No Pain

[Mjscer]

Hi all! I'm new to this group. I come from Malta (Europe), I'm 65 married with 3 grown up kids and grandma to a wonderful 5 year old boy. I have been diagnosed with RA 5 years ago after I had knee pain which lasted 6 months. I was used to bad knees since my early 30's but never been in pain. Well, after a steroid shot I went back to my trekking. Since I had no pain or RA symptoms, my rheumatologist agreed with my decision not to start treatment on condition that I make regular blood tests and visits at rheumatology for observation. However, last August 2023 I got plantar fascitis in my right foot and then after 2 months in my left foot as well. My Podiatrist prescribed massage cream and showed me how to do some stretches. In the meantime I had to see my Rheumatologist who said that the pain in my feet is associated with RA. So she now prescribed MTX 10mg/wk. My problem is that I do not have constant pain or other symptoms. My feet only hurt after sitting for a long time and I'm so reluctant to start the treatment because of this. What would you do ? I really wish to hear your opinions.

[cathie]

it does sound unusual for RA but I suppose that your dr has done blood tests for a diagnosis?

[Sheila_G]

Hi. I presume you have rheumatoid markers in your blood tests but knees and feet aren't the usual places for problems to start with RA. Maybe you could try to speak to a specialist nurse and ask them to explain your situation.

[Haz58 in reply to Sheila_G]

Mine started in my feet. I got up one morning and it was like I was walking on glass or small pebbles.

[Sheila_G in reply to Haz58]

Thank you. I have had RA for 22 years and have what you describe in your feet, like walking on pebbles but no-one has addressed that.

[Haz58 in reply to Sheila_G]

I don't know why they don't look at feet even when you tell them you have problems.

[Sheila_G in reply to Haz58]

I think it is because there are many small bones in the feet and they wouldn't be able to pinpoint the problematic ones. That's my theory anyway. I hope you get sorted.

[AgedCrone in reply to Sheila_G]

It could be Morton’s Neuroma…get your rheumy to refer you to a foot surgeon for ultra sound investigations…..to maybe get US guided injections which work well for most people.

[Sheila_G in reply to AgedCrone]

Interesting. I'll mention at my next visit. Thank you.

[AgedCrone in reply to Sheila_G]

I had both the injections & surgery….if MN js your problem it is worth having treatment…but I had to get it done Privately.

[Sheila_G in reply to AgedCrone]

Thanks AC.

[AgedCrone]

Presumably your rheumatologist saw something in whatever tests she carried out that her knowledge of RA suggested she prescribe Mtx?

Have you asked why she is prescribing medication?

Nobody wants to start taking RA meds, but unfortunately because you have no other tangible symptoms today doesn’t men they won’t pop up tomorrow….so early treatment could be just what you need?

[ruth_p]

Even without the symptoms you could be getting damage by not being on any medication.

[wilbertjellyfish]

Id get a second opinion. If your not in pain and have no other issues you'll have difficulty deciding if the mtx is helping apart from the side effects you could suffer.

[Gottarelax]

As others have said, I would question how the diagnosis of RA was determined. If it was the presence of Rheumatoid Factor (RF), this is present where RA is or has been active so I would consider the medication (though it's still not complete confirmation). If it was anti-CCP this can also indicate RA but it can be detected before onset of symptoms. Again, if it were me I would consider the medication as a preventative (as you are getting some mild symptoms). If there was no positive blood test, I would question the diagnosis, based on the symptoms that you have described...having said that my symptoms have been severe but not at all typical (including knees and plantar fascitis-like symptoms) and without the blood test coming back positive (and MTX working quite well), I'd probably still not be convinced that I have RA. Actually in retrospect, I always say that my symptoms came on very quickly but for years I had painful knees on and off and mild plantar fascitis which I used OTC orthotics to help with. Neither impacted my life so I just ignored them. When the RA hit it was all over my body, very painful and sudden...perhaps if I'd sought help with the little things, I'd not have suffered that!

[Mall]

my experience was similar to yours, I put occasional incidents of knee pain wrist and foot pain down to injury or strain and didn’t seek medical advice. Then I was hit suddenly by full on flare that couldn’t be explained away and sought medical attention which eventually led to diagnosis. I was told by the specialist that I had been experiencing symptoms for a few years.

[Creakywrists]

I was also hit very suddenly by full on symptoms in my 60s. It’s been quite difficult to treat and I’m still on 3 medications including Methotrexate plus my second biologic. The only symptom I had before this onset was unexplained pain for quite a while on the top of my feet. I also wonder if I’d followed it up earlier my RA might have been be easier to control.

[smilelines]

I would not go on methotrexate on the bases of planter fasciitis. No way. You need to get more information so you can be convinced you indeed have some sort of inflammatory arthritis. Blood tests? Does she feel all of your joints for fluid? Planter fasciitis can last for months and months and months. At present I have it and the ultra sound shows the inflammation of the tendons but even with that my rheumatologist and family doctor say they can not tell if it is related to my psoriatic arthritis. So why is your doctor so sure? Take care. Be strong and get the answers you need.❤️

[Mjscer]

Thanks to all for your comments which I found very interesting and am considering very much. In the meantime MRI result of my right foot is out and they say clinically it doesn't seem to be plantar fascitis but there seems to be some fluid at the rear. So I guess that says a lot