Achilles tendinitis and neuropathy in feet

[bluegirl7]

Dear All

I know PMR pro had Achilles T in the past and I have had a few minor bouts and now a big bout Driving a lot lately to help my husband who cannot drive now due to Ocular Myasthenia Gravis and right foot and ankle started throbbing Had to go to ER. Crutches etc. it’s better now but can’t sort out what shoes to wear because I also am having burning in feet. I have the heel lifts which I always have used on/off. I am wondering is there a connection to PMR? I had these symptoms with PMR when I was diagnosed along with other more usual PMR symptoms.

I had been down to 1 mg Pred several months going up higher during flares and going back down again. With this severe pain Pred didn’t help only pain killers. Now that there is less pain I am thinking to try 5 mg which I had been using for PMR flares for awhile but not sure if it will help. When this started I did try 5 as well but it didn’t help and had to go to ER for pain. Anyway trying to sort out what can help neuropathy as well. I have no diabetes etc that should cause it so again asking do others with PMR have similar Achilles issues and/ or neuropathy.

Thank you!!!

[SheffieldJane]

I got relief and extended my walking time with sheepskin insoles, bought from Amazon after feeling like I had wasp stings on the soles of my feet. UGG boots may help. My stout walking boots give the ankle support I need.

[Pixix]

I have Achilles problems right now in connection with plantar fasciitis in the bottom of mt foot, the pain to walk is dreadful, sometimes I can hardly do it. But if I walk through the pain in necessity (eg go to the toilet!) then it eases. But no walking is painless right now. I’ve had one appointment with a podiatrist at hospital, but have to wait a month now until I can get a second appointment. If the burning in your foot is ar the back under the heel look up plantar fasciitis & see if the symptoms match. I had two previous bouts about 17 & 20 years ago, when I didn’t have PMR. Just a thought.

[S4ndy]

I've just got through a bout of Achilles tendonitis aggrevated by long driving and extra sitting in uncomfortable theatre seats on my recent holiday. I had it together with piriformis (or Gluteal as they now call it) syndrome. Couldn't walk on it. Extremely painful. Had to rest up for 3 weeks. I strapped the ankle during the day with an athletic support and took antiinflammatories for a couple of weeks. Had bed rest as couldn't sit as too painful. The podiatrist had put heel cushions and insoles in my shoes which helped a bit.I found that swimming was the best exercise, not too much just 15mins. Then some exercises in the water to gently stretch the muscles followed by 10mins in jacuzzi and finishing with 10 min sauna. Did this twice a week. Then I bought a massage gun for £17. One of the best things I have bought. I followed instructions on YouTube for using it for Piriformis and Achilles problems. Twice a day on non-swim days and once a day on swim days. Within a week of using the "gun" I noticed a considerable improvement and now I am back to "normal for me"🙂.

Money well spent and I can use it to help other bits of my body! It came with lots of different attachments that enable you to get quite deep into the muscles.

I should mention that I am a qualified massage therapist and exercise teacher so I do have some knowledge around contraindications etc. I would recommend consulting your GP if you decide to go down that route to make sure that you are safe to use the gun and that you know what you are dealing with.

[Orange_2022]

I had pain in my achilles tendons for a year or more before being diagnosed with PMR. Podiatrist wasn't sure what caused it and it was on both sides so maybe a precursor in my case?! Since taking Pred. I've not had it at all...

[bluegirl7]

Hi Orange, I have tried raising my Pred but it hasn't helped. The doctors in ER were concerned that two things may have started this in an acute phase - that I take Pred and that I had 2 UTI's this summer treated with Cipro for 3 days each time. That combo not good apparently. I have not been able to speak to my rheumatologist for a variety of reasons and so not sure what to do about my red. My right ankle is the worst and my left also chimes in now and then. It has never been acute before but I have had it over the years on occasion and my physiology gave me the heel lifts for when it acted up and that used to work. I am off the crutches because they were hurting everything else and see a podiatrist next week. I am using rest- ice - compression wrap and a cane. Thank you

[PMRpro Ambassador in reply to bluegirl7]

Steroids and cipro can each cause achilles tendinitis all on their own - take both together and the risk is even higher. It happened to me. I was given small boot-like ankle supports by the orthopods in the ED and they made a major difference - I also used crutches when I did have to be mobile. It is important to avoid falling or twisting your ankles as swollen tendons are very delicate and prone to more damage, even snapping. And that is a serious injury so be careful.

