PMR Controlled but Ankle Pain Recently

[Ronswife]

For about 2 weeks I have had stiff ankles and severe pain with each step. Going downstairs is extra difficult. It starts just above the indentation of the foot and goes up to mid calf. The 10 mg of Prednisone I am on isn't getting it to stop. Has anyone had experience with this? I walk with very short steps now and oddly.

[SheffieldJane]

I get sudden shooting pains in the ankle or the knee that make me cry out usually as I am coming down stairs. I have been putting this down to arthritis as it pre-dates PMR. Your ankle pain sounds more persistent, affects both ankles and has the stiffness. It sounds more PMR- like to me. Have you tried upping Pred a bit?

[Ronswife in reply to SheffieldJane]

Actually I upped it to 15 as I had a flare all over. Now at 10. I do have arthritis but haven't had it there. I think it's a sprain now.

[PMRpro Ambassador]

Could it be shin splints?

nhs.uk/conditions/shin-spli...

which also gives other reasons for similar pain.

Definitely worth running past your GP - perhaps not as well put as it might be

[Ronswife in reply to PMRpro]

I read about shin splints and they are on the front side. Would hate it to be some of the other pains in the link sent but maybe sprain is likely.

[PMRpro Ambassador in reply to Ronswife]

Sorry - misunderstood your description. In that case - is it an achilles problem?

[Nitrobunny]

I'm no doctor but I can share with you an issue that sounds very similar and feels just like what you're describing - Posterior Tibial Tendon Dysfunction or PTTD. It feels like a cross between a sprain and shin splint and if I'm walking on uneven surfaces like a hilly lawn, it's unbelievably painful. Higher doses of prednisone hide it but as I'm weaning it's bad at times. The good news is I have an awesome podiatrist who's helped immensely. They are the key in a good foot and or ankle Dx.

There's just so many things and hopefully it's something simple and not long term.

Best ~

S

[Klah in reply to Nitrobunny]

Whatever it is, I still swear by KT tape. You can Google over 200 applications. You have seen it on athletes, especially at the Olympics😊

[Hidden in reply to Klah]

Just got to watch if you have allergies to elastoplast type glues when using KT tape. But before I realised I couldnt wear even hypoallergic versions actual support was fantastic on shoulder and knees

[Ronswife in reply to Hidden]

I'll check into that support tape.

[Nitrobunny in reply to Klah]

Me too!!! I love KY tape!

[PMRpro Ambassador in reply to Klah]

Do you have a preferred colour? I've had it once - from a privately paid (not by me, car insurance) orthopod and I really couldn't see it did anything. Except make me itch and rolled up as the adhesive failed...

[Ronswife in reply to Nitrobunny]

Yes that sounds likely and I will start looking it up online.

[Hidden in reply to Ronswife]

If you go online and search MY application for achilles/knee etc it shows how to apply properly. YouTube good for it too.

[Hidden in reply to Hidden]

KT not MY

[Amkoffee]

It sounds a lot like planter fasciitis. Although planter fasciitis does not typically go up to the ankles you could be putting stress on your ankles by walking differently because of the pain of the planter fasciitis there by making your ankles hurt too.

[Ronswife]

The Achilles' tendon seems like the area of pain. I looked at muscles on line. I read corticosteroids can cause weaknesses in tendons so I am worried of harming myself too. I will give it more time to heal with staying off my feet as much as possible and call my Ra. Thanks for responding everyone.

[Trixiechamp in reply to Ronswife]

Yes be very careful, I turned both of my ankles when on high dose Pred...you will see the result of one in my posts! I ended up getting ankle supports whilst they got a bit stronger as once I'd done them it only took a tiny twist to make them do it again :0(

[PMRpro Ambassador in reply to Ronswife]

You haven't been on antibiotics recently have you?

[lesley2015 in reply to PMRpro]

What difference would bring in antibiotics have PMRpro? I am curious - I akfonsuffer from my left ankle and had four courses of antibiotics over a 3 month period?

Thanks as always

[PMRpro Ambassador in reply to lesley2015]

What sort of antibiotics - do you know?

The group of antinbiotics called quinolones (ciprofloxacin is a commonly used one) can cause achilles tendonitis on their own - in combination with corticosteroids the risk is higher. It may not happen at the time, it can happen for some months after stopping them.

Been there, got the t-shirt (and the crutches)...

