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Is it Arthritis?

StevieDStevieD Posts: 10
edited 5. Sep 2012, 07:53 in Living with Arthritis archive
Ok... excuse the long story, but it has been going on a while...

(i've posted in the helpline forum too .. but saw another post that said may be better here...)

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??

Getting comfortable in bed when laying down is also not easy. One position tends to be best but does cause it to stiffen up more if just left in the one position...

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!
Steve

Comments

  • LignumVitaeLignumVitae Posts: 1,972
    edited 30. Nov -1, 00:00
    Hi Stevie

    Welcome to the forum, we are a friendly bunch on here so we will offer you support but we can't diagnose i'm afraid.

    That all sounds like no fun at all and you've put up with it for long enough. There are many forms of arthritis beyond RA so a negative rheumatoid factor doesn't rule out everything. It sounds like your doctor is on the case with you. I think it might be a good idea to keep a diary so you can work out any patterns such as eating and drinking/ exercising and other factors which could be contributing- does it feel different in the mornings/ evenings etc etc. You might also want to take pictures of any visible symptoms like swelling etc. Having a record can help the medics work things through with you.

    It can be maddening dealing with something that is intermittent - my arthritis was once and I spent time thinking I was mad! I think that's normal. Rest assured it isn't the case, waiting for a diagnosis is very hard to do, your mind explores every avenue and then some!

    I work on the basis of 'make hay while the sun shines' which means when I am good, I exercise, when I'm not so good I take it easy. It's usually important to keep your muscles strong and your joints moving. That said, go for sensible exercise so not high impact activities like squash or road running. Again, note how things feel before or after exercise.

    Hope that help and I hope the meds are helping too!

    LV
    Hey little fighter, things will get brighter
  • PetitessePetitesse Posts: 62
    edited 30. Nov -1, 00:00
    Hi Stevie,

    Oh, I can understand how frustrated you are. It is very difficult to wait for a diagnosis.
    You are doing a great job at describing the pain and I think that is important. However I am not sure that people experience pain the same way? Not even people with the same diagnosis will always have the same 'kind' of pain or pattern to it. If I were to describe the pain I felt in the beginning, it would not be the same as it is now.

    I am now diagnosed with reactive arthritis. For the first 4 years I only had symptoms in my left ankle.
    My ancle was crazy swollen, but the doctors insisted for 4 months that it was just sprained. After a cortisone injection the swelling went down. My blood tests went back to normal so my rheumie wouldn't see me anymore. Only if it got worse. (Apparently worse than not being able to walk!)

    But the thing is I have never been able to find any patterns in anything. I can be in a lot of pain regardless of my blood test showing everything is normal. It can be painful even at the times when my ankle is not swollen.
    It used to feel like it was sprained and it hurt all the time. Now it feels pretty much okay most of the time but I get bouts of intense pain that can last just half an hour or days. I also get flareups where I can't walk properly for several weeks or months. Like with you it hurts when I walk around corners or on non flat surfaces.

    In a way it is great to not feel ill all the time. But it does mean you have to get used to living with frustration and not being able to plan very well.
    It is like having Mr. Arthritis always standing in the doorway. 'Are you coming or going? Please make up your mind so I can close the door! And you either move in with me or leave for good!'

    I hope you will get a proper diagnosis soon and also that the meds will work for you.
    I also hope you will enjoy being on the forum and make great friends here :)
  • stickywicketstickywicket Posts: 25,993 ✭✭✭
    edited 30. Nov -1, 00:00
    Hello StevieD and welcome from me too.

    Your question isn't, unfortunately, one that we can answer as we're not docs. However, it certainly could be arthritis. Your GP sounds to be on the ball and doing all the right things. Sometimes diagnosis of arthritis can be a long drawn out process. If your GP doesn't suggest it you could ask to be referred to a rheumatologist. Meanwhile, you have some good advice from LignumVitae. Keep taking the pills and, at the first sign of any stomach problems, ask for a stomach-protecting one too as diclofenac is an NSAID and they can damage the stomach longterm. (Always take the diclos with food as a precaution.)
    “There is always a well-known solution to every human problem - neat, plausible, and wrong.” H.L. Mencken
  • StevieDStevieD Posts: 10
    edited 30. Nov -1, 00:00
    Thanks for the replies guys. Really appreciate it. Will certianly take everything on board.

    I understand no-one can give a diagnosis ...

    ...im never one to go trawling the internet making 2+2 = 5 in terms of random symptoms ... in fact I very rarely visit the doc for anything! But, because of the lenghty and intermittent nature of things I've started to try and take some solace and understand what is going on from other peoples experiences.

