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Living with Psoriatic Arthritis (PsA)

Foot swelling - not just sausage toes


#21

Hi Kris, she said the prednisone could reduce inflammation and probably relieve some of the pain, but you need an antibiotic to get rid of the infection (if that’s what it is).
So, I’d still bring this up to your doctor…I didn’t mention the ischemic foot question to her. If that’s something to do with the inside of the foot, joints, etc., I don’t think she’d know about that.


#22

Although this does not address the cause of your foot swelling, it may reduce the symptom. I sleep with a foam wedge under my lower legs, and it is very effective at preventing swollen feet.


#23

Thank you Nancy. Yes, I have two of the foam wedges and they help. My biggest problem is that I am a stomach sleeper, mostly because of the spinal arthritis issues and it is the only way I can get relief from this. But I do use the wedge throughout the day. :slight_smile:


#24

Trying an antibiotic (keflex) to see if it will help. FYI an “ischemic” foot is swelling and neuropathy from artery issues. I’m afraid that’s what I am likely dealing with since I know I have artery narrowing/compression in the knee. The odd thing is that I have no issues betwedn knee and ankle/foot. I always seem to find ways to stump the doctors! :-/


#25

Can I suggest a natural alternative to reduce the foot swelling or any swelling in general? I’ve had PsA for two years now and have tried to go down the natural route to seemingly unrelated swellings and odd things happening to my body. I have worked with a Bowen Therapist to improve my circulation and mobility and its worked a treat, better than any steroid boost. She suggested when I had my melon sized knee swelling ( I actually thought it would burst as the skin was so tight) that I used epsom salts as a means to draw fluid out. How this works is you get a cotton bag or pillowcase half fill the bottom with epsom salts and sleep with it on the swollen area overnight. I used a pillowcase and a hair bobble to tie it up. The trick is to have a towel under the area as it gets damp. The following morning my swelling had reduced by half and I could see my knee reappearing. A lot of the swelling was behind the knee and cutting off circulation, this was also reduced. You can only do this every second day until the swelling goes as every day is too much of a drain. Old wives tale that is still relevant today and works a treat. Most of us will have epsom salts or similar in the bathroom from being advised to have a bath with it when things get sore so give it a go.


#26

Thank you so much for this advice! When this first started I tried a foot bath with warm water and epsom salts. Within a minute the pain was excruciating. So I will try this without the warm water and see if it helps. Oddly my rheumy says I have swelling in my knee. My PCP says I don’t. But my knee hurts like heck and even though it isn’t red or inflamed looking there is obviously something going on there.


#27

Hi Kris, did you say your doctor started you on Keflex? Did he think it could possibly be cellulitis, or did he rule that out? Are you getting any relief?


#28

Doctor did not think it was cellulitis but humored me with a Keflex scrip. Pain is not as bad and the swelling is not as bad unless I am upright for too long. Yesterday the swelling was up into my ankle/lower calf, but I was on my feet way too long yesterday. We’ll see what happens! Thank you for checking! :slight_smile:


#29

I was at rheumatology on Thursday and so got to show her the swelling on my left foot, which has been giving me a little bit of cause for concern. She said there was clear signs that the arthritis was beginning to affect my toes, and the swelling from that and the more significant swelling in the ankle were simply moving towards each other, giving the impression that the foot as a whole was swollen - which is true. The central part of my foot is the least swollen. Back on steroids, so we’ll see how quickly the swelling goes down!


#30

Your foot description sounds very similar to my own symotoms, except that I also have the neuropathy…mainly numb and tingling toes. In the past steroids have helped within two days. The last 14 day tapered dose did nothing. The rheumy did not indicate that my swollen foot was at all unusual. But again, the steroid shot he gave me did nothing. I’m still thinking that the foot issues are related to the lumbar/sacro facet arthritis and bulging disc. Will have to wait until 11/7 to see what the neuro says. I hope the steroids will help you. Please let me know.


#31

I had a short, sharp dose of steroids a month or so ago, and they did nothing either. It took about a week last time I had them before I felt anything really improving below the waist (so to speak!), although my hands and elbows get better quicker. I don’t yet have pain in my toes, even though they have the swelling by the end of the day, but the arches and ankles of my foot are quite painful at the moment. I tend to worry more about swelling in legs and feet if there is no pain associated with it. If there is, then it seems to me that the swelling is likely to be related to that! It’s logical to me, and without a doctor at my beck and call 24/7 that’s the best thing I can hope for to put my mind at rest!


