Do your feet hurt?

One of the most popular posts on our Facebook page is an image of aching feet stating:

Fibromyalgia Symptom
Fibromyalgia also attacks the feet causing pain and inflammation making walking and standing very difficult.
Sometimes the extent of the pain is so overwhelming that wearing shoes is extremely painful.

Seeing this insight made me wonder about the link between fibromyalgia and foot pain. Several studies seem to confirm there is indeed a link.

• Ginevra Liptan proposes that “inflammation of the fascia is the source of peripheral nociceptive input that leads to central sensitization in fibromyalgia.”
• Fascia is a highly sensitive, thin layer of connective tissue that holds all our body parts (organs, nerves, muscles) in place. Plantar fasciitis is a common cause of heel pain, and it’s that fascia across the bottom of our foot connecting our heel bone to our toes where the inflammation – and resulting pain – occur.
• Myofascial pain syndrome, characterized by those small, hard knots where it feels like a muscle has pretzeled itself – also called trigger points – is often misdiagnosed as fibromyalgia or occurs along with fibro. Again, it’s all about the fascia, so Dr. Liptan’s proposition makes sense and may be corroborated in the 2016 study by Maria Tornero-Caballero and colleagues, in which they found foot pain to be present in more than 60% of the patients surveyed.
• Patricia Palomo-Lopez and her colleagues concluded that “Impaired foot and general health-related quality of life was observed in women who suffered from fibromyalgia compared to healthy matched women,” in their 2019 study. They recommend paying more attention to “foot-specific health-related quality of life in women with fibromyalgia.”
• A 2011 study published in Arthritis Research & Therapy found that nearly half of the 202 patients with fibromyalgia in their study had pain in their feet.

Hmm. Who wonders about so many of these studies being led by women?

So many things can cause our feet to hurt, from our shoes to our activity (or lack thereof) to injuries and more. Having fibromyalgia does not mean that your pain will be only in your feet (if only) nor does having foot pain mean you have fibromyalgia. But with fibro, there’s so much pain anyway, figuring out if something else is causing the pain is a good idea.

In fact, any new pain or symptom should be clearly evaluated
rather than just assuming it’s another fibro complication.

The foot is made up of 26 bones connected by joints, muscles, tendons, ligaments – and fascia – and our feet bear all of our weight when we’re standing and walking. Common foot pain issues include plantar fasciitis, bone spurs, bunions, and fractures (ouch, I stubbed my big toe on the table leg again!). Diabetes can affect the blood flow to the lower extremities, which can lead to neuropathy. Many of these conditions can be addressed with medication, surgery, and lifestyle changes. Check with your doctor to see if there is an underlying cause to your foot pain.

The pain in our feet with fibromyalgia, however, may be more difficult to assess and to treat. So, what can you do? Here is a list of suggestions.

• Wear the right shoes – if at all possible, choose comfort over beauty.
• Ladies, if you feel that you must wear heels, keep them as low as you can. A one-inch heel can be every bit as attractive as that stiletto. (Well, maybe not, but you will pay for the stilettos later.)
• Maintain a healthy weight.
• Be as active as you can, especially out in nature.
• Soak your feet. A warm soaking solution with Epsom salts does wonders.
• Alternate ice and heat on your feet.
• Stretch and massage your feet. If you can afford it and a practitioner is available in your area, try reflexology.
• Acupuncture was amazing for me.

Let us know in the comments below if foot pain is an issue for you and what you’ve done to relieve it.

Cindy Leyland is a struggling perfectionist whose superpower is bringing calm to chaos. Her daytime (and sometimes nighttime) hours are spent working as the Vice President of Operations and Fund Development at the Center for Practical Bioethics, whose mission is to raise and respond to ethical issues in health and healthcare. She serves as a Board Member for The Pain Community and LivingLove International, both of which share her life missions of passion, compassion and peace. She’s the spoiled wife of Dave and a grateful mom, stepmom, mom-in-law and Grandma.

By Sarah Ann Shockley

So many caring people are anxious to help their friends, relatives, and co-workers who are living with chronic pain that they are quick to offer recommendations and words of advice. But is more advice what people in pain really need?

I would suggest, most respectfully, that it is not.