    I guess I just wanted more to 'talk' about it to others who have experienced similar issues etc. as it is quite a lonely experience when no-one really understands what you are going through. ..

    ..And then when it just seems to 'dissapear' for months everyone thinks you are mad !!

    Just be nice to get an answer so I can start to move on!

    If it didnt get any worse than it currently is for me (i.e no pain at night) I could live with it. Be a shame to give up my cricket but i could live with it.

    Again, appreciate all your comments guys ! And I'll keep you informed how I get on at the docs next week.

    Steve
  • stickywicketstickywicket Posts: 25,993 ✭✭✭
    edited 30. Nov -1, 00:00
    StevieD wrote:
    Be a shame to give up my cricket but i could live with it.

    Just a thought. Do you bowl? Do the flares coincide with the cricket season/winter nets? Do you wear your insoles in your cricket boots?
    “There is always a well-known solution to every human problem - neat, plausible, and wrong.” H.L. Mencken
  • frogmellafrogmella Posts: 1,115
    edited 30. Nov -1, 00:00
    Hi,

    I understand your wanting to talk - the battle to get professionals to listen can be a lonely one. Sometimes the things you learn on the net can be helpful - at least you have an idea what the doc is going on about! Or sometimes you can suggest things they haven't mentioned. I have asked for my last two meds myself. Both times the GP said that was a good idea!

    Good luck at the doc's and let us know how you are doing.
  • StevieDStevieD Posts: 10
    edited 30. Nov -1, 00:00
    No. No bowling. Just a keeper/batsmen. I tend not to go to too many winter nets either - dont want to peak to early!!

    I've only played twice this season - because I wanted to take a back seat this season anyway .. but due to the discomfort in my feet have cryed off a few matches too.

    In terms of patterns - there doesnt really seem to be any! I will start to do a diary as per the earlier post and see what happens.

    Steve
  • Soretoe2Soretoe2 Posts: 198
    edited 30. Nov -1, 00:00
    Hi Steve, just wanted to offer my sympathies and support.
    I have dreadful tootsies and have had several operations that quite frankly have left me worse off.
    Everyone has given you great advice, you've obviously got something going on there.
    Keep on top of the docs, don't let them fob you off.
    Good luck and hope things improve for you soon.
  • julie47julie47 Posts: 6,142
    edited 30. Nov -1, 00:00
    Hi Steve

    Ask your doc to be referred to a rheumatologist.

    I hope that he will and that the rummy is able to give you a diagnosis then start you on the right treatment.

    Take care
    Juliepf x
  • dreamdaisydreamdaisy Posts: 31,567 ✭✭✭
    edited 30. Nov -1, 00:00
    Hello, it's nice to meet you. I understand your not trawling the interweb for answers because that is a doubtful place at the best of times. :wink: Have you considered gout as a possible cause of this trouble? My husband has troubles similar to yours in that every now and again a toe or an ankle (the latest development) flare, the joint goes hot and red, stiff and very painful. He takes his diclofenac for a few days et voila! He is sorted until the next time. I take my diclofenac for a few days every now and again too et voila! Not sorted. :lol: Your GP is doing all the right things but inflammatory arthritis can be a tricky beast to label as there are so many kinds. DD
    Have you got the despatches? No, I always walk like this. Eddie Braben
  • StevieDStevieD Posts: 10
    edited 30. Nov -1, 00:00
    Hi DD

    All tests for gout have been negative. It was one of my first thoughts when it first happened as my Dad suffers from Gout but is controlled by a pill a day.

    There is no real redness when I have a flare up and generally to the touch my foot/ankle is ok .. another stanage (am i going mad) phenomenon associated with my flare ups - i can knock my foot, press it against the floor or wall etc.. and no real extra pain or need to jump up and shout ouch! But turn over at night .. it will feel stiff or heavy .. or move it funny, or not put my foot correctly on the floor and ouchie! ..

    ... having known people with gout - if anyone went within a few yards of them it would hurt if slightly touched! :D .. along with the fact my problems tend not to affect my toes/big toe. Although i know Gout can affect the ankle too.

    It really is difficult to explain all the symptoms / nonsymptoms / red herrings !!!

    Im sure i'll get there .. will wait to see what the doctor says this time and push for a referral to a rehumatologist.

    Although I've got to the stage now ... Its weird I almost dont want the current discomfort to go away until I get a diagnosis as Im sure when it dissapears (if it does this time) its more difficult to test / diagnose. Does that sound really awful?!

