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Living with Psoriatic Arthritis (PsA)

Any advice welcome

Hi all - diagnosed PsA four years ago, rheumy put me on 200 mg Ciclosporin and 500 mg Naproxen daily which kept arthritis in knees well controlled. Two months ago started having horrendous foot pain in left sole. Rheumy injected with steroid (ouch!) and pain went away. A month ago did longish walk - two hours without sitting down. Next morning had terrible pain on the top and side of foot and little toe was bright red and squashed looking.

Over last four weeks have tried loads of different things - bought new squashy trainers, kinseology (is that the right spelling?) tape, compression socks, gel insoles, open toed sandals. Nothing has worked and compression socks particularly make the pain on upper foot far worse. Have also noticed it gets even more severe if I eat red meat, seafood or anything sugary.

Am terrified that I’m becoming disabled as I can only walk short distances and the pain is still an 8 out of 10. I have painful bone spurs on the other ankle and get severe leg and foot cramps in the night. Any tips/advice/miracle cures welcome from fellow sufferers. The only thing that seems to give respite is hot baths and soaking feet in water with Epsom salts, vinegar and tea tree oil. Rheumy thought maybe it was a stress fracture but neither X Ray nor ultrasound showed inflammation. Meanwhile counting the days until I see rheumy again on the 11th. Yours hobbling - Sorefeet.

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Make sure it is not gout. Easy enough blood test.

Definitely look into gout and then cross your fingers that’s what it is! Gout is so much easier to fix that PsA. Because my toe was so disastrous my initial orthopedic doc thought I must have gout so I went through all the testing, including DECT scans to look for crystal deposits. They found nothing but I learned a lot about gout along the way…the advice you could try immediately is to drink huge amounts of water.

My favorite foot helper is a rafting sandal with such good arch support that it transfers a lot of weight off the metatarsal area. It’s called the Chaco Z Sandal. The strap is infinitely adjustable, just one long strap that goes through the sole at various points so you just tug it until it fits each area of your foot. Since my feet swell in different areas and get better and worse daily I adjust the straps frequently. It’s ugly, but it’s worth it!

I can see why you chose your user name.

After complaining about my feet at every single rheumy appointment for the last 7 years, erosive changes in both feet were finally found on x-rays in January this year. My feet have never been swollen and previous x-rays and ultrasounds showed nothing much, apparently. Strangely that was not what the ultrasound technician said at the time!

Shoes are massively important. I have just spent nearly £200 on 2 pairs of sandals which seemed comfortable at first, but really aren’t. Were this any other item I’d be furious with myself but I’ll try again, trial & error’s the only way.

I also get night cramps. I think I’ll stop calling them cramps, ‘spasms’ sounds worse and they really are rock solid spasms. If I haven’t walked all day they tend to be particularly bad.

You are on very light treatment, what are your thoughts on that?

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Morning and thanks for your advice. It is gout. Had a blood test at the beginning of the week and my doc called me last night to say that my uric acid level is sky high. He wants to wait until I see my rheumy next week and then put me onto a gout drug (not colchicine, begins with an ‘a’.). Did some research last night and discovered that Ciclosporin can cause gout. I’ve been on it for nearly 3 years and had bloods taken every 3 weeks to check for kidney probs so I don’t understand why the high uric acid levels weren’t noticed until now.

The advice on shoes is very useful and have ordered a pair of Chaco Z’s this morning. Just confused as to what to do now. Ciclosporin was the only thing that healed my top to toe psoriasis in 2015 (which was so severe I lost all my finger and toe nails, my hands and feet were covered in oozing fissures and my body looked like a pizza) as well as helping the PsA so I could walk normally again. Obviously I am going to have to come off it but know you can’t just stop is suddenly. Feel relieved that I have a new diagnosis but worried about what the next stage will be.

Sybil thanks for your wisdom. Re, cramps - I read another post on here where someone said they heard an old wives tale that if you sleep with a bar of cheap scented soap in the bed, you won’t get cramps. She tried it and hers went away! I tried it last night and had a cramp free night. Spooky! Interesting comments about treatment - I thought Ciclosporin was quite a big drug?

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Haha, maybe I will try the soap!

Gout! Blimey. But glad at least to hear that you now know what’s going on and have a way forward. My eldest son had that recently, he made a fairly rapid recovery.

I don’t really know anything about cyclosporin, perhaps I should have said that it’s just rather unorthodox for PsA. You must be really worried about a return of that psoriasis … perhaps time for a biologic that, with luck, would deal with both the PsA and the psoriasis?

It was me who talked of the bar of cheap scented soap and cramps! And it can work for some people me included. What also helps is magnesium spray easily available too.

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Have you heard about Dacytalitis? You symptoms seem like this could be the case and is symptomatic of PsA. Hope you feel better very soon.

I have PSA and had a severe gout attack just over a year ago. My symptoms were similar to yours. I also had an infection in my foot so I was put on antibiotics and on colchicine for a few days and then my doctor put me on allopurinol. I take it daily and it works… with diet changes…less meat and seafood and more vegys and LOTS of water. I take one pill a day 100 mg I think. I still get gout pain but not as bad and no where near as immobilizing as the severe attack. Some foods that benefit me are pineapple and green onions. Take care!