Metatarsal Twinge: Down to 3.5mg a day after 2... - PMRGCAuk


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Metatarsal Twinge

DMBpmr profile image

Down to 3.5mg a day after 20 months. I started getting pain in my left big toe when moving about. Eventually went to see a podiatrist today. It turns out that I have very little metatarsal padding and will need insoles and/or Skechers to compensate. The podiatrist told me that this could well be a deleterious side effect of taking Prednisolone. She has come across this before a few times. Has anyone else experienced this?

9 Replies

Had, have , this problem and have the insoles ect but it started 12 or so years ago way before pmr . Had 3 lots of steroid injections over a couple of years that helped but don’t seem to need them now .

Hello! The short answer is "yes" and I'm seeing a podiatrist about it, next week.

Ironically, since I was referred, it has improved considerably, but I'm keeping the appointment, anyway.

It'll be interesting to see what they say about Pred, especially as my symptoms began as I was trying to reduce (too quickly, in my opinion - needless to say, not my idea!) to 6mg., and improved when I had to increase the Pred again. Of course, it may be that it had been building for some time but was being masked by the Pred, or maybe it was the PMR, though the rheumatologist who referred me to podiatry didn't think so.

Will report back, when I've seen the podiatrist.

DMBpmr profile image
DMBpmr in reply to Mrsd12f

The premise that Pred can possibly reduce the protective padding under ones feet, if true, is a concern. I don’t suppose it can recover and it may even predispose one to OA.

Mrsd12f profile image
Mrsd12f in reply to DMBpmr

Thanks, DMBpmr. Yet another joy to look forward to!

PMRpro profile image

Like Chrob I've had a similar problem for which the podiatrist in Dundee made padding insoles which were useless as, other than trainers, I couldn't find shoes that accommodated them! But it was actually undiagnosed PMR that was causing the problem and making me walk "wrong" - it definitely wasn't pred as I wasn't taking it and being on pred improved it no end.

I saw another podiatrist, recommended by my chiropodist neighbour in Durham, who took one look at my feet from behind and how I walked and she identified the mal-position of my feet. She made rigid carbon-fibre insoles and within days the pain improved, it wasn't gone until the pred though.

The wrong position of the foot was putting pressure on various places - which in some ways is much the same as saying the padding is thinned. There are rheumatologists who say they can diagnose PMR by looking at the patients' feet. I still occasionally get corns though never as bad as then and they are in different places. The chiropodist here has commented on how my feet changed over a period of about 3 years - I first went to her shortly after starting pred so she saw them as they had been due to PMR.

Chrob profile image
Chrob in reply to PMRpro

Thinking , um yes my feet have been a lot less of a problem the last eighteen months since pred , not even had to order any more insoles . I have a standing appointment with our local hospital for them if needed , they have a firmish raised part under the ball to spread the metatarsal. Today’s reason to be cheerful.

Yes, I was diagnosed with the same issue about a year ago. The podiatrist indicated it was a common problem. I expect it's not related to PMR or prednisone, but more likely to be a further symptom of aging.

I've worn custom orthotics for many years for appropriate arch support. Now my orthotics have metatarsal padding. There are also a number of shoe brands with similar supports, including Mephisto, Birkenstock, and Finn comfort. I've never looked at Sketchers as an option but may do so.

Is the pain all under your toe? I have problems with pain on the top of my big toe.

When I very first got pmr I went to the foot doc thinking I had a broken foot—swollen twice it’s size and impossible to walk on. It turned out to be costochrondritis (probably misspelled). Occurred because of tendinitis in my foot. Took weeks of icing and elevation and wearing special supportive bandages before it got better. Now my foot is misshapen. I blame it on the initial untreated pmr and walking unusual due to the different gait caused by the disease inflammation.

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