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aching feet

Posted , 12 users are following.

braden74
braden74

Recently diagnosed with PMR. Wondering if foot pain is common for anyone. Bottoms of my feet feel bruised when I'm not on Prednisone.

0 likes, 14 replies

14 Replies

  • Anhaga
    Anhaga braden74

    Posted

    Hi Braden, sorry to hear you've been diagnosed with this unpleasant disease, but this is a great community.  I've noticed that lots of people complain about foot problems.  I've had pathetic feet all my life, so not much difference now in relation to walking.....  Get a lot of cramps in my feet and can't bear the weight of bedding on them at night., but have found that a hot water bottle helps.  
  • maid_mariane
    maid_mariane braden74

    Posted

    I had problems with my toes, couldn't walk pre prednisone. Now I occasionally have pains in my feet so have to watch what I wear. I have noticed lately that I'm getting cramps in my toes but I use to years ago so can't say pmr.
  • VickieS
    VickieS braden74

    Posted

    One of my first symptioms was pain in the joint of my big toe of my left foot. Even now that I've been on prednisone for 1 1/2 yrs, when I seem to be having a little flare, it appears again. 
  • dan38655
    dan38655 braden74

    Posted

    Braden, although my foot tenderness was not one of my earliest symptoms, I did later experience just what you describe, the soles of my feet felt bruised.

    That occurred after about five months of treatment, or about the time I had tapered to 9mg or so.  It lasted 8-10 weeks as I recall, and has not recurred.

    I've had many different symptoms that have occurred over the last two years, very odd how they randomly pop up like they do.

    These varying symptoms result in my having to constantly re-adjust my dosage in response to whatever specific symptoms become severe enough to cause disability or loss of sleep.

    At one time it was the palms of my hands that became painful enough to force increased dosage, that was a couple of months after the soles of my feet had been acting up badly enough to force me to buy bigger shoes and increase my dosage for a while.

    I've had thumb joints flare up more than once, have had headaches while sleeping, had a months-long ribcage episode and currently have bursititis to the left-rear hip area.  Each of these isolated symptoms caused me to go back to a slightly higher dose for a while.

    Perhaps none of those localized flare-ups would have occurred if I had used a higher dosage since being at around 10mg/day, but I would never have known what the dosage requirement was unless I had continued to taper down the dosage. Starting at 15mg/day, I was prescribed a 1mg/month reduction taper, but have had to use higher dosage than prescribed ever since getting below 10mg/day.

    And for reference, I was already down to ten stone (140lbs) by the time my treatment began at 15mg/month, so may have needed higher dosing if I weighed more. I am currently using 4mg/day and still weigh about 140#.

    • diana21296
      diana21296 dan38655

      Posted

      Does weight have anything to do with steroid dose? I thought it was on how the bloods were and how bad the pain was on being diagosed. I am not heavy but started at 30mg.
    • dan38655
      dan38655 diana21296

      Posted

      You're right, that dosage should be adjusted to bloods, symptoms, etc.

      But a larger body needs a higher dosage to get serum levels into the same therapeutic range that would be achieved in a smaller body with a lower dosage.

      Fat mass might be excluded from the patient size adjustment as it does not contribute to blood volume, but bigger muscles, organs and circulatory apparatus will need proportionally higher dosage.

    • diana21296
      diana21296 dan38655

      Posted

      My 3 friends and I, none of us whom are big or overweight , all started at 30mg.  One stayed on that for 3 months before slowly dropping successfully within 2 years with no flare ups.  I tried to drop from 30mg to 25 after 4 weeks but had flare in right leg and couldn't walk so back to 30.  Going to try 27.5 shortly! Ooo err!  We are all so different I guess. I have dropped over half a stone on the Pred diet of no sugar, salt, caffeine or alcohol.

       

    • dan38655
      dan38655 diana21296

      Posted

      I don't really know how physicians and rheumatologists decide on the appropriate initial dosage.  Maybe it's the blood numbers.