    Steve
  • dreamdaisydreamdaisy Posts: 31,567 ✭✭✭
    edited 30. Nov -1, 00:00
    No, of course it doesn't, and I'm glad to hear you've checked out the gout thing. It is hard to identify what's going on, in my case it took seven years, the first five were spent being told that my fat left knee would sort itself out, then orthopaedics and rheumatology bounced me between themselves for another year fighting over whose pigeon I was and measures were not taken until I was seven years in - and my left knee was 27 inches in circumference all above the kneecap! That was all solidified inflammation and the op was not pleasant (my wrecked knee is in medical textbooks now!)

    All I can suggest is that you keep a diary of what happens when, what helps and what irks, your tiredness levels, whether the weather is a factor (seriously, low pressure weather affects my joints) your diet etc (pickles and chutneys are no-nos now for me but there are times when only Branston will do) and then, when you next see somone about this (GP or rheumo) you will have a little dossier, all about you, to give them a time-line of information. It's worth doing. DD
    Have you got the despatches? No, I always walk like this. Eddie Braben
  • barbara12barbara12 Posts: 20,906 ✭✭
    edited 30. Nov -1, 00:00
    Hi Steve and welcome to the forum
    The others have said it all, to me it does sound like some sought or Arthritis or maybe the tendons in your foot are inflamed.
    I do hope you get some answers very soon, it so frustrating when you dont know what is causing the pain.
    Good Luck
    Love
    Barbara
  • knorahsknorahs Posts: 5
    edited 30. Nov -1, 00:00
    Hi Steve,
    I've already sent you a reply but not seeing it on the board I have no idea where it has gone to. Apologies if I am repeating myself.
    Your symptoms sound a lot like mine 15 years ago. I would wake up in the night with unbearable pain. Mine would be in any joint though. Mostly the pain would go sometime during the day and it could be months before I got another flair up. Eventually I was diagnosed with something called Palindromic Rheumatism. I don't recall if I was offered any medication for this as I just tried to manage it with ibuprofen. I was just happy to have a diagnosis.
    Slowly the flair ups subsided and I developed Rheumatoid Arthritis which I manage quite successfully with low dose Mtx.
    I'm sure you'll be able to find out more about Palindromic Rheumatism online to compare it with your own symptoms.
    Hope this helps. Good luck.
  • StevieDStevieD Posts: 10
    edited 30. Nov -1, 00:00
    Thanks knorahs ... another angle to be 'armed' with.

    Can i ask a question .. was there redness with your inflammation and pain?

    This is the other (amongst many!) strangeness with my inflammation and pain - there is no associated redness ..

    Its strange it only affects my feet. usually only one at a time (until this time) The doctor and podiatrist have all asked if other joints are affected but they aren't.

    All i have is symptoms and questions and no answers ! :?:

    Steve
  • knorahsknorahs Posts: 5
    edited 30. Nov -1, 00:00
    I never had any redness and sometimes no swelling either. It only affected one joint at a time. The most common joints were arm/shoulder, knee and wrist. I must say flare ups with RA are 100 times less painful than the pain I had with Palindromic Rheumatism.
  • dreamdaisydreamdaisy Posts: 31,567 ✭✭✭
    edited 30. Nov -1, 00:00
    Are you ever affected with psoriasis? DD
    Have you got the despatches? No, I always walk like this. Eddie Braben
  • StevieDStevieD Posts: 10
    edited 30. Nov -1, 00:00
    dreamdaisy wrote:
    Are you ever affected with psoriasis? DD

    :arrow: Another negative there ... never had it.

    Steve
  • dreamdaisydreamdaisy Posts: 31,567 ✭✭✭
    edited 30. Nov -1, 00:00
    OK, I asked because the arthritis associated with that is a sero-negative type but can show high ESR and CRP, plus it's known for starting in the smaller joints. That's my auto-immune one (which didin't start that way and the psoriasis showed up later!) but it was worth a punt. :wink: DD
    Have you got the despatches? No, I always walk like this. Eddie Braben
  • StevieDStevieD Posts: 10
    edited 30. Nov -1, 00:00
    Well, just a quick update peeps..

    It is a very slow process isnt.

    From my follow up appointment, they have taken more blood.

    Will compare it with the previous one to see if this have settled or not - in terms of the inflammation count, and will then discuss it with a rheumatologist.

    So progress I guess....

    Good news is though - no pain for a few weeks. a bit of discomfort here and there and ankle still slightly swollen, but that is how its been for last 5 years.. on and off?!!!

    Over and out for now.

    Steve
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