Chronic pain is a complex condition that is not easily remedied by typical treatments, supplements, or exercise routines. While we appreciate everyone’s sincere desire to help, what we require usually isn’t more advice. To support us in our healing, here’s what we would ask for:

1. Respect

Please understand that everyone in chronic pain is doing our utmost to heal. We are not malingering or making it up or exaggerating. We are not lazy, or melodramatic, or trying to get more attention by being ill. In fact, most of us understate our situation in order not to make others around us feel bad. And please respect our intelligence and tenacity. If we have been in pain for any length of time, believe me, we’ve tried most of the treatments, both alternative and traditional, that you have ever heard of. And then some.

2. A Free Pass

Just being in pain is hugely exhausting, and we are using most of our available energy and personal resources just to get by. Getting out of bed in the morning and lurching through another day may be all we can manage. The fact that we found the energy and wherewithal to make one important phone call or fill out a necessary medical form may be a major triumph for that day.

3. Understanding That We Can’t Be Normal

Most of us are sleep deprived and under a great deal of stress trying to handle work and parenting and relationships and self-care and medical demands while in pain. We don’t have any reserves left over to participate in life at normal levels. We are not being selfish or acting like victims if we have to say no to a lot of things. We are not doing this to make you angry or to get attention. Just having a conversation may take all our available energy. Imagine having pain in your body and the flu and jet lag and severe sleep deprivation all at once. It can be like that most of the time for us.

4. Allowances for Our Cylinders Not Firing

People in pain simply don’t have the brainpower that we normally would. All our available stamina is going into healing and into living with pain. There doesn’t seem to be a lot left over for our noggins to draw on. We forget things easily, we can’t find the right words sometimes, and sometimes our brains go offline for a few moments and we simply blank out. We have trouble focusing and we may not be able to make sense of complicated instructions. Actually, we may not be able to follow any instructions. Just imagine finals week at college. You know, the last day, after not sleeping all week? Remember how brain dead you felt? Some of us feel that way every day.

5. Compassion and Trust

What we really need from you is compassion, understanding and trust that we are already doing our best and to refrain from asking us to hurry up and get out of pain. We need you to not be so scared of your own pain that you refuse to allow us to experience ours or feel like we have to hide it and not speak of it. For whatever reason, we are still in it for the time being and, even if we wanted to, we can’t move out of it to make you feel better. Believe us, we certainly would if we could. We wish we could be more available to you and to our own lives, but we can’t at this time.

Instead of trying to help us by offering methods for healing, we are in need of you simply being with us, being there for us when you can, and trusting us to find our own individual path through pain. We will let you know if we need more than that. We appreciate your loving-kindness, your gentleness and your compassion most of all, and these, really, more than any words of advice, are the most healing things you can offer anyone in pain.

This article was first published on ProHealth.com on July 6, 2018 and was updated on June 13, 2021.

A native of Connecticut, Sarah Anne Shockley is a multiple award winning producer and director of educational films, including Dancing From the Inside Out, a highly acclaimed documentary on disabled dance. She holds an MBA in International Marketing and has worked in high-tech management, as a corporate trainer, and teaching undergraduate and graduate business administration. As the result of a work related injury in the Fall of 2007, Sarah contracted Thoracic Outlet Syndrome (TOS) and has lived with debilitating nerve pain since then. She has been a columnist for Pain News Network, is a regular contributor to The Mighty. She is the author of The Pain Companion: Everyday Wisdom for Living with and Moving Beyond Chronic Pain and other books on living with pain, and currently resides in the San Francisco Bay Area.

Editor’s Note: Suzan’s tips may be especially helpful after living this past year with the pandemic.

By Suzan L. Jackson

We’ve had a tough year with a lot of unexpected crises, creating emotional stress, financial problems, and the need for fast action. Most recently, when one son was assaulted in Europe and had to return early from a study abroad program, a family member commented on how well we coped with these kinds of emergencies, how we stayed calm and did what had to be done. It made me realize that 16 years of living with chronic illness has taught us how to go with the flow when things go wrong.

