My Experience With Recurrent Stress Reactions

I’ve lived with rheumatoid arthritis (RA) symptoms since childhood, and an official diagnosis/treatment plan since late 2016; and still, to this day, I find myself learning things about the disease and how it affects my body.

Let me share with you a quick story.

A difficult recovery from a previous injury

In September 2022, I had a tubular microdiscectomy (spinal surgery) in which, for the following 8 to 12 weeks, I could not bend or turn at the waist. I wrote previously about how that set of instructions and adaptations caused another significant injury for me — a Lisfranc fracture (breaks in 3 of the bones in my left foot, near the foot joint).

I spent 12 weeks in an Aircast waiting for those breaks to heal, and when it came time to walk on my foot again, I learned I’d developed bursitis (or inflamed pockets of fluid) between the bones that had previously been broken.1

That required very painful cortisone shots as well as special pads that had to be worn in all of my shoes to prevent pain when walking. This went on for about another 2 months, after which I was finally cleared to wear regular shoes again.

I had another compensation injury

Approximately 1 month after that, the pain in my foot came back. This time, the pain was both where one of the breaks had been and higher up on that same bone in a different location. I went back to my rheumatologist, who sent me to my podiatrist, who took X-rays and said, "What you likely have is arthritic pain around where the first break was, and a stress fracture higher up where you were compensating for the previous injury."

Another compensation injury.

How did this keep happening?

Recurrent pain in my foot

I was given 2 more months in the Aircast, followed by cortisone shots in the inflamed area thought to be arthritic, and off I went. Within a few days, I felt normal again.

That was in June of 2023.

At the beginning of September 2023, the pain at the top of my foot — same bone, same space as the last stress fracture — began to hurt. I was very observant of the pain; it hurt on both the top of the foot and the bottom, and it impacted the webs of my toes when I tried to stretch.

Before even going to my podiatrist, I went for a CT scan.

Another CT scan

The good news: The CT scan didn’t show anything concerning.

The bad news: My pain was concerning.

So, my podiatrist sent me for a second opinion, and this, friends, is where I learned about recurrent stress reactions.

Why do I get recurrent stress reactions?

Individuals unlike me who don’t struggle with malnutrition from Crohn’s disease, arthritis, or steroid dependency from adrenal insufficiency tend to have stronger bones, and it takes an accident or specific movement to cause an injury like the ones I’ve been experiencing.

Now, is it possible that I have another stress fracture in my same bone? Yes, it is, because my bones are sort of soft, I have osteopenia, and I have a bunch of other adverse effects working against me. But what’s also possible is called recurrent stress reactions — stress reactions to my bones which cause inflammation and possibly as much pain as small breaks. They are indicating that my bones need more support than I’m giving them.

Seeing a bone health specialist

This doctor recommended I find a rheumatologist who works in tandem with a bone health specialist, so this is my new quest: to successfully find this set of doctors that, unlike the referral I was given, aren’t booking out 9 months in advance.

Have you heard about or experienced bone stress reactions? How have you managed them?

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