#32

I am fortunate (knock wood) that I don’t have any serious issues with my arms and hands. One finger that is arthritic but generally not painful unless I overuse my hand, which is not easily avoided since I am a glass artist. Had not thought about the pain with swelling versus swelling and no pain. The really odd thing about my foot issue is that I had no serious pain in my foot (other than the norm, but tolerable) then suddenly my foot went pale, numb, cold. Then after 12 hours of that the pain set in and slow swelling. But my foot regained warmth, not hot. The doppler ultrasound did not show any clots. And from what I have read about arterial issues and the foot, the foot is generally cool to the touch. Plus I had zings that felt like little electrical impulses in my inside ankle and at the heel. Sure sounds like nerve issues to me. Honestly, I think doctors take stabs in the dark a lot of the time.


#33

Side note: I have been using Arnica cream on my foot and it does seem to help the pain just a bit. It is supposed to help swelling too but time will tell. It does soothe the burning. Thought it was worth a mention. The brand is Arnicare.


#34

Hello, I have psoriatic arthritis/fibro–well that is what the rheumy has on paper. I can tell you this. The first symptom that I had to flag that something was wrong with me was that upon use–my hands would swell. I have talked with my rheumy and he did not have much to say other than that was unusual. It still occurs. I currently do not play guitar anymore because of loosing agility and the cramping/swelling that occurs upon use. All of my muscles are tender but some places are worst than others. Sometimes my forearm swells and sometimes if you feel or have someone else feel it will be heated. I think this occurs from increased blood flow due to inflammation. I could be wrong but I do not think so. I think this disease is not fully understood yet. I personally believe anything related to any muscle or tendon can be effected and this depends on the over all systemic inflammation that can occur anywhere in your body. My two cents anyway.


#35

Thank you for your two cents! :slight_smile: What you describe does sound like the same type of inflammation. And I don’t have much doubt that the tendons and joints are involved. I honestly wish I had pressed my rheumy for more input, but had only been dealing with this for a week when I saw him. He didn’t say either way if it was usual or unusual…just offered to do a shot. I know it must be really tough dealing with pain in your hand. Makes me sad you can’t play your guitar anymore. Fibro and PsA together are tough. Thank you so much for the input.


#36

You are welcome. I wish you well. It is a good idea to bring it up with your doctor. Sometimes it is helpful to keep a journal. Some doctors are not good listeners. I have been told ice can be helpful but I am of the opinion that is treating a symptom and not the systemic inflammation. I am not sure if this applies to you but diabetes can cause water retention and swelling. The zings could be nerve related. Just throwing out some ideas. It could however be part of the psa. Do you notice an increase in swelling on use? Is it tender?


#37

Side note–the reason I mention diabetes is that a common go to treatment for inflammation is prednisone. The way it works is by increasing blood sugars basically. So it is helpful while on Prednisone to monitor blood sugar levels. This type of thing can cause nerve issues and zings as you mentioned. I have to be real careful my self because I am type 2 and must take prednisone because that is all I am left with for options at this point in time during times of flares. It may not hurt to check your blood sugar out by way of a blood test and possibly a urine test. It is the quickest way to rule it out. And those shots the doc is giving you is probably cortizone–a known blood sugar elevater.


#38

For people who aren’t diabetic the steroids will have little impact. For people who are diabetic, even a joint injection can cause problems with blood sugar control.

It’s a good idea to get HBa1C tested once a year at your physical. Other than that, I wouldn’t be overly concerned.


#39

Hey Stoney, from what I was told–sometimes prednisone can induce blood sugar problems. I heard this from my dermatologist. And for the most part I agree that in theory taking the prednisone should be fine for healthy folks but many of us fall into the comorbidity category. It can induce diabetes.


#40

Yes, the prednisone has definitely impacted my glucose levels. Even at a maintenace dose of 7.5mg (which is deemed to be the highest dose without causing long term impact) raises my glucose in blood tests. But A1c levels are in the normal range. Even so, I am weaning off of the 7.5 dose since it is doing good.