Advice on talking to GP

lesley123

Hi, I would like your advice on how to get my GP to take me seriously.

I have arthritis in my big toe joints and lumps at the base of both my little toes. My GP says that I have osteoarthritis in the big toes but I'm unsure as to whether the trouble with my little toes is due to walking on the sides of my feet or more arthritis. My big toes have been affected for about 5 years now but have worsened considerably over the last year. I have had no blood tests to confirm osteoarthritis. My GP says that she knows this is what it is even though I am young to have it. I am 51.

I work as a researcher and so spend all day on my feet. I used to use piroxicam gel or ibuprofen to ease the pain and swelling in my feet. However, I recently had a severe allergic reaction to diclofenac which was prescribed for surgery. Consequently, I cannot use my arthritis meds and the doctor prescribed Co-dydramol but it is not as effective as the piroxicam for me.

I don't know if there is something more effective that I can take and I would also like tests to discover if my pain is due to osteoarthritis. I don't know why my GP is unwilling to allow me to have these. It is coming to the point where I'm thinking that I cannot continue with my job as I was in agony today. Plus the pain makes me so tired.

Any advice on this would be very much appreciated.

lesley123

In addition to the above, the last time I saw my GP about my feet she said I had a fallen arch in one of them and prescribed a metatarsal arch support. I have been to 7 pharmacies and in every one I've been told that they no longer stock them. I don't know if my fallen arch is related to my arthritis

helpline_team

Dear Lesley,

Thank you for your enquiry to Arthritis Care. We are here to offer support and share information about self managing arthritis. We can't give you individual advice, but let's see if this will help.

Experienced GPs may well be able to diagnose osteoarthritis (OA) on examination, so not all x-rays make a difference. Blood tests are not used to diagnose OA. If what you really need is help (a referral) in dealing with the condition, then you may find it helpful to discuss that with the GP. First referrals are normally to services like physiotherapy /musculoskeletal services.

(For specialist insoles the referral might be to an orthotist/podiatrist - but referrals can be slow.)

Wanting to self manage better, so that the pain is not so intrusive may well involve a medicines review (try a pharmacist as well as the GP perhaps?), looking at diet/healthy eating if relevant, and your levels of muscular fitness. Many people with arthritis do improve if they do more daily exercise and lose weight. But I'm not sure from your message how much of this side of things you've been exploring and how well or badly that's gone for you.

So there might be a conversation that we could have with you to see a bit more what's your story. It's really your choice - to come back to us on the phone or to explore some of the other self management options that Arthritis Care has to offer.

I just hope we can help

all the best

Guy

lesley123

Thanks for your reply. I do exercise regularly as I have a horse. This also keeps my weight down and I also eat healthily.

Waht has made me wonder about my toes is 2 relatively recent conversations with consultants at hospital. A year ago i damaged my finger and so had it x rayed. The hospital doctor asked if I had seen a rheumatologist as he noted crystals (I think) in the joint of the finger. Also the consultant who carried out some recent surgery asked about health problems and said that I need tests to establish what sort of arthritis I have.

I will talk to my GP about my medication though.

Thanks again

stickywicket

Hi Lesley. I'm not a member of the Helpline team, just an ordinary forum member.

If a hospital doc and a hospital consultant have both suggested that your arthritis might be auto-immune based rather than OA you should insist on seeing a rheumatologist. I am not a person who usually tells people to insist but, if it's not OA, you need the correct medication which only a rheumatologist can put you on.

lesley123

Thanks. I think I've been burying my head in the sand about it as I'm not sure I want to know. Consequently, I might not have been as insistent as I should. But it has been so painful recently and the finger that was x rayed has still not straightened. I think I'm going to make an appointment with a different GP at my surgery and see what comes of that.