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A handful of years ago on the advice of my Gastroenterologist, I went to see not a Rheumatologist, but another GI who specialized in Rheumatology (if that makes sense). 

The reason was because I seemed to regularly have issues with inflammation - especially on the right side of my body.  My right foot skin, toes, and toe nails have been discolored and appeared to contain a lot of dead cells.  I would also get occasional intense shoulder pain feeling like my deltoid muscle was 'blown out', or extremely sore and had no strength.  Finally, the top of my right foot, where all the little metatarsal bones are located, occasionally gets extremely sore to the point that the achiness radiates through my body.  Any form of walking, wiggling my toes touching that area, or even doing nothing at all becomes extremely painful and uncomfortable.  After 2-5 days, that pain usually disappears...  I am dealing with this foot pain right now as it started acting up two days ago.

That GI doctor, whose 'side specialty' is rheumatology, was trying to explain to me that my Intestinal history / issues were likely the result of an infammatory disease or some form of inflammation in my body rather than a specific inflammatory bowel disease.  He believed that my bowel issues were caused by this general inflammation in my body that affected some organs.  It makes sense, but unfortunately, he didn't seem to have any solution to these issues.

Two days ago the top of my right foot started acting up once again.  Today there is total pain and discomfort in that area of my foot.  An aching pain that radiates even when I am sitting still.  Any slight movement of my ankle, toes, touching the area, or walking makes the pain and discomfort increase a lot more. 

Do any of you deal with issues like the ones I am describing?  When it "flares up," the pain on the top of my foot is acute.  It differs slightly from the achy lower back pain which is more of a chronic thing.  That said, on occasion my back pain increases where the discomfort reaches a whole new level.  The same type of achy stiff pain, however, it becomes more uncomfortable and interferes with day-to-day life a lot more. 

I usually go running once or twice a week.  With the flareup of my foot and the current pain I am suffering, I couldn't imagine running for 30-60 seconds, yet alone 2-3 miles....   I did, however, manage to officiate some beer league hockey games yesterday - during this current flareup - without too much trouble.  That said, today the foot pain seems to have reached its high point.  While I maybe could still get my skate on and hit the ice for 3 hours, I have a feeling that I would have suffered a lot more. 

It's a strange thing.  Unlike most 'injuries' that are painful then slowly heal and get better, this issue I have seems to progressively get worse over 2-5 days, reaches its peak of pain and aggravation, and then suddenly goes away without a trace.  I have never found ice or heat to help in treating it. 

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When I had my colon/rectum and was going through a flare- my legs, thighs, joints in my hands, fingers, ad stomach all locked up with joint pain and the joints were locked in place. It was scary and painful. It was like I had no control over my body.

When the colon/rectum came out, everything was better! No problems with joint pain ever again. But I have/had UC.

Were you originally diagnosed with UC or Crohns??? I wonder if that is causing your pain?

I was originally diagnosed with UC.  I believe that when I was 12 (I'm 56 now) I broke my 5th metatarsal in my right foot.  Perhaps this could be an arthritis pain related that injury 44 years ago?  This has been off and on for years (much more often off than on thank goodness!). 

It is very painful at the moment.  Not sure if I should do something for the pain and discomfort.  I took a muscle relaxant.  Not sure it will do much as it feels like all bone pain!

@capper posted:

I was originally diagnosed with UC.  I believe that when I was 12 (I'm 56 now) I broke my 5th metatarsal in my right foot.  Perhaps this could be an arthritis pain related that injury 44 years ago?  This has been off and on for years (much more often off than on thank goodness!).

It is very painful at the moment.  Not sure if I should do something for the pain and discomfort.  I took a muscle relaxant.  Not sure it will do much as it feels like all bone pain!

Oh shit, that sounds like deep pain! How do you feel about seeing a pain management specialist?

It's not anything I haven't dealt with before.  I should be able to sleep okay.  Mind you, I haven't slept well at all over the past few weeks!  It's not because of pain.  Not sure the reason - maybe stress...  I am averaging about 4-5 hours a night...  I have to say that this is a really strange type of pain / flareup.  There is no visible inflammation but it is quite painful in that small area of my foot. 

