them take a biologic. But what do you do for it? I never took narcotics or strong pain meds. He knew I didn't want to put that stuff in my body. So, it was weird even going to my doctor appointments. I was always hoping he'd tell me some natural remedy would work. Enbrel has really made a difference for me by reducing my pain considerably.

I did some really challenging reading the other day about various disease activty scoring systems that rheumatologists use. I’d need a weeklong tutorial from tntlamb to get my simple mind around most of it. But what I did get and understand is this. The DAS28 (a common system that a lot of rheums use, which scores number of swollen or tender joints, and then factors in things like blood work)doesn’t always give an accurate picture of disease activity. The authors identified two situations in which DAS28 doesn’t work well:

  1. Where ESR isn’t elevated
  2. When the disease is active in the feet.
    OK, so my simple but reasonably logical mind is thinking like this. About fifty percent of PsA patients have normal ESRs. And a lot of PsA people have disease in the feet, and a lot of doctors aren’t interested in feet. So a high proportion of PsA patients have normal ESRs and perhaps underestimated disease in the feet. Rheum does a DAS28 score and says “hey, the disease is pretty much under control”. But it isn’t. Time goes on, and the disease damaages the feet. Patient now has permanent foot damage.
    Maybe that’s how it happpened in some of us. If I’ve got this wrong, I’m sure tnt will set me straight.

I think you’ve hit the head on the nail: politely assertive. Work off your list, and maybe even make two copies so that you can give one to the consultant. (Some docs like t his, others not so much. You will need to feel your way through that situation.)

About disease activity scoring: I have an atypical presentation of PsA. My mid-feet are heavily affected, my toes less so. I’m one of the 50% of PsA patients with inflammatory markers in the normal range. One rheumatologist pegged my disease as “mild and improving”. The PsA specialist assessed me as “severe with a lot of damage”. Clearly, they were using different tools to estimate my disease activity. Scary stuff, no?