What can it be?

StevieD Member Posts: 10
Ok... excuse the long story, but it has been going on a while...

I am 37. Male. Generally healthy. 16 1/2 stone (down from 18 1/2 this time last year). I did have a mini discectomy for a partial slipped disc back in 2003.

I have been suffering with intermittent foot pain/discomfort for about 5 years now. When I say intermittent I can go months without an 'attack'.

Only affects my feet and can attack either foot at any time. It usually starts/flares up overnight (with maybe a twinge in the ankle a few days running up to an attack) and the first I now is when i experience pain or discomfort when moving in bed or first stepping on the floor in the morning.

It usually affects the ankle, sometimes the heel, sometimes the instep. Usually feels bruised to the touch but no signs of trauma etc..

Pain is usually worst at night ... joints/feet appear to stiffen as the day goes on (I work at a desk ... but do have to move from desk to desk on occassions). When pain gets at its worst I cannot sleep and nothing, rest, painkillers, ice anything goes anywhere near it. These bouts of severe pain tend to only last an hour or so, usually in the early hours.

During a flare up - the foot is very uncomfortable to walk on, accompanied with swelling to the ankle/instep / lack of mobility - basically walking in a straight line is ok, but going round corners or non flat surfaces tricky. Usually worse wearing normal shoes.

So when it first flared up - I went to the doc and even A&E to no avail after x-rays / blood tests. As it kept going away - i just got on with it until a spate of attacks three years ago...

So I go see a podiatrist who I knew as a friend (what appears may now be a mistake/coincidence/misdiagnosis) who asked to see me when had no pain etc so could do a bio-mechanical assessment on me. It showed my feet over pronate so had some custom made orthotics made for me.

This seem to stop the flare ups every month and only happened every 5 or 6 months and only lasted a few days when did, rather than a week.

Until the last year where the flare ups started happening more regularly. Again I just got on with it - as a fact of 'my' life until the last attack where my feet have given me discomfort/swelling/pain for the last 4 1/2 weeks.

Weekend before last 3 nights in a row had unbearable pain at night - that no painkillers or anything touched. Can only describe the pain as if my foot was broken (never broken anything to compare) - it felt heavy and empty with pain all at the same time. After resting and moving foot was very 'heavy' and painful. Only real respite was sitting up and resting feet on floor??

So I go to another podiatrist for a 2nd opinion. She can see the swelling on my foot and its hot to the touch and she suspects I have some form of inflammatory / rheumatoid arthritis and refers me back to my doc asap for a blood test and referral to a rheumatologist.

I visit my doctor the next day who gives me blood test and sends me for an x-ray and I make an appt for 14 days time to get results etc. She also prescribes me diclofenac and co-codamol for any further pain.

The pain has stopped over night now (some sporadic stiffness or feet feeling heavy at night) and I'm almost walking ok now - some slight discomfort / stiffness in my right foot but it appears im heading for another bout of 'remission' (thank god).

I phone for my blood test / x-ray results today and the Dr advises my X-Ray is clear, my Rheumatoid Factor is normal/clear as are other test. However some tests CCP and CRP i think she said are slightly higher - which just proves I had some inflammation at the time of the test.

So she is going to discuss with her colleague and then see me as planned next week to see how I am / discuss the next steps.

Its almost as if I'm going mad when it flares up with no-one knowing what it is. It takes over your life when bad as cant play sport or go out for walks etc...

Some kind of diagnosis would be good - so I know what to do both when have an attack and in between, i.e should i be exercising .. stretching ... resting.. not knowing is just a nightmare!!

No other joints are affected - just my feet.

Anyone else had similar symptoms ? / Can anyone suggest what it may be / are some tests for RA sometimes negative / suggest what I say to my doctor next?

Thanks for listening!


  • helpline_team
    helpline_team Posts: 2,852
    edited 29. Aug 2012, 06:48
    Dear Stevie,

    Thanks for your post to Helplines. We are not medically qualified so can only give you pointers to explore with the folks who are medically qualified, so I hope you will bear with that.

    If you are trying to get a diagnosis when early investigations are unclear then it may require a certain degree of patience.... not easy if your pain is severe.

    Because you've mentioned a history of disc trouble in your back, then mechanical problems may need to be explored very fully to completely rule them out. If the GP goes in that direction you'd probably be looking at a referral to a musculoskeletal clinic where you'd be seen for a few sessions by the senior physio and they'd watch you walk, perhaps order more images etc.

    As the GP's already done a fair number of inflammatory tests and there's nothing glaring if that's the avenue their experience is pointing to they may well want a rheumatologist to look into matters.

    One increasingly common inflammatory arthritis these days is gout (as the population is tending more towards overweight).

    If you would like some immediate practical guidance then being weighted and measured and given a general lifestyle MOT from a physiotherapist is often extremely useful. But if you'd like any more suggestions you may need to be examined and see what a medical professional suggests.

    In the meantime do see http://www.arthritiscare.org.uk/LivingwithArthritis/Self-management


    If you'd like a chat you are very welcome to ring us on our free phone.

    hope that helps

  • lizzy100
    lizzy100 Member Posts: 235
    edited 30. Nov -1, 00:00
    rheumatoid arthritis would usually be pain and stiffness in the mornings and not so much at night and after doing things.
    rheumatoid factor is pretty much always positive in rheumatoid. but negative in seronegative arthritis. gout would normally affect the big toe. hope they get to the bottom of it!