Archive

Posts Tagged ‘splints’

Psoriatic Arthritis – Things to do when your feet hurt.

Okay, just like the “Things to do when your hands ache” this post is for my own benefit. If I’m having a bad day then it can be hard to think of things to try, at least if it’s written down I’ll have some hope of remembering the good advice I’ve received. Actually, I plan on writing another post on all the BAD advice I’ve received, because I’ve heard quite a lot of that too. Anyway, much of this post will overlap with the one on sore hands, but, if my hands hurt painkillers are top of my list. I’ve yet to take a pain killer that dulls the burning pain in my feet. Obviously there are some I haven’t tried but for the constant, Achilles tendonitis/plantar fasciitis I’ve not taken anything that helps and I’ve had sore feet for more than twenty years.

Things I’ve tried that help sore feet

1 Sit down

The only thing that works. Not standing. I’ve been moved on from the steps of art galleries and museums all over the world for daring to sit down when I just couldn’t bear to stand any more. That’s the trouble with being young and having arthritis, you look perfectly fit and healthy so it is just assumed you are sitting because you are lazy or selfish. My feet started hurting when I was 10 years old, the arthritis wasn’t diagnosed until after the birth of my first child, in my late twenties.

2 Pacing

The idea of pacing is that you sit down before it hurts, I’d like to say I do this but I don’t. I’d never get anything done, but at least in theory I know that I don’t need to wash all the dishes in one go and can work for 10 minutes, sit for 5 minutes and then get on and do another 10 minutes. Just as with the sore hands I picked up these tips from Living Well with Pain and Illness and using the Gymboss timer helps.

3 Shoes

I don’t like shoe shopping, having spent most of my teenage years trying to find shoes that fit the (useless) over the counter orthotics suggested by various GPs, I developed an aversion to shoe shops. Clearly I’m missing out on some valuable part of the female psyche, but I usually only have 2 pairs of shoes I can wear at any one time and they have to do all occasions (including my own wedding!)

At first I loved Birkenstocks, expensive but comfortable and had lots of room for orthotics and funny shaped toes. When I eventually got to see an NHS orthotist (after having sore feet for 20 years) he was delighted that I wore Birks because it made his life easy, the custom orthotic was easy to fit as the shoes were deep and practical. A few years ago I gave up on the orthotics when I discovered MBT shoes. These have a rocker in the sole and I discovered that I could walk half a mile, in relative comfort and use a lot less energy to do it. I was a convert. I wore them religiously for years. My first pair lasted a couple of years, good job too at over £100. My 2nd and 3rd pair didn’t fare so well, they were knackered within 6 months and I could not afford to keep replacing them. The squashy bit in the heel would wear unevenly on one side and this would give me hip pain. It was a relief to discover the hip pain was being caused by worn out shoes and was NOT the arthritis progressing, but anyway, I gave up on the MBTs, my bank balance couldn’t handle it.

Next I tried Skechers Shape Ups, same idea as MBTs, rocker bottom soles but for less money. I still wear these today. So what happened to the custom orthotics? Well, I still have them, the orthotist put a rocker on the bottom of my Birks to combine with the custom insole, but I never found that as effective as the MBT/Skechers. I think the rocker bit is in the wrong place, but I’ve moved and haven’t seen an orthotist or podiatrist since. Anyway the skechers are working for now so I’ll stick with them. One of the “rules” for plantar fasciitis is NEVER go barefoot (easier said than done), so in the house I wear a pair of Birk Noppies, with lots of knobbly bits on the soles. I’m sure millions of people would find them uncomfortable but I think they are great and have been wearing them for more than 10 years. Well meaning relatives who give me “novelty” slippers for Christmas are always disappointed to see me in my hippy sandals.

