Kickas.org Forums Ankylosing Spondylitis General Discussion Helpful Tips the feet: have any of you noticed......

Wow, I can so relate to everyone. Standing is very tiring for me and walking too much causes inflammation. But some regular walking does seem to help my feet stay strong and conditioned which helps me function enought to walk in stores. For a couple years when I first had plantar fasciitis, the pain was so bad, I stayed off my feet as much as possible, but then it got so that any walking, even in the grocery store was too painful. My internist encouraged me to try walking 5 minutes every other day, and it hurt at first, but after a couple weeks it got better and I was able to work up to about 20 minutes 3 times a week.

Sometimes when my feet get aggravated, I have to stay off them for a week or two to get them to calm down. I also have tried orthotics, but they are too hard. I have better luck with cushiony, shock-absorbing inserts like Lynco. Also, I often switch shoes during the day when my feet bother me, it seems to give them some relief. And sometimes I need support, and sometimes it feels better to use a shoe with a simple, flat insole for freedom of movement.

It's a constant trial and error, and balancing act to keep my feet relatively happy.

thanks for the question:

i have an appointment with my physiatrist, the one who does the cortisone injections to my SI, scheduled for next week. see if she will order the MRI with STIR imaging of the SI joint. if she won't, then may just have to wait until i can find a way to be seen by one of the two good rheumies i want to see.

i have an appointment with my podiatrist in two weeks. see if she will order the xrays of my feet. again, if not, then it will have to wait til i can see a new rheumy. could be months before that happens.

my GP did agree with me that there was probably no point in continuing a relationship with the rheumy who has been stringing me along for two years but not helping me very much. though i won't burn that bridge til i have another one. the GP said he'd help me but i'd have to do the leg work putting together whatever info was needed to try to get in to see either of the rheumies i want to see. i'm fine with that, i have the packet i put together for the philly rheumy already. still find it ironic that seeing the much better doctor in philly was so much easier, no referral, no decisions of whether he would or wouldn't see me, just a bit of a wait. but rheumatologists are in such short supply here, and good ones even more so. the GP didn't sound very hopeful that i'd be able to see either of the rheumies that i want to see. one day at a time.........

thanks for asking

hopeful that the remicade helps your feet. one of the pharmacists at our local CVS has AS. i found out because when i was asking drug related questions, he suspected i had a spondy, so we talked. he actually went on the enbrel more for his feet than anything else, he told me. i can imagine as a pharmacist on his feet all day that that could be the case.

those new balance arch supports, can you link a webpage or something for them? always interested to learn of new products that could help me. while thus far, flat is better, cushioning really is kind of needed. thanks!

Hi Sue,
I am the same as you. If I have been off my feet for too long they get stiff. In the morning when I get up from bed my feet feel deformed, I feel like I am walking on rocks or something. They come good pretty quick though. Does this happen to anyone else. I often wonder if its the bones in my feet or numbness in my feet from my spine.
Cheers Debra

those first few steps in the morning are oh so critical for me. i have to very gently wiggle them before i even get up. then gently take a few steps. if i don't do that, often pull some tendon or ligament in them. then must put on rubber flip flops before standing in the shower, or have once again set something off in my feet shifting weight on them on the hard shower floor. if i can get through all of that, often my feet are good to go. so long as i don't stand in the kitchen for too long to make my lunch even standing on my mat. so yes, like you. for me i know its not numbness from the spine, just simply inflammation of the entheses of the feet: achilles heel (where the achilles tendon attaches), plantar fasciitis (where the PF attaches on either end), etc etc. i think when inflamed body parts are moved (like when we sleep at night), i think they collect fluid, hence the stiffness, etc in the AM - at least that's the way i understand it.

I haven't been exercising as much as I should...now one doc said I have undifferentiated spondylitis, others said As. Either way my feet have been aching. I went on a binge walk...5 miles, the day after I couldn't walk...now after 5 days they continue to ache.
Has anyone tried reflexology? Just having a good ole foot massage sounds wonderful right now...instead of lotion, myorx.

Besides the arthritis...I have SI dysfunction, where my joints sublux. Very Painful...and I need manual manipulation to get things back in order. I think a flare and inflammation is what sets it off....anyway when things get bad, I have lidocaine patches to put over the area. I get nervous about the cortisone injections because like all steroids, it can thin the bones and make them weaker...resulting in compression fractures after a while.

Hi Linlan,

Would you mind explaining more about how your joints sublux? Are you referring to your SI joints? If so, do you have erosion of those joints that makes it possible for them to partially dislocate?

Also, who does the manual manipulation that puts them back in place?