I have learned to expect the unexpected while living with ME/CFS myself, plus for many years having two sons with the same disease and one of them also battling tick infections. The only thing you can count on with these illnesses is their unpredictability. I’ve lost count of the number of times I’ve had to cancel time with friends at the last minute or couldn’t go to my book club or our whole family had to cancel a trip. It’s never fun, but you do get used to the rollercoaster life.

Our sons have grown up this way, learning to roll with the punches and change plans at a moment’s notice. They’ve learned to bear the disappointment of missing out on something but also to make the best of a bad situation. When my oldest son relapsed from the flu and we had to cancel our usual Thanksgiving trip to see family, we focused instead on the rare treat of being in our own home for a holiday.

When we recently got that unexpected phone call from our son in Italy, of course my husband and I were very upset. With so much experience of crises under our belts, however, we quickly moved on to what needed to be done. I contacted our son’s concussion specialist (he’d had one before), a caring doctor who replied immediately with advice for our son and assessed him long-distance with online concussion testing software. We spoke with our son every day to assess his progress (or lack thereof), and when it became clear that he couldn’t participate in any activities, we made arrangements to bring him home early.

Back home the next day, our son kept thanking us for acting quickly and bringing him home. We got him into the concussion specialist immediately and followed the instructions for “brain rest.” Even at that point, our son was remarkably positive about his experience. Yes, a horrible thing had happened to him, and he missed two-thirds of the program he’d been looking forward to…but he told us that his first week there had been amazing, that he’d seen and done so many wonderful things and learned a lot.

Now, a month later, he is almost fully recovered. He can think clearly, has returned to normal activities, and his headaches are almost gone. His professor is working with him on an individual project to get credit for the course. And we are hoping that the travel insurance (we never travel without it!) will come through with reimbursement for us soon.

In the midst of all of this, I realized that living with chronic illness has made us emotionally stronger and taught us to adapt when things go wrong. All of those unpredictable days, weeks, and months taught us how to cope with uncertainty and crisis. Here are some tips for when the unexpected happens to you:

Take time to grieve. It’s important to acknowledge and feel the raw emotions that come up when something horrible happens. You can’t move forward until you allow yourself to grieve. It’s OK to cry and let go and feel awful for a while. In fact, it’s healthy and necessary.

Start moving forward. Once you experience that anger and hurt and sadness, it’s time to start thinking about what you can do to help. Even in our case, thousands of miles from our son, we could contact the doctor, talk to our son frequently (he was very upset at first), and begin thinking about what came next. Taking steps to ameliorate the situation will also help you to move forward emotionally, as long as you have first dealt with the grief.

Face one day at a time. Try to think about what you can do right now, today, to help with the crisis. It’s best not to worry too much about what comes next week or next year because that can lead to ever-worsening anxiety. Instead, focus on today – or even just this minute. Taking things one step at a time will help you to stay calm and able to help.

Seek support. A few days into our crisis, I realized I really needed someone to talk to (besides my very supportive husband). I turned to my online support group of parents whose kids are sick. True, this incident had nothing to do with ME/CFS or the other chronic conditions covered in our group, and it was the recovered son who was injured, but I knew they would “get it.” And they did. I vented out all of my concerns and anxiety to our private group, and – as always – they responded with compassion and understanding. It was just what I needed. Try to find just the right source of support for your situation, whether a friend, support group, or therapist.

Unexpected crises are not just a part of life with chronic illness; horrible things happen in every life at one time or another. When these things occur, though, our lives of chronic illness have an unexpected silver lining. We’ve been training for this ever since we got sick! You can use the skills and coping mechanisms you’ve learned from your chronic illness world to help you through whatever else comes up. As an added bonus, we can also help our loved ones to find their way through whatever life throws at them. Hang on – it’s going to be a bumpy ride!

This article was first published on ProHealth.com on August 26, 2018 and was updated on June 14, 2021.

Suzan Jackson, a frequent ProHealth contributor, is a freelance writer who has had ME/CFS for more than 20 years and also has Lyme disease. Both of her sons also got ME/CFS , but one is now fully recovered after 10 years of illness and the other was in college, still with ME/CFS plus three tick-borne infections, when this article first posted. She writes two blogs: Living with ME/CFS at http://livewithcfs.blogspot.com and Book By Book at http://bookbybook.blogspot.com. You can follow her on Twitter at @livewithmecfs.