4 Walking Stick/Cane

Oh this is a big topic.  Yes it helps my feet but it hurts my hands. I’d rather have sore feet than sore hands. For me personally, it hurts my pride most of all. With a few notable exceptions (work conferences), I’ve only used a stick on holiday where I can be sure that I won’t bump into anyone I know.  For a start when you are a fit looking teenager and “all” that’s wrong with you is a sore tendon its impossible to explain why you would “want” to use a stick. Especially as tendonitis and plantar fasciitis are self-limiting conditions (i.e. they should get better on their own).  Trouble was my tendonitis and PF weren’t self limiting, they haven’t gone away and they were caused by auto-immune arthritis.  With hindsight, I should just have used a stick when I needed it and not cared about my family and friends comments but hindsight is a wonderful thing and even now I find it hard to use a stick, when I KNOW I have arthritis and my joints are swollen like grapefruit. For me this subject has best been summed up by Rheumatoid Arthritis Guy (a true super hero), in his post “On Becoming Visible”.  The trouble with using a stick is the vast majority of people don’t know I have arthritis and if I used a stick I would have to explain why and I’m not ready to do that (I’d rather be in pain, go figure, what does that say about my messed up psyche?)

Anyway, my first stick was too long, it was solid wood and it was beautifully carved.  I loved it.  I could walk for miles, in fact within a couple of days I wore out the rubber end and discovered that it wasn’t a standard size and that those rubber ends were actually very useful.  After a few days I realised how much I was using it when I developed an angry welt on my hand and all the bones felt like they’d been crushed.  Yes, yes, I should have gone to a physio, got a proper sized NHS stick with an ergonomic handle.  But at that point the physios were still telling me the reason I had the tendonitis was because I wasn’t doing their exercises and if only I would be a “good patient” I wouldn’t bring this pain on myself. Anyway, I was on holiday, my pride wasn’t up to using a stick at home.  I soon solved the problem with my hand by using a lovely pair of mountain biking gloves with a padded leather palm. I loved those gloves, sadly I leant them to a friend who needed to use crutches for awhile and never saw them again. They looked a bit like this.

My next stick was a more considered purchase.  I went for one of those leki hiking poles, a lot more trendy.  The handle was made of cork and more comfortable and the suspension took a lot of strain out of my wrist.  It’s also a damn site easier to get replacement rubber tips for the end. However I would still only use it on holiday.  Next time my ankle flares I may be tempted to bite the bullet and explain to everyone I know that I have arthritis, I have a sore ankle and the walking stick helps. Having said that I spend most of my life pushing a pushchair and I don’t see how I could combine the two, I’m actually dreading having to get rid of the pushchair, it’s great having something to lean on (and no one knows that I need it more than my toddler!). It also doesn’t attract any rude questions or pitying stares.  Obviously you need to have a toddler in it or it would be a somewhat less effective disguise 😉

5 Heat Helps

My feet are cold even if it’s 20 C out, they also go vivid shades of purple/red and white. It has to be seen to be believed. Heat helps ease the pain, but it isn’t really practical to go about your day with a hot water bottle strapped to your foot. I like my microwave hottie, it’s great for sore backs and hips, but only really good for sore feet if you are lying in bed. I think that is why I like hot baths too, a bath relaxes all my muscles, although it plays havoc with my psoriasis.

6 Relaxation/Meditation/Visualisation CDs

I have a few of these, some have exercises specifically for your feet and legs, I think I’ll write a separate post on them.

Things I’ve tried that haven’t helped

1 Nightsplints

The idea of a night splint is that it holds your foot in an L-shape overnight, this keeps the Achilles stretched and should reduce the “first step” pain in the morning.  The trouble is I can’t sleep with them  on and no sleep makes me more cranky than sore feet, so the night splints have been consigned to the back of the wardrobe.

2 Physio

Yes, I understand the theory that I need to stretch my Achilles.  Years worth of toe raises, wobble boards and hamstring stretches have utterly failed to bring me any benefit or relief and quite frankly life is too short to pick marbles up with your toes or roll bottles of ice under your feet. Ultrasound never helped me either. One thing that DID help me were the “Personal Foot Trainers”, basically they are two poles with plastic bits on the end, you push your feet towards you and away from you to exercise different muscle groups.  It definitely helps and if you stick at it for a few months your feet will feel stronger (mine did and I thought I was a hopeless case), the idea is that you do the exercises in bed, before you stand up in the morning.  The trouble with this is these exercises only help if you do them (!)  I have three kids under 5, the days of exercising in the morning are long gone, maybe when they kids are a bit older I’ll get back to using them.

