RA and Recurrent Stress Fractures

I have previously written about an initial injury (a herniated disc), which led to a very difficult surgery and recovery, and then how adaptations made to move and exist during that recovery led to another injury (3 fractured metatarsals in my left foot) and then how that recovery led to ANOTHER challenge — bursitis between multiple bones in that same foot.

What a saga, right?

The comfort of knowing we're not alone

Several community members commented on those articles, sharing such similar stories, saying that they felt seen and heard in my sharing this seemingly ridiculous journey I've been on. To be honest, all of those comments made ME feel less alone, AND made me realize that what has happened to my body is in fact similar to many experiences other rheumatoid arthritis (RA) patients have had, too.

I can't tell you how much comfort this brought me.

In fact, when I recently started having pain in that same foot again, I thought about this community.

Had I developed another stress fracture just from walking?

I thought about ignoring the pain until it got much worse, and then I remembered how many of you shared that you'd tried that approach, and it in fact was majorly unhelpful in the long run.

So I went to see my doctor.

And we talked about the likelihood that I'd developed another stress fracture in the spot near where the old breaks had healed, leaving my bones weaker and more susceptible to repetitive stresses like... walking on the hardwood floors in my home.

How was it possible that I could have a break in my foot from literally just walking?

Our increased risk of stress fractures with RA

I started doing some research and learned that it is, in fact, more common for patients with RA and other rheumatoid conditions to get repetitive stress fractures. The underlying cause tends to be a combination of things — the corticosteroid therapy we receive, the stiffness of our joints, the way the inflammation in our body has affected our joints, and osteopenia or osteoporosis.¹

Ultimately, all of these things together do make us more susceptible to stress fractures, especially in areas where there's not a lot of padding for our bones, a lot of repetitive movement, or where there's been healing (and adaptation) due to old injuries and surgery.

How frustrating!

Learning recovery techniques for my injury

The advice I got from my doctor? (Please note: every injury and RA patient is different. I'm sharing here suggestions that I was given by my doctor, but please don't apply any of these without consulting your own doctor first.)

For my specific areas of injury at this time (the metatarsal bones in my feet), it's best to wear supportive shoes both inside and out of the house — a.k.a. always. Around the clock. No more walking around barefoot. Also — to ice. When there's any sort of pain in my feet, use ice for 20 minutes on, 20 minutes off. Additionally, use a firm ball like a golf ball as tolerated to roll out the bottom of the foot each night so there's some movement and decompression in the area to reduce swelling.

Learning all of this has changed my perspective a little on my body, and how it literally walks through life.

Taking one step at a time

There are many things I need to be more careful of. I'd like to see my orthopedic doctor much less than I have this past year, and I also recognize that the odds are not in my favor for that to be the case.

So, I take one step (literally) at a time.