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Lisa, MSN, FNP-BC, CCRN, Nurse Practitioner
Category: Health
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Experience:  Board Certified Family Nurse Practitioner
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I have had a problem with my foot, i woke one day last week

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I have had a problem with my foot, i woke one day last week and my foot was swollen and couldnt walk. I had a doctor come out who prescribed anti inflamatories,and within a couple of hours i was fine. I have been going to the gym 4 x a week and taking up running on the other day (so 5 days of exercise and i walk for over an hour as well each day) and when had problems with my hip, after seeing 2 doctors who both reackon it was a bursa and due to my intense gym routine, I also had problems with my wrist which was due to a personal training session, where i used too much weights. since only going to the gym once a week i have been fine apart from my foot last week. my question is that i had a blood test last week which came back with a liver enzyme sligtly high cud be down to medication but another one cud indicate Rheumatoid arthritis,but if it was rheumatoid arthritis they would expect other tests to be high but they were normal,im just terrified it is rheumatoid arthritis, pleasehelp


Thank you for writing in today. I want to provide you with the best possible information, so I do have a question. Do you know any more information about your lab tests? For example, which liver enzyme was elevated and how much. Also, do you know exactly what the other test were that were done? If you don't have this information, this is fine; however, I just wanted to ask. Please let me know. Lisa

Customer: replied 7 years ago.
im not sure to be honest, they think it the liver enzyme could just be because i have been on medication- the ant inflammatories and ibuprofen, its more the other test im scared oof. they think the tests which with rheumatoid arthritis would come back high have come back normal, but their is just one which is slightly above normal and with the pain in my foot thats what they are concerned about but they siad it could be nothing. i havent had any problems since, i walk a lot have been to the gym etc and no problems. i need to have anotther blood test in 2 weeks, its just i have got a lot of other things going on at the moment, in the last week have started with depression after a relationship finished and family problems. i just cant handle this
I just want to ask a few more questions. A simple yes or no would be great. I will explain why I am asking these questions in my answer. Do you have any of the following: fatigue, loss of energy, lack of appetite, low-grade fever, or stiffness. Is your discomfort worse in the morning and after periods of inactivity? Are the joints also red? Do you have any joints that are painful on both sides, meaning both feet or both wrists? Any family history of Rheumatoid Arthritis?
Customer: replied 7 years ago.
Hi Lisa, can i first say thank you for your help. No Fatigue, loss of energy. Lack of apetite happened after my foot problem, basically when i split up with my partner which is more due to the depression(i have suffered depression before) no fever or stiffness, the problem with my foot has only happened once. My hip can be after going to the gym or after not going. Since going to the gym less and stopping running my hip has been fine. No pain on both joints, it was one foot and one wrist. They have never been red, my foot did go a funny colour but not red. Their is a family history of arthritis but not rheumatoid arthritis. My mum who is 66 has a knee replacement and my nan who is 91 needs a hip replacement, but it is normal arthritis. im just panicing that every ache is a sympton of rheumatoid arthritis.
Thank you for responding to all the questions. I know questions are a bit of a hassle; however, this information is very helpful. Well, Rheumatoid Arthritis is diagnosed based on a number of things, labs, diagnostics, and symptoms. In addition to labs, symptoms are particularly important. Those aforementioned questions are representative of rheumatoid arthritis (RA) symptoms. In particular, the early morning and bilateral, red joint discomfort are particularly concerning for RA. You do not present with those symptoms. This is a great sign. Also, your blood work was not suggestive of RA. I suspect they checked your Rheumatoid Factor (RF) and Antinuclear antibody (ANA). These tests are not always elevated in RF. However, in 80% of patients with RA, the RF will be elevated. The ANA is also elevated in other autoimmune disorders too. Since you don't have the classic symptoms and have good blood work, I think you can relax about the RA. This is most likely related to your vigorous workout routine, particularly since you just started running. For what it's worth, I have seen these types of complaints and injuries dozens of times. In general, I don't share personal information; however, I am a runner, and I too had a similar foot complaint. I awoke one morning swollen and thought my foot was broken. I too had to use anti-inflammatory and reduce my workout routine. After a number of weeks, the problem resolved. My case is similar to the dozens of cases I've seen and cared for over the years; however, the reason I wanted to mention my personal experience is because I know first hand that the discomfort can be very severe, and it makes a person want to worry about other possible problems. At any rate, I think you'll be fine with some rest and anti-inflammatory treatment. When you do start exercising again, ease into it slowly. Also, I'm sorry to hear about you and your ex-boyfriend. Breakups are never easy for anyone. I hope you're leaning on all your girlfriends for support. I hope you start feeling better soon. If you have any additional questions or concerns, please let me know. Lisa
Customer: replied 7 years ago.
thank you for your answer so do you think that if one test could indicate RA but the other ones are normal that it could just be going to the gym too much and not be RA?????. I have gone from not doing exercise and being overweight to losing 5 stone in 2 years which i started using an exercise bike 5 x a week when going to the gym 4 x and running on my night off. thank you for your help again, i have been getting myself all worked up about it. im hoping the next blood test will come back normal and i suppose just want reassurance
I suspect this is NOT rheumatoid arthritis. Your blood work was probably negative for RF and ANA. Also, you don't really present with the joint symptoms that we see with RA, such as the bilateral, red joint or early morning and inactive stiffness. This is most likely from your exercise routine. I also suspect that your blood work will normalize, particularly your liver function once you taped off the anti-inflammatory meds. When you do ease into activity, you can consider using some cardio, such as the elliptical. Elliptical work is lower impact than running, and it still provides good cardio. I hope this helps. Lisa
Customer: replied 7 years ago.

thank you for your help. if i had any questions in the it possible to request tyhe question being reffereed to yourself?

thanks again, you have put my mind at ease!

You are very welcome. I am glad I could help. Yes, you can always request me in the future. In your postings, you can specify the request. Have a great night. Lisa
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