Sore feet and hands?

September 6, 2024 11:02 PM

Every morning after I get out of bed, I hobble around for a while because my feet are sore and tender. It's still present throughout the day, to a lesser degree. I also feel this in my hands, particularly when subjected to a firm handshake or pick up something heavy. Looking for some possibilities to run by my doctor.

I'm 46/m. The soreness in my feet has been going on since my 30's, but in the past two years has grown much worse. It only used to happen if I did a lot of walking the day before, or spent a lot of time barefoot on hard floors. Now it's constant. Indoor slippers and soft-soled shoes help, but don't stop it.

Doctor Google turns up a few ideas, but my symptoms don't clearly match.

• Plantar fasciitis (at least, for the foot problem). My issue is not a sharp pain, nor is it in my heel. It's soreness in the ball of my foot. It feels like walking on a bruise.
• Peripheral neuropathy. But there's no numbness, no tingling, no loss of sensation. I wouldn't call it weakness, either.

I will bring this to my PCP, but I want to come armed with the right questions to ask. Without that, 100% he'll be dismissive and tell me to take ibuprofen without further diagnosis. I'm largely sedentary; if the prescription is just "be more active", I'm happy to hear that.

posted by qxntpqbbbqxl to Health & Fitness (24 answers total)

Best answer: It does sound like plantar fasciitis though, at least for the feet, there might be something else going on as well. Do you have flat feet or high arches? People with flat feet or high arches often get plantar fasciitis. Try a whole bunch of stretching, especially feet and toes, but also calves and the rest of the leg. Icing, soft braces, and toe spreaders, along with low impact exercise (yoga, swimming and weight training) have helped mine.
posted by Sar at 11:31 PM on September 6 [2 favorites]

Best answer: I have a similar issue and it resolves with movement, better hydration and dietary changes. Gluten seems to be a trigger for joint and tissue pain for me, I almost always feel better whenever I am not eating it. Movement means stretching and massage but I’ve found that doing some simple strengthening exercises for my feet has also been really helpful. Lastly, if you are sleeping in a way that puts pressure on your hands and feet, it might help to rethink how you are sleeping. My partner sleeps with clenched fists and routinely has sore hands when waking up. If I sleep in a bed with the sheets tucked in tightly, my feet and ankles are not very free to move and are sore on waking. I know you asked for ideas to take to your PCP but maybe these suggestions could be helpful in the meantime? Hope you get some relief.
posted by yogalemon at 11:49 PM on September 6 [1 favorite]

Best answer: Have you had any blood tests to rule out rheumatoid arthritis, or any other auto-immune disorders?
posted by itsflyable at 12:07 AM on September 7

Best answer: When you say sore and tender, is the feeling more in the muscles, the skin/surface, or something else? Is it like an dull ache or a burning sensation?

Are your blood glucose levels and blood pressure good? Does this happen more after you get up from sitting a lot, or after sustained physical activity (like long walks)? Do you ever notice the skin on your hands or feet seems darker than usual, or more sensitive to heat (like if you're taking a shower and the water is hot)?

It does sound like being more active is a good place to start. If your doctor dismisses, I'd try insisting on a referral to a rheumatologist - or I'd get a second opinion. Say it's getting to the point where it's really interfering with your day.

(By the way, does ibuprofen make a difference?)
posted by trig at 12:52 AM on September 7 [1 favorite]

Best answer: Agreed that for the feet it still sounds like plantar fasciitis, especially because of the barefoot and hardwood floors making it worse thing. Mine is also not a sharp pain and is much more like walking on a bruise. I have extremely tight hamstrings, hate shoes, and am mostly sedentary. All the maintenance things to do for PF helps me, I’m just usually not going to do those things. For me, calf stretches and anything to help my hamstrings are key, including building up muscle to improve my gait and posture. I’m going to buy a slant board soon to help stretch my feet more easily and with more stability.

My mom’s PF seems to have started similarly to mine and has progressed past your experience, into a much more consistent discomfort as she’s hit 70. The thing that helps her the most is to take gentle regular walks up and down a hill near her home, with very supportive shoes that have custom insoles from her podiatrist. Also she never goes barefoot. She really likes Oofos brand flip flops for home shoes, and I agree they are excellent. So I suggest for you, since you (and I) are self admittedly sedentary, to try your best to work in a gentle walk most days of the week. There is basically nothing more all-over beneficial to long term comfort and health than being more active, and we have to stretch our feet somehow! And invest in much more supportive home shoes so it’s really easy for you to not do barefoot on hard floors.