3 Cold or Contrast Baths

Heat helps, cold is agony. While I understand the theory behind plunging your feet between hot and cold buckets of water, the actual act of sticking my feet in a bucket of cold water makes me want scream. I tried it and the costs far exceeded any benefits. That’t not to say it won’t help you.

4 Insoles/Arch Supports

I’m not talking about custom orthotics here, I mean the things you can buy in Boots. The various gel pads, heel lifts, arch supports and insoles. I’ve tried heaps of them. Several GPs seemed to think that these would “cure” me. How I wish that was true. Sadly none of them worked.  I even saw a NHS podiatrist once (waiting list 1.5 years), who took a pair of over the counter insoles and stuck a bit of cork to the bottom of the heel.  He seemed to think that would be the answer to all my problems. I can’t begin to tell you how wrong he was, they gave me the worst knee pain I’ve ever had, Ipersevered for weeks but eventually gave up. They didn’t even make it to the back of the wardrobe, they went straight in the bin.

Things I haven’t tried but I would consider if I have a flare

1 Crutches

Yes, even more obvious than a walking stick, but easier on the hands.  Not really practical when you have small children to chase after. I do like the idea of crutch covers (skins to stretch over your crutches so you can change their colour), crutch clips/magnets, so you can pay for stuff in the shop without looking infirm and useless as you struggle to hold two crutches and a purse (screaming toddler and tutting onlookers optional). In fact there are loads of crutch accessories here, some of the stuff, like the crutch tips/ferrules are stocked in the UK but I’ve never used this company. Chic-aid and Funky Arthur both stock some cool coloured crutches and sticks with ergonomic handles and are in the UK.

2 TENS

1 A TENS machine (perhaps with a TENS sock?)  Llyods Pharmacy have some reasonably priced TENS machines.

3 Hydrotherapy

I don’t even know if there is any hydrotherapy in this area, I’ll need to look into it, chances are it will be over a hundred mile round trip so the childcare costs alone would probably make it prohibitive.

4 Perching Stools / Ironing Stools

I know having a stool in the kitchen would help but they are all so UGLY. Plus the kids would use it as a climbing frame.  What i need is a very large kick stool (you know the type you get in libraries), so I could whizz round the kitchen but always have it close at hand to sit down when I needed to. And for the record, I never iron, a pointless task if ever there was one.

So, there you go.  If you’ve got arthritis some of these ideas may (or may not) help you. A good source of information is heelspurs.com, they have active message boards where you can get tips from other people with foot pain and an “Ask the Dr” section where you can post questions to a US-based podiatrist and orthotist, not everything suggested on the site is sensible. Some of the suggestions on diet or infrared lights has little in the way of scientific evidence, but like the rest of the internet, you need to use your common sense. It’s also good to talk to other people who understand, I like the Arthritis Care forums (UK) and the National Psoriasis Forums, (US) a little sympathy can go a long way  If you’ve got any tips or suggestions for coping with sore feet, I’d love to hear them, please feel free to leave a comment below.

Psoriatic Arthritis – Things to do when your hands ache.

This post is for my own benefit.  I’m in remission just now and it’s easy to think straight, but my arthritis will flare up again.  I know if I hit a bad flare its very difficult to know what to do for the best, so at least if I have some ideas written down I’ve something to try when the pain gets too much and maybe it will help someone else.

In psoriatic arthritis entire fingers swell up at one time, so called, sausage fingers.  One finger can hurt like h*** but the one next to it can be totally normal.  When a finger is normal this is called “sparing” presumably because it’s spared the disease.  Rheumatoid arthritis is different and the joints all the way across the hand tend to hurt, e.g. all the knuckles and you tend not to get sparing.  Either way, sore hands make your life miserable very quickly.