[Ronswife in reply to PMRpro]

Pmr pro

No antibiotics taken. I'm a small boned person and have thin everything. Probably a side effect of the Prednisone for a year.

[lesley2015]

I was on erythromycin and metronidazole if I remember correctly....,, ?

[PMRpro Ambassador in reply to lesley2015]

They shouldn't cause the problem.

[lesley2015]

just a weak ankle then, poss OA I think but who knows - thanks as always

[PMRpro Ambassador in reply to lesley2015]

Yes, but steroids themselves can also cause it in susceptible people. It isn't the end of the world but you need proper support for the ankle in the meantime if that is what it is.

[lesley2015 in reply to PMRpro]

Oh can they, well I should get a support then - I look like a drunk John Wayne when they are bothering me !

[PMRpro Ambassador in reply to lesley2015]

You ought to try and get an opinion as to whether your achilles tendons are inflamed/swollen. If they are they are very delicate and tripping off a kerb could be enough to tear them. And that means fancy surgery. If they aren't - you don't need to worry.

[lesley2015 in reply to PMRpro]

Gosh I am finding it hard enough to find a good Rheumy, with my doc suggestion I am having a one off private consultation - I dont think I have the energy for even discussing the ankles....

[PMRpro Ambassador in reply to lesley2015]

Write a bullet list of symptoms for the consultation - and include the ankle problem. All a good doctor has to do is feel them.

[lesley2015 in reply to PMRpro]

Oh thanks I will do that. I have never been physically examined at all.

[PMRpro Ambassador in reply to lesley2015]

In which case I am left to wonder how your GP made a diagnosis!

Clinical skills: Lost, lost...

[lesley2015 in reply to PMRpro]

THe Rheumy did on my inflammatory levels, temple pain and other symptoms consistent with PMR. Two days on steroids and I was pain free ..... then.... not so much now!

[PMRpro Ambassador in reply to lesley2015]

Ah yes - but what did you do once you were pain-free? Did you try to go back to normal activities? That doesn't work - you will be in pain again. You have to pace and rest appropriately. Lots of people fall into the trap.

[lesley2015 in reply to PMRpro]

Rheumy and GP said don't worry about any 'body' pain, just stop reducing if temple hurts. So I am on 8mg, just stopped as temple dodgy, but neck, shoulders, back , hips, knees and ankles ache, told not to worry by gp/and consultant, most probably OA or something else going on! (OA confirmed in knees and shoulders) and Rheumy wants me on Mycophenoalte, which I am declining. Hence seeing a private consultant and hoping she may listen a little!

[PMRpro Ambassador in reply to lesley2015]

More likely to be PMR symptoms appearing. Why do some doctors only see the zebra?

[lesley2015 in reply to PMRpro]

Maybe it's the easier and quicker option for them ?

[PMRpro Ambassador in reply to lesley2015]

Or they are wearing special specs that make everything look like zebras...

[Nitrobunny in reply to PMRpro]

I completely agree - very sound advice. It really takes a team and sometime that means a huge amount of time and effort to find the docs that suit you best. My podiatrist asked the same questions PMRpro did when he Dx my ankle. He asked about the antibiotic and pred use specifically In addition to the complete history and explained the relevance. Not to mention all the ugly autoimmune things that can contribute to ankle pain. I've been seeing him four months now and between some manipulation, a series of braces and exercises I am much improved. Not pain free but on the right track. This after another doctor told me there was no way I'd get relief for my ankle without surgery. I was improved after the very first visit. I was stunned. I also have a pair of custom orthotics that I can wear in any of my boots and sneakers that were made after my feet were scanned in his office.

Specialists are concerned with their speciality and obviously at the top of the rheumatologist's concerns are the GCA flare and signs of the same. We all can agree that no one ever wants to experience that killer headache again and all that goes with it. Very serious stuff no doubt. Being ambulatory is a big deal too and what is pain and inconvenience one day turns into not being able to move without assistance or worse. I completely get not having the energy to add one more appointment to the mix and believe me I put it off way too long but I'm glad I finally did.

Best ~

S

[lesley2015 in reply to Nitrobunny]

Thanks for sharing, I know exactly what you mean. I need to see consultant then take it from there .......... I have learnt patience this last two years....

Best wishes

[Ronswife in reply to PMRpro]

Pmr pro

I appreciate the warning and will.