Enthesitis and Ankylosing Spondylitis: Part 2
Last updated: March 2022
"Centipede to the physician: Doc, when my feet hurt, I hurt all over."1
In Part 1 of this discussion, I talked about how foot pain can be linked to ankylosing spondylitis (AS) and how the term enthesis is defined. I also discussed how enthesis is connected to foot pain. In this part 2, I will discuss how to treat enthesis and what I do to prevent pain.
How is enthesis treated?
Again, looking back to our very own Editorial Team here at AnkylosingSpondylitis.net, these are the suggested treatments for enthesis pain in the foot:2
- "Non-steroidal anti-inflammatory drugs (NSAIDs), which can help relieve pain and inflammation
- Biologic medications, which may help slow or stop the progression of the disease by blocking key processes or compounds involved in the inflammatory response.
- Corticosteroids, which may be used for short-term relief of inflammation
- Slow-acting anti-rheumatic drugs (SAARDs), which may help relieve pain and inflammation, especially in those who cannot take biologic medications"
What can you do about heel pain?
The British National Axial Spondylarthritis Society released a terrific video about how to relieve foot pain for people with ankylosing spondylitis. It is an excellent 20-minute video. I suggest that if you have this foot pain, it is a terrific place to start learning what to do to relieve pain.
I do calf stretch exercises prior to each time I walk which helps stretch that inflamed tendon. It helps to relieve the immediate pain and lessen post-exercise pain that always comes with walking.
Another thing I have done (under a doctor's supervision) is a nighttime tendon stretch. This helps as well. I was fitted for a brace that I had to wear all night that stretched my foot forward in a fixed position. The flex always felt good in the morning when I woke. But by mid-day, the relief always washed away.
One problem with the night stretch brace is that it so limited my mobility when I had it on that I could not turn on my side. Or when I woke up, I had to unstrap it to move around the house. At a certain point in life, some men tend to enjoy a stroll into the bathroom each night. Strapping and unstrapping this device was more than just inconvenient to me. After the podiatrist, I saw at the time pronounced me cured (the podiatrist who dreamed of retiring to West Palm Beach), I conveniently forgot where I placed that brace. If my heel becomes severely inflamed once again, I may have to try to find it. But I am hopeful I will not have to do that again.
I also wear my shoes in the house most of the time. Walking around in stocking feet hurts my feet because I need the arch support of my specialty diabetes shoes to prevent plantar fasciitis.
If you have this issue, what have you tried? I am all ears. I know, this is not that big of a deal. In my case, it hurts (feels awful, actually), but in the whole scheme of things, I have bigger fish to fry right now. Still, if you have this issue, I would like to know your routine? Does it work? Hopefully, all of us suffering from heel pain can learn a few things to help end the pain.
Do you notice worsening flares in colder weather?