The hand thing sounds like a completely different issue. I mean, it might all be connected through some kind of autoimmune thing or other mystery ailment, as suggested above. But I suspect the symptom treatment will be different. I think you could do some careful exploration of your hand pain and bring those details to your doctor. Make a couple diagrams of your hands and label areas and types of pain as you experience them. Go through a full range of motion for all your joints and pay close attention to any tightness, grinding, or other odd sensations. Do the same for your arms and shoulders because there is probably some kind of referred pain thing mixed up in there too. Hands are extremely complex areas of the body, with so many tendons and joints and layers of tissue all doing fascinating different stuff. So it will help if you can really detail the specifics of your symptoms. See if warm or cold compresses provide relief or not, or help stave off more intense pain. Because you mention a firm handshake causing issues, I wonder if it’s to do with a trapped nerve. But it could be many, many things given the vagueness of your description.
posted by Mizu at 12:57 AM on September 7 [2 favorites]

Best answer: While you're ticking things off the suspect list, I'd also ask if you can be investigated for vascular issues, especially with a sedentary lifestyle. Do your feet and hands feel cold to the touch even when your body is warm?

I think with something like this and a historically unhelpful PCP, the thing to do would be to request referrals to specialists (if that's appropriate) or go straight to the specialists themselves and ask for investigation.

Don't be afraid to let the doctors know how much this is impacting your daily life. It will help them measure the severity of the problem. This is a chronic, painful, daily issue which is getting worse. Don't let them dismiss that.
posted by fight or flight at 1:14 AM on September 7 [2 favorites]

Best answer: How about just plain old osteoarthritis. Here is a symptom list from the Mayo Clinic - it largely overlaps with what you describe. They also provide some suggestions for self care (ie things you can try at home without seeing a physician) that includes movement, heat/cold & diet.

The Arthritis Foundation (US) has some diet recommendations - turns out some foods are inflammatory and can aggravate or exacerbate arthritis.

Good luck with all this.
posted by lulu68 at 1:49 AM on September 7 [5 favorites]

Best answer: Are your hands and feet **stiff** as well as sore? For how long? If yes and for a while an inflammatory arthritis might be considered
posted by cotton dress sock at 2:37 AM on September 7 [1 favorite]

Best answer: I get this too. I've had it most of my life, certainly all of my adult life. (I've also had hardwood floors most of my adult life, so it's more noticeable.) It's not plantar fasciitis, it's not rheumatoid arthritis, it's not normie arthritis. Always for me for the first few minutes of waking up, then it goes away. Also happens if I've been lying down on the couch for a prolonged time, then get up.

I think it's fluid. I'm not using my feet while I'm horizontal, and I'm mostly a back sleeper so there's gravitational pooling in my heels. Pretty sure that's what's going on otherwise why go away with a small amount of vertical activity?

Anyway, here's some stuff that helps:
Wiggling my feet/squeezing my toes together before I get out of bed.
Pumping my legs in a bicycle a few times (also while I'm still lying in bed).
Smushing the soles of my feet together a few times.
A plush rug beside my bed to take my first little steppies on.

Doing that means I only have a minute of hobbling around instead of several minutes of hobbling around. Also have a pair of house crocs which it helps to slip on if it's worse one day for some reason.

Can't help you about the hands though. I have chronic hand weakness secondary to a neurological condition that I'm pretty sure has zero to do with the feet thing, since the feet thing always dissipates quickly and every other symptom of my chronic neuro thing is, well, chronic.
posted by phunniemee at 2:45 AM on September 7 [1 favorite]

Best answer: I’d skip straight past your primary physician (while keeping them informed, of course) and see a physiatrist. That’s a physician in the specialty of physical medicine and rehabilitation. In my experience, both as a physician and as a patient, physiatrists are the best doctors for the diagnosis of a musculoskeletal complaint.
posted by ocherdraco at 4:47 AM on September 7 [1 favorite]

Best answer: If your feet and hands are stiff as well as sore upon waking, and improve after moving around a bit, that's one of the warning signs of inflammatory arthritis. Definitely mention that your hands also have symptoms - it's possible that you have two separate things going on, but you probably want to get bloodwork to look for inflammation markers and signs of RA (and possibly a referral to a rheumatologist.)
posted by restless_nomad at 4:55 AM on September 7 [1 favorite]

Best answer: If it's the ball of your foot be on the look out for metatarsalgia which is different (but related to) plantar fasciitis. "Walking on a bruise" is a perfect description.
posted by seanmpuckett at 5:54 AM on September 7 [1 favorite]

Best answer: I had something similar that sounded so similar to plantar fasciitis but wasn’t and it turned out to be that my hamstrings were really tight. Stretching therapy and PT helped a lot. Stretches like these were particularly helpful.