[bluegirl7 in reply to PMRpro]

Thank you. I see the podiatrist next week. The ER gave light stretch wraps which help and I sleep with them also because the night is the worst as feet can move and twist.

I have difficulty getting shoes/boots that support the ankle to go over them.I can't get the wedge in there also.Maybe the doc will have something akin to your small boots. All I can find online are those very heavy jobs for breaks or plantar f. I can't left that kind of weight.

I am being very careful, But I am afraid to take my Pred. I had been down to 1mg and going up on occasion and then down again. Didn't help going up with this and afraid to go up anyway now after knowing this. I took .5 yesterday and today. My doc is not available - not his fault.

Thank you as always

[PMRpro Ambassador in reply to bluegirl7]

At this stage 1mg pred won't be too much of a problem for the ankle - but could be a problem for the PMR/adrenal needs.

Why they persist in using cipro for banal infections like UTIs is beyond me - there have been enough warnings about it. Especially for patients with a history of pred! And the risk persists - it is the history that matters.

[bluegirl7]

Thank you. I feel like an idiot for taking Cipro because it has always worked quickly for me and I have issues with some others but never again!! The internist nor the pharmacist mentioned that the combo could be even more dangerous. The MRI read that the tendons are intact but there is tendonosis. I am not sure about the distinction. But I still feel it in both actually especially after sitting at the desk to work. I am putting wraps on both ankles. It is boot season and I am trying to sort out what I can stand on my feet!! Thanks again!

[PMRpro Ambassador in reply to bluegirl7]

med.unc.edu/ortho/services/....

explains the difference ...

[bluegirl7 in reply to PMRpro]

Hi PMRPro

I stayed off feet and iced etc and had a nice Christmas Day but a week later it was all back and down again with pain in both feet and ankle especially the right. The rheumatologist thinks since the pain is mostly on top of my foot and around the right upper side of the ankle that it is autoimmune and not so much AT. The MRIS said mild tendonosis and swelling in November.He thinks even though I tested neg for lupus and RA etc that I could still have some RA. I cannot take those meds and even others for PMR because of esophagitis and colitis and twisted colon.

Been on Pred - no enteric kind in US - since 2018 and was down to 1 mg in summer. Been going up to 5 and 2.5 etc trying but not helping. Saw ortho last week who said I have osteoarthritis and I already have osteoporosis. He gave shots for bursitis which also appeared. I do feel inflamed everywhere. I will see another foot/ankle specialist this week that rheumatologist recommends. I live on Tylenol and lidocaine patches.

I read something you wrote about awhile ago and realized I had a flu shot on Nov 10 and all this this started on the 13th and ended up in ER on the 16th!! The vaccine did not contain an adjuvant which can be the culprit but who knows. Really been inflamed since then. Coincidence? I will ask for my ESR and CRP to be tested I read that if osteoarthritis they won't be up but usually up in PMR as we know.

Any thoughts?

Thank you

[PMRpro Ambassador in reply to bluegirl7]

It took 9 months for my AT to resolve - there are no quick fixes to it either, especially if it is mixed up with PMR

[bluegirl7 in reply to PMRpro]

Thank you. It is just confusing yet as to what it is because I don’t have back of heel pain. And worried about going up in Pred if that can be cause. Also really think about how this all began 3 days after flu shot. And I couldn’t wear a boot. It was too heavy and while fitting me fell 3 times. Doc said no you will break your hip. Anyway thanks again. We all carry on somehow. We have to fly to Nice this week for husbands final prefecture interview. They won’t reschedule again and we can’t lose it or we can’t stay longterm in France this year. It will be interesting!!! 🤪

[PMRpro Ambassador in reply to bluegirl7]

Good luck.