Sorry I’m late to the thread, but I felt the need to chime in.
First off, I hope PT is treating you well! I love PT, and can’t wait to get my next referral… However, my toes doubt and wanna smack some sense into your PT…
I am definitely going to be the biggest fan of ‘postural and habitat changes for pain reduction’ that you are likely to meet. It can help immensely (otherwise I wouldn’t be in training to be a ‘movement coach’ ), but if inflammation has your number, it will still come up.
The widest toe box in my shoes, attention to alignment, slow adjustments, gentle foot stretching… utterly pampered toes and feet mechanically speaking. And the sausage toes came for me all the same… Don’t wait for your number to come up. Move more, move in a manner kinder to your joints, but don’t let yourself be mislead into thinking it’s gonna stop or fix the issue if it is inflammatory in nature, no matter how much better things can feel.
Unless you have some sort of sports injury or other trauma to the area, it shouldn’t just pop up hurting enough for tears, then disappear. Things hurting to the point of tears is a big deal, especially if it’s not constant, and slowly getting worse.
Joint pain roulette is not a game to be playing every morning, and if you are playing, the rheumatologist is gonna help you place your best bet. Even if your body is playing joint pain craps, it still sounds like some sort of inflammatory joint game.
And now the main reason I’m here… I wanted to say this about your ‘lack’ of swelling:
I have hypothyroidism, and didn’t get treated because my labs were always juuust inside bounds, but based on a swollen thyroid large enough to impact breathing and swallowing and anti-Tg+ only. I still had the cold nose, feet, hands (which masks the heat that accompanies the joint pain, making it seem ‘normal’ in temperature), but lots, and LOTS of swelling that I didn’t know was swelling.
When I got on thyroid hormone replacement and the seas of swelling receded I finally saw face-to-face the true swelling in my joints in feet, ankles, knees, etc, etc. But for the longest time just thought it was ‘residual swelling’ (my denial is very strong, if you couldn’t tell…)
When the malleoli of my ankles turned from islands to mountains, it became apparent how much swelling around them I have and how that corresponds to days with extra pain. This wasn’t noticeable before, at all. Ever. When my sausages appeared, I was most bitter about my toes being fat again, and didn’t I just get rid of the swelling??? Oh, wait, it’s just a few of them… Must be something else…
What I’m trying to say, I guess, is Hashi’s (or other sources of full body) swelling can ‘mask’ some of the joint swelling if it’s ‘minor’.
If you have such a strong family history for it, maybe you’re having the same problem I was with regards to seeing the swelling?