      I'm pretty sure that at higher dosage levels that I would have been spared a great deal of discomfort and fatigue.  But I still wanted to get below 5mg, and like I mentioned earlier I would never know what my minimum dosage was if I didn't test my response to ever-lower dosage.

      In hindsight, it does seem like my prescribed initial 15mg dosage was appropriate to my needs, but my rate of taper itself needed to be tapered as it turns out, heading into the dead-slow range as I dropped below 10mg.

      I can say that I never suffered any noticeable side effects from even my initial prescribed dosage of prednisone, and still haven't gained back more than a few of the fifteen pounds that I lost during first three months of pre-treatment pmr.

    • diana21296
      diana21296 dan38655

      Posted

      Lucky with no side effects of Pred!  I get steroid fogs and have to lie down for 30 mins but guess it will get better as the dose comes down.  Have been a very active person, so Polly is a Pain at the moment! But my static bike is good. Thanks for your response.
    • EileenH
      EileenH diana21296

      Posted

      Until some years ago the common starting dose for PMR was about 30mg. In recent years it has been recommended that a starting dose of 15-20mg be used as this is generally enough to achieve a response. i.e. well above what is likely to be the longer term maintenance dose, but then avoids many of the side effects both long and short term which are associated with high doses of pred. Below 10mg is regarded as low, up to 20mg moderate and over 20mg is into the high region. A study in Italy a few years ago found that 75% of patients with PMR will respond well within a month to 12.5mg - but, although they DID respond acceptably, the men who were larger and heavier didn't respond as quickly as the smaller women. 

      In GCA there is a recommended dose per kg for pred but only up to a maximum of 60mg, i.e. however heavy you are, 60mg should generally be the top of the range. If, however, there are visual symptoms, then an even higher dose may be used to reduce the risk of loss of vision but the 80 or 100mg dose is only used for a few days until the symptoms are seen to have resolved.

      The dose chosen should depend on the symptoms - because the numbers are only a very rough guide as different people produce a different inflammatory response. There is not necessarily a correlation between the severity of the symptoms and level of ESR/CRP - and about a fifth of people, even with quite severe symptoms, never have raised blood markers at all.

    • Anhaga
      Anhaga dan38655

      Posted

      Dan, I agree with Diana, you are lucky not to have side effects.  So far I have elevated blood sugar and increased ocular pressure.  My "low bone mass" may or may not be affected by prednisone.  I have thinner more fragile skin and although it seems to have turned around now for a while my hair was getting thinner.  All at the relatively low dose of 15 and below....  You'd have to ask my family if my mental condition changed at all, but I did get out of serving on jury duty because I was on pred! cry
    • iellen32
      iellen32 EileenH

      Posted

      Your explanations are greatly informative and precise.

      I am grateful to you, Eileen, for the contents of all your posts.

    • Elijo
      Elijo EileenH

      Posted

      Just like me, my ESR was WNL. My symptoms were severe.  I started on 40 mg. for 1 mo. then to 30 for 4 months.  I'd like to lower it due to so MNAY side effects.

       

  • EileenH
    EileenH braden74

    Posted

    A survey done in Leeds in northern England by one of the very active PMR/GCA research groups a couple of years ago found that PMR can and does affect feet and hands - that's official, not just what we could have told them! But many doctors will deny it - they haven't, of course, asked their patients it seems!

    A lot of people say it feels like walking on sharp pebbles or broken glass. I felt as if my feet were being squashed in desperately tight shoes - and I needed a good size larger than I had ever done before. I threw out a lot of pairs of shoes. Others have commented it feels as if the soles of their feet have been rubbed with sandpaper - that was also a sensation I had if I walked far, especially in sandals without socks on.

    Like Vickie, long before anything identifiable as PMR. I had sore toe joints in both big toes so that I wore Birkenstocks all year round as long as it was dry - thick socks!

    All these things faded after I eventually was put on to pred and have never returned. My chiropodist has commented on how different my feet are now compared with when I first visited her - in fact, they are so much better I only see her about once a year now.

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