Things I’ve tried

1 Painkillers and anti-inflammatories.  These only work if you take them (!).

Paracetemol is a good drug, most people think it is too mild and not strong enough to deal with their pain.  That can be true, but don’t knock it till you’ve tried it, properly. Bandolier has some good articles on paracetemol and arthritis, that show it doesn’t help most people but it can be useful in combination with other drugs (not least because you can take it on an empty stomach, i.e. first thing in the morning before you get out of bed).  If your doctor agrees you can take paracetemol, then two hours later take an NSAID (e.g. diclofenac) and 2 hours after the NSAID take take another paracetemol (i.e. so there is 4 hours between paracetemols but only 2 hours between drugs). There isn’t a lot of evidence for this but there has been some research. Of course you shouldn’t combine 2 NSAID drugs e.g. dicofenac and ibuprofen, see this BUPA factsheet for more info.

2 Heat Helps

Heat helps, but it isn’t really practical to go about your day with a hot water bottle strapped to your hand. I like my microwave hottie, it’s great for sore backs and hips, but only really good for a sore hand if you are sitting at the computer. On the subject of heat, I find wrist warmers really help, if my fingers are swollen gloves just irritate them, but as these have one large hole for your fingers they are much more comfortable if your joints are flaring.  You can also get them in funky colours and can use them to hide the more medical looking NHS splints. And no, I’m not a skier and never have been, I can’t think of anything worse!

3 Computer Keyboards and Mice

I work, I use a computer, most people do.  At the moment I use a logitech wave keyboard and mouse. It’s fairly arthritis friendly, they keys certainly have a nice “action” when pressed and unlike other logitech mice, it doesn’t have an annoying click on the click wheel.  If my hands are really sore, I sometimes find it easier to use a graphics tablet instead of the mouse, I have a bamboo one. It takes a bit of getting used to. I also use more keyboard shortcuts, as I find constantly moving my hand between the keyboard and the mosue can be very painful.  A bookstand is also useful, I like this soft squishy, book bean bag, called a bookseat, because it’s good for reading in bed as well as for working at your desk.

4 Taking a break/Keeping moving

Not staying in one position too long helps, which is easier said than done if you’ve got a lot of work to do.  I picked up this tip from the Living Well with Pain and Illness book, where it was suggested you use a vibrating watch/meditation timer to remind you to stop and have a break.  I find stopping easy, but starting again is a problem!  Anyway, the thing that works for me is something called the “Gymboss”.  No I haven’t been inside a gym for years, but it is a vibrating timer, its much cheaper (smaller and easier to use) than a meditation timer and you can set different time intervals. So when I’m working on the computer, i set it for 30 minutes and then it vibrates, I take a break for 5 mins and then it vibrates and reminds me to start working again.

5 Wrist Splints

I don’t use wrist splints all the time, but I find if I put them on, I can get a few more miles out of my hands if my fingers/wrists are especially bad.  During the day I like WristEasy, as they are light and don’t look too “NHS”. It’s getting harder and harder to find different sizes of these, so I fear they have stopped manufacturing them.  I hope my pair last a long time. I also have a night splint for when the pain is really bad and I can’t even bear to have the duvet touching my hand.

6 Relaxation/Meditation/Visualisation CDs

I have a few of these, some have exercises specifically for your hands and arms, I think I’ll write a separate post on them.

Things I haven’t tried yet but would consider if I had a bad flare.

1 A TENS machine (perhaps with a TENS glove?)  Llyods Pharmacy have some reasonably priced TENS machines.

2 A paraffin wax bath (a poor mans wax bath, washing the dishes in hot water!)

3 Arthritis gloves.  Are these a gimmick?  I’m not sure I haven’t tried them, that’s not to say I never will…

So, there you go.  If you’ve got arthritis some of these ideas may (or may not) help you. Its also good to talk to other people who understand, I like the Arthritis Care forums (UK) and the National Psoriasis Forums, (US) a little sympathy can go a long way  If you’ve got any tips or suggestions for coping with sore hands, I’d love to hear them, please feel free to leave a comment below.

Silver Ring Splints

November 14, 2009 Leave a comment

http://www.silverringsplint.com/index.html

I hadn’t heard of these before. The joints on my 5th fingers are starting to “fall in”, I notice it most when I play the flute (I mean, apart from typing you don’t really use your pinkies that much…).  Perhaps something like that would stop them caving in, at least long enough to get through a piece?

http://www.rheumatoid.org.uk/article.php?article_id=81

http://www.sciencedaily.com/releases/2008/06/080603174302.htm