Sore Stinging Sensations in Feet

[Obscureclouds]

Ever Cheerful but can’t help asking what next? and Why? When sitting for a while I’m in the habit of giving my legs a bit of a stretch and circulating my feet. Lately I began having a really sore stinging sensation (can’t call it pain but just as bad) just below my ankles and into my feet. It’s rather like having a lot of wires or elastic being pulled. I don’t feel any discomfort when walking or sitting but as it has been getting worse it’s rather disturbing and this morning lying on the bed I raised my legs in the air and circled my feet and in was excruciating particularly down the outside of my feet (but also around my ankles and across my toes). I know I have a good pulse in my feet as this was tested by the nurse checking a leg wound this week so I’m guessing it’s tendon/ligament related. Anyone else had similar?

Something more to add to my current list of seemingly unrelated oddities I’m experiencing. Even the weather’s gone very cold - Still at least the sun is shining and it’s so good to be alive 🌞😃

[DorsetLady PMRGCAuk volunteer]

Bit odd as pulse is strong -but there may be something in the related posts to help..

[Obscureclouds in reply to DorsetLady]

Thanks. I looked at Q&As and now did a search on past posts but surprisingly didn’t get anything up relating to feet. So hoping someone on the forum may have experienced something similar ( if not feet then in hands. ) to see if it’s something that just settles down on its own. Also wondered if it may be a nerve thing.

[DorsetLady PMRGCAuk volunteer in reply to Obscureclouds]

There isn’t in FAQs - probably because it didn’t come up enough to warrant a post if its own when they were first initiated..

As for HU search.. it’s very obscure at times (no reflection in your name!) - and of course you have to ask the question before related posts come up! Did you find anything useful in them?

Agree it could be a nerve thing.

[Obscureclouds in reply to DorsetLady]

Unfortunately not..Some but more related to swollen or aching feet. I tried stinging feet in the search as well. Not sure there is anything I can do about just another mystery but thanks for getting back to me

[SnazzyD]

The pain around the ankle, outside of foot and into toes after stretching your leg sounds like Peroneal tendinopathy. The peroneal muscles are up the side of the leg and the tendon runs down to the bottom of the foot. See if this rings any bells.

mskdorset.nhs.uk/ankle-pain...

[DorsetLady PMRGCAuk volunteer in reply to SnazzyD]

I should have found that link!😲

[Obscureclouds in reply to SnazzyD]

Thanks for the suggestion and attaching the link. I’m not sure if it is related as there is no issue when weight bearing and there is nothing above my ankles. The odd twinge along the side of my food when side stepping but it’s really just confined to moving my feet when legs are elevated. Generally ok moving feet up and down but really bad at the slightest side or circular move. Blessing is that I can still get out for a daily walk without any bother👏

[SnazzyD in reply to Obscureclouds]

This muscle is used for sideways and upward of the foot. Does it depend *how* you’re weight bearing?

[Obscureclouds in reply to SnazzyD]

No I don’t feel anything when standing or any form of weight bearing. Only had the odd twinge on the side of my foot if I’ve angled it wrongly (eg going up a step). The problem is only when my legs are elevated and for side moves rather than up and down. I’ve tried to explore nerve type issues on line but still drawn a blank. Not ruling out what you suggest as it might go on to develop more symptoms. As it really hurts, I can of course avoid it happening by keeping my feet still when they’re off the ground but not an ideal solution. Thanks for trying to find an answer

[SnazzyD in reply to Obscureclouds]

I mean side to side movement, not straight line up and down. Anyway, it could be a number of things. Thought of a podiatrist?

[pegpowell]

You mention a leg wound. Has Peripheral Arterial Disease (PAD) been considered?

[Obscureclouds in reply to pegpowell]

Thanks I’m open to considering anything especially as this may be the early days of symptoms which might develop further over the coming week eg Legs not effected at the moment. Might be as well to raise the issue with the Nurse when I go to have the wound checked on Tuesday.

[ValleysBoy]

Are you sure it is not periphferal neuropathy. I suffer what you describe I think burning shooting pains in different parts of my feet. I am sure there is a section in HU on peripheral neuropathy. Check it out.

[Obscureclouds in reply to ValleysBoy]

Of all the things I’ve looked at on line this (PN) did seem to have the closest similarities although at the moment still not enough to make me think it’s the answer, I don’t get shooting pains as such and it’s hard to describe but it is probably more like an intense burning sensation than anything. Plus it is early days so further symptoms may build up over the coming week or so. I have been to the Doctors with so many random things since the start of the year and although they’ve always taken each concern seriously I’m rather dreading ringing about yet something else. I do have a regular full blood test booked for tomorrow so it will be interesting to see if that throws up any changes in any of my markers . I also see the nurse on Tuesday for a wound check so can see if she has any ideas but I guess if it goes on/worsens I will have to raise it with a Doctor . Did your Rheumatology Consultant(if you have one) get involved with your diagnosis?

[gaqke10 in reply to ValleysBoy]

I have intermittent pain, burning sensations in my feet. Dr. thinks it's steroid induced myopathy. Google it. Mine is better since I switched to hydrocortisone.

[PMRpro Ambassador in reply to gaqke10]

Myopathy wouldn't usually cause those sort of symptoms - are you sure he didn't say NEUROpathy?

