Walking with Psoriatic Arthritis: Unpredictable Foot Pain

Psoriatic arthritis (PsA) is a complex autoimmune disease that affects millions of people worldwide, and its symptoms can vary significantly from person to person. For me, it impacts my joints and tendons and comes with an array of unpredictable sensations and challenges. In this article, I’m sharing the pain and discomfort it inflicts on my feet, the strategies I employ to manage it, and the role of medication in my journey.

Unpredictable foot pain

For some individuals with PsA, foot pain is an ever-present companion, yet it's as unpredictable as the weather. On some days, I can walk and stand with ease, feeling no more discomfort than the average person.

Then, suddenly, without warning, it hits me like a ton of bricks. My feet feel as though every bone is breaking, tendons are ripping, and joints are dislocating. It's a pain that defies the norms of predictability, making each step a gamble.

One peculiar experience I often describe is the 'floppy toe' sensation. It's not an actual dislocation but rather a manifestation of the intense inflammation in the joints. A toe feels so disconnected that it seems to flop, creating an unnerving sensation when walking. While it doesn't necessarily hurt, it can be incredibly uncomfortable.

Managing enthesitis

Enthesitis, the inflammation where tendons insert into bones, is another familiar foe. For me, this typically manifests in the arch and heel of my feet. It's like a rubber band being stretched to its limits, causing pain that can make walking or standing excruciating.

The unpredictability extends to the triggers of these symptoms. While damp weather often acts as a catalyst for PsA-related foot pain, there's no specific pattern to watch for.

It's a guessing game, making it nearly impossible to predict when a flare will strike or how severe it will be. This unpredictability adds an extra layer of complexity when making plans, forcing me to live with a constant sense of uncertainty.

In the face of such unpredictability, I've developed an arsenal of coping strategies. I keep a fleet of mobility aids ready to assist, depending on the severity of the pain and the amount of standing and walking required. This adaptability allows me to navigate my daily life with a degree of control.

Balancing temperature and medications

Managing temperature plays a significant role in my daily life. When my feet are cold, the pain intensifies, which can be a problem in the summer when I prefer wearing flip-flops.

The transition from hot outdoor temperatures to ice-cold air-conditioned buildings can be excruciating. To counter this, I carry socks to warm my feet whenever necessary.

Two medications, low doses of Cymbalta and meloxicam, have become valuable allies this year in my battle against PsA. While these medications are not a cure, they have proven to be effective in reducing pain.

However, the path to relief was not without its challenges. Both drugs brought on fatigue, particularly in the initial weeks and when doses were adjusted. Fortunately, my body adapted over time, allowing me to experience the pain relief without the crushing tiredness.

Adapting and finding hope

In the quest for a more predictable and comfortable life, I am not settling for the status quo. I am planning to reevaluate my medication dosages after a year. Given my current low dosages, there's room for adjustment. The journey is a learning experience, and the anticipation of a potentially even more significant reduction in pain keeps my hope alive.

Mobility aids have become essential tools in my journey. When PsA-related pain flares up, I use canes or crutches to alleviate pressure on my feet.

For more extensive outings or days when PsA isn't my only source of pain, I turn to a power wheelchair. This adaptability enables me to continue enjoying life, whether it's exploring Disneyland, embarking on a shopping spree, or attending events that require more walking.

Living with psoriatic arthritis is an unpredictable journey, filled with sensations that range from excruciating pain to unnerving discomfort. But as my story shows, it's possible to adapt, manage, and regain some level of control.

Through a combination of adaptive strategies, temperature management, and the use of medications, the unpredictability of PsA can be faced head-on. The journey may be uncertain, but with each step, I prove that resilience and adaptation can lead to a brighter future.