I have had that problem since I was 16...and it was only a chiropractor that could help.Then as I moved and got older...it happened more often, and found a wonderful osteopath who would do manipulations to "put me back in" I can barely walk when it happens...and the sciatica is horrendous. It tends to happen when I am flaring..it can happen to either side but recently it was the left. My recent osteopath called it SI dysfunction so it has a legitimate name. I have been to therapy to strengthen my back muscles, but I think it happens mainly when I am beginning to flare(recurrent diarrhea is a tell tale sign I am flaring)...I am not fused in my SI joints, but they do get inflamed hence the subluxations. Since there are few osteopaths around that do manipulations, I generally see a chiropractic
who has seen me so often...usually in extreme pain, he knows what to do. I now try to get in before it gets that bad...for an adjustment and even though I am not compliant in doing my exercises faithfully, I believe they help.

I do think I have erosion....because it has happened so often and the osteopath looked at x-rays prior to making a diagnosis.

hi linlan!

i know exactly what you are referring to regarding the SI joint!

i first developed SI joint problems in oct 2000. was on my way to the PT for my upper back (rhomboid) / neck issues that she had been treating when BAM! i had my first episode of SI joint "subluxation". my lat muscle on my right side went into severe spasm in response, but i had no idea what had just happened, though over the years i learned what was going on. anyway, she "put me back in" as you describe. she also taught me the isometrics i needed to do it for myself, and often i could.

as you have described, over the years, it would be part of a flare, but it wouldn't go along with IBS necessarily. when i flare, the joints become inflamed, and then some of them become lose enough and subluxate. for the longest time it was mainly the SI joint that did that. now, since last fall (2009) my ribs do that too. i only learned that this fall when i met a wonderful chiropractor. he has literally saved my life.

it has taken a long time to realize all these things. for the longest time i wondered. is my SI joint loose for some other reason, subluxates, and then is inflamed because of that? or do i have the inflammation first and that is what makes it loose enough to subluxate? lots of different ways for me to know now that the inflammation is the catalyst. one thing is that if i can prevent the inflammation with antiinflammatories (cortisone injections, nsaids like aleve, a flector patch now worn 24/7, prednisone), that prevents all the other symptoms, or at least lessens them.

last fall, 2009, i got bilateral SI joint cortisone injections, as my SI joint had gone from cycling through flares to just being permanently inflamed. the injections rid me of all SI joint dysfunction, pain, subluxation, etc etc, for about 6 months. but then the problems returned. like you, i didn't want cortisone injections to become the habitual solution, so i thought i'd try the flector patch. i had been given a lidocaine patch by my rheumy in the spring 2009, but it really was pretty ineffective. but if i wear the flector patch 24/7, changing it every 12 hours, it is good except for in the middle of a strong flare, then even it isn't strong enough, as i found out this past august. my SI joint has slowly been settling down since then. and finally i think the butt spasms are starting to subside as well, for now!

my current chiro tried more aggressive techniques of manipulation initially to realign my SI joint (before i could warn him "hands off!" (this was only our second visit and we were just getting to know one another)). anyway, his methods did make it worse, but i told him on the next visit, asked if there were something gentler ways (like the isometrics my old PT used to do), and now he uses the gentlest method i have ever come across: i lay on my front, with wedges under my pelvis, but unevenly to let gravity reposition my pelvis back into a proper neutral position. i've continued to wear my flector patch, but those two things together, and about 2-3 months after my august flare, my SI joint is almost back to "normal".....for now.

anyway, sounds like we have a lot in common. i too have undiff spondy. finally dx'ed by a rheumy down in philadelphia back in september. he's helped me to understand a lot of what is going on in my body. things that seemed a bit odd, partially because they seemed a bit different from some others on here with AS, things like the torn tendons and ligaments and the joint subluxation. a CT scan of my SI joint shows arthritic changes (not remembering the exact wording of it all). on monday i go for the proper MRI of my SI joint and L-spine (the one with the STIR images) to see exactly what those changes are. get the impression that those images will help decide if its undiff spondy or AS, but i'll know more after the imaging.

oh, you are right, this subluxation thing is not fun! the rib subluxation had put a rib of mine under my shoulder blade last fall. i don't know if it was bone on bone, or nerve trapped between bones, but i think that may have been the worst pain of my life. of course its hard to compare that to the muscle spasms that make one scream with every movement. but the rib subluxation caused my body to go through physical panic attacks, shutting down the bowels and causing the heart to race. but within about 30 seconds, the chiro could treat what no doctor or PT could do in 6 months last year. the right chiro can be a life saver, though thrusting maneuvers are off limits. only gentle active release technique, letting gravity do its thing, gentle pressing on joints, gentle joint mobilization, things like that. nothing rough. he's very gentle to my spine, as an MRI of the c-spine and t-spine showed some damage and i have osteopenia as well, another reason for being gentle.

anyway, this got long, but thought i just wanted to say how much i understand what you've been going through with the subluxation.

right now, just trying to find a drug to manage the inflammation better. one that works without side effects, that's the challenge, isn't it!