[Obscureclouds in reply to gaqke10]

From my worsening symptoms I had feared it was more likely to be Peripheral Neuropathy as it seems more nerve based than muscle. Unfortunately my previous call back from the surgery regarding this had been delegated to the Physio. Which was a waste of time as after going through everything he said he would have to refer to a Doctor to get back to me on what they wanted to do but as after several days I heard nothing further I have had to make another appointment. But at least it’s a face to face with a Doctor on Monday. Did you have symptoms elsewhere? As it has continued progressing I’ve found my arms also now feel quite solid and heavy at times and I have some dull tingling in my hands (which I think is how my feet issue started) I also have some tingling in my lips and numbness around my mouth.. I mentioned this to the nurse dressing a leg wound last week and she thought she should do a blood test for vitamin B12, Ferritin, Folate and sugar levels (and on discussion with the duty doctor added a full blood count and CRP etc. ) So at least I now know everything is within normal range on those before I see the doctor. I see PMRpro has also responded to you asking if it maybe neuropathy that you have. You mention switching to hydrocortisone please can I ask what dose of Pred were you on at the time and if you are taking a sparing agent medication? I’m still in my first year of tapering on Pred only but did see hydrocortisone may be prescribed for PN. I didn’t know how that would work along with the level of steroids I need to manage my LVV. Hopefully the Dr I’m seeing will have a better idea ( and of course I might not even have PN or anything similar 🤞). Thanks for your input.

[PMRpro Ambassador in reply to Obscureclouds]

From what I can see, using HC in PN is as local injections to suppress the pain. So would be used in patients who are NOT on pred. It is certainly not a usual treatment.

[gaqke10 in reply to PMRpro]

I'm on Actemra and reducing steroids. First I switched to hydrocortisone when pred got down to 5 mg. Now I'm slowly reducing hydrocortisone. If you read about steroid induced myopathy you see that switching to a less powerful steroid is one suggestion. Unfortunately not an option for those who need pred. It's been 4 months and I definitely have less neuropathy but it's still not gone.

[Obscureclouds in reply to gaqke10]

gawker 10 I’m glad this seems to have improved your condition and hope it will continue to reduce your discomfort.. I’m just about to go down to 10mg of Pred so am thinking I’ll need it for many months to come to manage LVV without a sparing agent so it doesn’t sound like hydrocortisone would be an option for me at the moment. I saw the Dr today and she thinks it likely that I have P neuropathy but says there are several possibilities for cause which include Vasculitis itself, Pred and antibiotics I’ve taken over last few months. My vit B12 level was well above the minimum but although my iron levels were in range they are on the low side so she has suggested I take a course of iron tablets to see if that will improve my situation . Can only give it a try but a bit concerned that I’m getting some of my initial symptoms in my hands now and I also have tingling and numbness around my lips. Hey Ho at least there’s sunny weather and plenty of spring flowers to enjoy 😃

[gaqke10 in reply to PMRpro]

Yes I did mean to say NEUROPATHY.

[Stills]

note I do not have PMR. I do however recognise your description of foot pain. In my case I have developed Enthetitis following a severe muscle rupture in the lower leg and foot that went untreated during the pandemic . Peripheral neuropathy is also present. I’m surprised at the intensity of the pain although the extreme levels are sporadic and relatively short whereas the stiff ache is constant and areas are too tender to touch, it never stops hurting and keeps me awake at night. I’ve been advised not to use compression sleeves on the foot with PN although they are useful for the overall injury.

[Obscureclouds in reply to Stills]

I’m sorry to hear your condition is causing you so much pain and hope you have a course of treatment that in time will ease your suffering. Fortunately at the moment I have no discomfort until I raise my legs and move my feet in a sideways movement so it doesn’t effect me in bed and I don’t have any areas sensitive to touch. However, I don’t know if that is something that may develop. Do you recall if your PN started with just limited symptoms in your foot? In my case both feet are affected to the same degree. By coincidence I saw a different nurse to check my leg wound last week and she has prescribed light compression socks as she said they aid healing of leg injuries. The pharmacy had to order them in so I’m due to collect them on Monday but I’m now wondering if I should wear them as the wound is now nearly healed anyway.

[Stills in reply to Obscureclouds]

It’s difficult to say really as two things are contributing. Firstly I have RA in both feet and damage to the big ball joints so they are stiff and quite immobile and have been for years. Over the last 20 years they have got much worse as I’ve clearly got older and I’ve had to adapt my footwear. Secondly the PN in the injured leg appears to be as a result of nerve/tissue damage from the rupture and not caused directly by RA.

I should add I’m having thyroid problems atm and am probably mineral deficient which I understand is a big contributing factor to PN.

Compression sleeves have always helped my wrists and knees and my injured leg feels more comfortable with one, especially when walking outside. Please take medical advice on using them as we’re all different and I’ve learnt long ago the rheumatoid conditions have a habit of non conformity.

[JeremyNZ]

It wouldn't hurt to take some vitamin B12. Peripheral stinging or tingling is a symptom of a B12 deficiency. Apparently to can't overdo B12 unlike B6. Anyway, wouldn't do any harm. Good luck.