I also started wearing Birkenstocks around the house instead of going barefoot.
posted by kate blank at 6:14 AM on September 7 [2 favorites]

Best answer: Doesn't sound like my plantar fasciitis fwiw. Sorry, I don't know what it might be though I'd follow up seanmpuckett's and phunniemee's ideas with a physiatrist as ocherdraco suggested.
posted by anadem at 7:07 AM on September 7

Best answer: Have a Google of Morton’s Neuroma. It’s best diagnosed by ultrasound, but have a look at the symptoms and see if they fit. I hope you haven’t got it, because I have and it sucks. :(

I would also recommend getting a referral to a rheumatologist, as mentioned above. Sounds like the beginning of rheumatoid arthritis, possibly.
posted by Salamander at 7:07 AM on September 7 [1 favorite]

Best answer: If it's on both side and right after you get up in the morning, please get tested for autoimmune issues. Also get a FULL blood panel done. It could all be osteo related but a couple of things you said give me cause for concern. Please get a full check up.
posted by WalkingHorse at 9:09 AM on September 7

Best answer: I had similar symptoms and sought care from a podiatrist, who diagnosed arthritis. After x-rays, he gave me an injection of hydrocortisone, which gave relief for 7 months. Eventually I’ll need surgery for permanent relief as the shots I’ll have diminishing returns.
posted by coldhotel at 9:38 AM on September 7

Best answer: Welcome to myofascial stiffness and pain in middle age. I’m terrible at taking my own advice, but daily stretching and getting acquainted with the variety of foam rollers will become part of your life. There’s a lot of books on stretching for over-40 folks, I have this one.
posted by matildaben at 10:14 AM on September 7

Best answer: If metatarsalgia rings true, I highly recommend sticking felt pads in your shoes (I use these in the 1/4 inch thickness, but they all look pretty similar). Pretty sure you're supposed to stick them to your feet but I know me and I won't, so they're stuck to the bottom of my insoles.
posted by smangosbubbles at 11:16 AM on September 7

Response by poster: Thank you all for your thoughtful and kind responses! I'm excited to have some exercises to try, some conditions to read up on, and great suggestions for the right kinds of specialists. I'm going to keep following this thread for a bit and I'll post a follow-up in six months or so since it's always interesting to see how things unfold. It's comforting that many others have similar issues, although I am sorry to hear that your feet also suck :)

Answers to questions in the thread.

Are my hands and feet also stiff? No.

Have I had a blood test? Not recently. A test a few years ago didn't reveal anything outside normal ranges. Not a full panel, though. Blood pressure tends to run on the low side of normal.

Does ibuprofen help? I don't think so, but I haven't tried for this specifically. Just took 600mg; let's find out.

Do I have flat feet? Flat and wide.

Do you ever notice the skin on your hands or feet seems darker than usual, or more sensitive to heat? No

metatarsalgia... This helps me describe it better! The soreness is spread out over the metatarsal region. The hand pain is in the corresponding metacarpal region.

Vascular issues... do your feet and hands feel cold to the touch even when your body is warm? In the winter, yes.

Is the feeling more in the muscles, the skin/surface, or something else? Is it like an dull ache or a burning sensation? Muscles and connective tissue inside the foot, not on the surface. When I'm sitting, I feel it as sort of a "glow" not dissimilar to how muscles feel after exercise. When I put pressure on it, it feels like a bruise, except inside my foot.
posted by qxntpqbbbqxl at 12:10 PM on September 7

Gout is something that is easy to test for - high uric acid in your blood - and it presents in odd ways sometimes. It is nice to have several UA measures over time, but there are cheap meds (allopurinol) they can start you on while deciding if that is the issue. It is a form of arthritis and can be managed well if properly diagnosed. I was given a probable diagnosis by a Orthopedist and put on Allo by a rheumatologist. If your regular doctor won't investigate, I'd see if you can get an appt with an ortho. Rheumatologist can be very busy.
posted by soelo at 2:21 PM on September 7

Consider that diabetes or pre-diabetic conditions can lead to numbness in feet and hands which can manifest as dull pain.
posted by RandlePatrickMcMurphy at 2:59 PM on September 7

Nearly all of the above need to be explored, possibly with the exception of Morton's. Mine certainly didn't present like that, and from talking to several people that have or have had it, doesn't/didn't present like that with them either. Given that your hands are involved, it's pretty doubtful.

Salamander, surgery sucks, but my foot was so painful, even after exercises, drugs, and injections, that surgery was the only option. One and done, and I never looked back.

Again, make sure you stress to your PCP that this is seriously affecting your quality of life by impacting your work and sleep. Somehow docs seem to think work is important, and they sympathize with people who can't sleep.
posted by BlueHorse at 3:53 PM on September 7 [1 favorite]

In addition to all of the above, I'll plug that if you're just walking around town and indoors, the supportive foam of your shoes will wear out long before they start to look worn down. If you do have some form of plantar fasciitis, an easy fix is to get new shoes more frequently than you have been.

If you have a pair of beaters you've been wearing for years, it's probably time for them to go.
posted by matrixclown at 2:49 PM on September 8