@capper posted:

It's not anything I haven't dealt with before.  I should be able to sleep okay.  Mind you, I haven't slept well at all over the past few weeks!  It's not because of pain.  Not sure the reason - maybe stress...  I am averaging about 4-5 hours a night...  I have to say that this is a really strange type of pain / flareup.  There is no visible inflammation but it is quite painful in that small area of my foot.

Yeah stress is very powerful unfortunately.

I am thinking maybe arthritis. Did you ever injure your foot in the past???

@capper posted:

I was originally diagnosed with UC.  I believe that when I was 12 (I'm 56 now) I broke my 5th metatarsal in my right foot.  Perhaps this could be an arthritis pain related that injury 44 years ago?  This has been off and on for years (much more often off than on thank goodness!).

It is very painful at the moment.  Not sure if I should do something for the pain and discomfort.  I took a muscle relaxant.  Not sure it will do much as it feels like all bone pain!

Yes...

@capper A very non-standard plan I worked out with my doctor is that when symptoms that seem inflammatory occasionally become severe I take 10 or 20 mg or prednisone for a day or two (rarely longer). I might do this once a year or so, and sometimes it’s magic for me. This won’t work for everyone, of course, but I was happy to find another option.

My colo/rectal surgeon sent me to to a rheumatologist for joint inflammation/pain because evidently there is a connection between arthritis, psoriasis (which I may have on my scalp, but it is indeterminate), and ulcerative colitis.  The condition is called psoriatic arthritis.  There are new meds that are supposed to help-they're advertised on TV constantly.  I didn't end up getting those, because the rheum said I do not have psoriatic arthritis- my joints aren't inflamed enough.  They're not red or hot.  And I still have pretty good range of motion.  He said it's just regular osteoarthritis from being old.  And dang, I hoped a wonder drug might address all my issues!  But maybe it'll address yours?  BTW I saw all those ads after all these explorations...the ads did not start the whole thing, which is, of course, their intention. 

There is significant overlap in the meds used for IBD, psoriasis, psoriatic arthritis and what I believe you’re getting at, Capper, which is called IBD arthropathy or enteric arthropathy. I don’t know you or your health history/risk factors but I wonder about gout based on your description of the foot pain. A rheumatologist would typically be able to distinguish between all of these diseases and not sure what to make of all the talk about “inflammation.”  While the diseases can be complex with protean manifestations, rheumatology is not black magic. Immune mediated inflammation can have several different etiologies and some of these pathways have been elucidated. That’s how we have TNF inhibitors, IL-23i, JAKi, etc. If you saw a gastro/rheum (not even sure what that means) and they said you have some undefined disease with systemic inflammation affecting all of your organs with no recommended treatment than I would find another doctor.

I also wondered about gout.  I have never heard of IBD arthropathy/enteric arthropathy.  I will go look that up!  Ah...here is what is says:

"Enteropathic arthritis (or enteropathic arthropathy) is a type of arthritis associated with inflammatory bowel disease. The condition causes joint inflammation and tenderness in the arms, legs and sometimes spine. It also involves digestive problems. Certain medications and lifestyle changes can help reduce symptoms and prevent joint damage." (https://my.clevelandclinic.org...teropathic-arthritis)

Very interesting information there!  I'm sure there is way more on the web.  It's good to know about these conditions and connections between seemingly unrelated (western medicine style thinking) things. 

@Sara Marie posted:

I also wondered about gout.  I have never heard of IBD arthropathy/enteric arthropathy.  I will go look that up!  Ah...here is what is says:

"Enteropathic arthritis (or enteropathic arthropathy) is a type of arthritis associated with inflammatory bowel disease. The condition causes joint inflammation and tenderness in the arms, legs and sometimes spine. It also involves digestive problems. Certain medications and lifestyle changes can help reduce symptoms and prevent joint damage." (https://my.clevelandclinic.org...teropathic-arthritis)

Very interesting information there!  I'm sure there is way more on the web.  It's good to know about these conditions and connections between seemingly unrelated (western medicine style thinking) things.

Yeah I never heard of that either but I would not doubt it. I know I had that Joint issue when I had my colon/rectum but it went away after surgery.

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