Confused about advice from GP

ChrisG9

Hi, I've been diagnosed with advanced OA (is 'advanced' a thing?) in my right foot with bone spurs near my big toe. I've also been diagnosed with OA in my hands. Since original diagnosis I have now been referred to Orthopaedics this week.

I have been given different advice and would appreciate some views. For the ongoing discomfort with occasional intense pain, one GP has prescribed Naproxen whilst another has advised just using paracetamol.

Also with reference to my toe, I was told to rest the feet. Yet in all the literature I read, movement is recommended. Before being diagnosed, I ran regularly and went to the gym.

Lastly, why do we get fatigue? It's really frustrating 😃

jonr

Hi @ChrisG9 - no surprise you're feeling confused with advice like that. Unfortunately, health professionals are individuals with opinions of their own and we cannot rely on them to understand best practices for Arthritis in all its forms.

First off Naproxen is a NSAID, like super-strength Ibuprofen, so an anti-inflammatory. It's usually prescribed with something to protect the stomach lining from bleeding, Omeprazole is the usual one we're prescribed. This shoudl reduce swelling, fever, aching, throbbing and any itchiness.

Paracetemol is a good painkiller so the two together should work in harmony to help manage your pain, another alternative is Co-Codemol which can be prescribed or bought behind the Counter at Pharmacies (a mixture of Paracetemol and Codeine).

You're spot on about movement - it aids lubrication, prevents stiffness and helps to build strength in the tissues surrounding affected joints, etc. I used to be a keen runner and Badminton player before the OA hit my knees but I've substituted cycling, swimming, walking and hiking for those and go to the gym so no reason why you shouldn't carry on in my opinion. The advice is to avoid high-impact sport like Running but there's no medical link with Arthritis, perhaps altering how you do it might be necessary if it causes pain, such as running on a treadmill or trail running, both of which are less brutal than road running.

Good luck at Orthopaedics and hope some of these may be helpful.

Jon

jonr

ChrisG9

Thanks Jon

Yes, omeprazole was also prescribed with the Naproxen.

Thanks for the advice re exercise, I’ll keep going to the gym and maybe start using the elliptical machine instead of running

helpline_team

Hi @ChrisG9

Thank you for posting on the Online Community and for your enquiry about treatment for osteoarthritis (OA) in your foot and hands. Jon has given a helpful response to your post. I am sorry to hear that you have received confusing advice from GPs but pleased to hear that you have now been referred to an orthopaedic specialist for an expert opinion. Pain and restricted movement can limit daily activities and feel very debilitating and frustrating.

If you would like to talk things through informally and in confidence about your arthritis, you are welcome to call our Free Helpline on 0800 5200 520 9am - 6pm weekdays.

As Jon says, low impact exercise such as walking, cycling and swimming is better than high impact exercise for arthritis. Specific exercises a little and often are important to maintain range of movement, reduce stiffness and to strengthen muscles to increase joint stability and help protect against further damage. Response to pain medication is very individual, what helps one person may not necessarily help another. NSAID gels, such as Ibuprofen and Voltarol, or Capsaicin cream on prescription or Flexiseq bought over the counter may be effective and help to reduce the number of tablets you are taking. There is a shortage of Capsaicin in some areas at the moment. Heat and / or cold may help too.

Eating a healthy balanced diet and keeping a healthy weight can help to put less strain on your joints. More suitable footwear may make a difference. You may wish to consult a podiatrist. Tailor-made insoles can sometimes help. Your GP may also be able to refer you to a hand therapist or hand clinic for treatment and advice about exercises and splints to help prevent deformity.

Tiredness and fatigue is a symptom experienced by many people living with arthritis. Pacing yourself and not overdoing it, balancing activity with rest, , and breaking down tasks into more manageable instalments may help to reduce your fatigue. Spreading more physically demanding activities over a day or week may help.

If you would like to have more replies to your post, you are welcome to repost on our Living with Arthritis forum which is another source of support to ask questions and share experiences with others facing similar challenges.

I hope you will find the information given below of some help.

https://www.versusarthritis.org/about-arthritis/conditions/osteoarthritis-oa-of-the-foot-and-ankle/

https://www.versusarthritis.org/about-arthritis/conditions/osteoarthritis-of-the-hand-and-wrist/

Best wishes,

Fiona, Helpline Advisor 

Tomos

I do not take NSAIDs because of how they work in the body - can cause other problems. So paracetamol for me. My left big toe is arthritic with bunion type formation as a result. Can be very painful at times and affects the way I put my foot down. So I bought boots and trainers with a deep toe box and they definitely help. I was advised by an Orthopaedic Consultant to buy rocker bottom shoes.

Nurina

I was prescribed Naproxen but it doesn't sit well in my stomach, even with Omeprazol and my pain was still there so I stopped having it. GPs follow the standard protocol for your condition but there aren't two people with same symptoms. Listen to your body. It'll tell you what's wrong and right to do. Exercise is vital for us and we have a long way ahead of us.

Welsh1

https://community.versusarthritis.org/discussion/comment/714694#Comment_714694

Waiting for podiatry appointment I have RA toe is painful and stiff. I am on meds early days. Are there any brands who do rocker bottom shoes? just brought softer wider boots which are a bit better my trainers seem to press on my toe. I have used a cushioned toe pad think it's for bunions when really painful superdrug do a good one doesn't move like some of the more expensive ones.

helpline_team

Hi@Welsh1

If you are looking for suggestions you might try posting on the Living with arthritis forum as more peer suggestions come there. As a Helpliner I'd avoid mentioning brand names as that might imply a recommendation. What I can say is that if you search rocker sole shoes, lots of suggestions come up (so whether expensive brand names are worth it I can't say). Waiting to talk to the podiatrist might be an idea.

I appreciate that waiting for your meds to calm down inflammation can a difficult time. You'd be most welcome to give us a call on 0800 5200 520.

Foot and ankle pain | Causes, exercises, treatments (versusarthritis.org)

All the best

Guy - Helpline Team