I am in SO much pain. Surely this can't just be because I am fat?

[herewegoroundthebastardbush]

This is really a question either for the medical or for my fellow fatties - I'm 5'6, about 14 stone (😬) and 39. I used to be around 10 stone. put on a lot of weight very rapidly about 5 years ago when my mum died, and ever since then have struggled with binge eating and the weight has continued to creep up.

So the past 6 months or so, I'm in horrible physical pain much of the time. It started with my knees, which have never been great since I went through a phase of running to work on concrete in my 20s (idiot). But now it's not just the odd twinge, I'll be literally limping and whimpering and climbing the stairs is murder. I've also developed a horrible permanent pain in my right foot which the internet tells me is plantar fasciitis. And I can't ever seem to get comfortable in bed as whichever way I lie seems to pull the base of my spine out of alignment and it feels strained.

I have a busy life, two small kids and one is at nursery and the other at school, so every day after work I have to do a very brisk march march up the road to nursery and then turn and walk very fast back to school to get the eldest (about 40mins fast walking - or jogging if im late!) all told. I've started to dread it with a mortal fear as I am in SO much pain - some days I'm literally limping and gasping with it, but I can't stop because obvs then no-one would pick up my kids (partner has the car as works in a different city). That's the low point of my day, but just getting out of bed and standing up in the morning is horrendous too, it hurts so much and I literally limp like a comedy pirate for the first 20 mins of the day my foots so bad.

The one time I went to the GP about my knees, she did the head tilt and talked to me about my weight (didn't even examine my knees), and that aches and pains are more frequent as we age so its important to take care of our weight to reduce that. I agree I am too fat and need to lose weight. I am trying. But I see people far fatter and older than me who don't seem to be in total agony as they walk around!? So is this normal and fixable by losing some weight? Or is there something I should be worried about?

You didn’t read the whole post, did you?

I have had plantar fasciitis myself, and I hate to say it but very little works (sorry!). It seems to go when it is ready. However, I would recommend doing some calf stretches, then get a tennis ball or a bottle of water (freeze it first) to roll under your foot.

Weight won't help joint issues, but a Dr should still be looking at what else it could be, to dismiss your pain without checking anything out is pretty poor. But equally, loosing some weight would take the strain off your knees etc so be worth trying to do this (not easy I know).
I know you said money is tight but a pysio or osteopath may be able to help, and offer you some exercises you could do at home after the initial consultation. I would also take some jointace tablets (amazon usually do a good deal) to see if they help (can take 3 months to work). In the meantime, ibuprofen is good for joint pain as is the ibuprofen gel (chemist own brands work just as well as the others).
Finally, take a look at the shoes you wear, if they are very flat with little or no support this will make Plantar way worse so look at insoles.

I’m not a doctor or a medical
professional but I’m really disappointed to hear your GP has been so dismissive. You are not morbidly obese so your weight really shouldn’t be the sole focus when addressing this issue. I would go back to the GP and lay it on thick. Get as upset as you can, don’t hold back, cry, explain your financial worries and make sure you say this is affecting your mental health. I’m not usually one for suggesting things like this but sadly GP’s this days are very reluctant to refer or take general pain seriously. The only time I’ve managed to be taken seriously was when I was pregnant and very hormonal and emotionally and struggling with debilitating SPD. I cried and said it was affecting my mental health (which was true but I would have normally had a more stiff upper lip approach). They really can’t ignore you as easily if you let it all hang out. As I say, you shouldn’t have to do this but sometimes it’s necessary.

When exploring whether the foot pain was PF I did notice al my shoes have worn really unevenly deeply at the middle heel - which is apparently a classic sign of overpronation!

I get this though I don't have your pain - did get occasional knee and hip pain and clicking out of joints - my teens started complaining of knee pain - and insoles from amazon have sorted us all out.

So I'd look at shoes - look at plantar fasciitis home treatments.

I'd also get some vitamin D - my Dad was told his aching joints were due to his weight - not helped by medication they had him on - but then he had blood test for anotehr reason and somehow vit d level were tacked on - there was panicked phone calls when results came back he was very close to being needed to be admitted immediately to hospital - he was dangerously low - it was get him on high does vit d now. Interesting just before this I had thought I had SAD for years took a magnesium, zinc, vit k and vit D supplement more to help with endless colds one winter and it was just gone.

Then I go back to GP - say you do know my family medical history have you ruled out me having the same or related conditions and if so how - maybe dig out NICE guidelines to see if they help you. IME women do often have to trot back and forth more than my male relatives.

Even if you need to lose weight being in such chronic pain it hurts to move isn't going to help with watching diet and exercising - not to say as a long term goal it isn't something to work towards just you need help and support now.

I'm on 60mg dihydrocodeine with 1g paracetamol each morning just to get moving. It's the only way I can function to get everything done.

The first indications of RA for me was excruciating foot pain that I had for nearly a year before I was diagnosed. I did all the PF stuff, had special inserts made etc which made no difference. I could barely walk.

Go back to Dr, tell them about your mum and insist on bloods being done to look for markers. My first appointment with a rheumatologist he gave me a steroid injection into my foot and it's never hurt like that again (7yrs ago). Sadly everything else hurts instead now but there are effective treatments available that can help with most arthritis.

I can't believe you are taking no pain relief at all. There are obviously some very complex things going on here and you've had some great advice but for goodness' sake pop a couple of ibuprofen. Co-codamol has its uses but the codeine can cause digestive issues and it is much more quickly addictive. Ibuprofen is a non-steroidal anti-inflammatory and will address at least some of the inflammation, whether it is RA, PA, or something else, and take the edge off. Ibuprofen dependency exists but it is rare. Just make sure that you don't take it on an empty stomach.

@jeanne16 oh dear, is naproxen prescription only in the UK? I've been popping it every month without much caution as I thought it was just like ibuprofen.

Thank you for saying that, it's so kind of you. I know i've reacted a bit defensively to @DeliciouslyDecadent , but I just feel it's so unfair to characterise me as defeatist etc when I really, really am trying my best just to get on with life, and it's a daily struggle with MH, BED and now physical pain.

I don't WANT to be someone who just has problems and complains about them and doesn't do anything to make it better, who gives up and lets that become their personality. And I'm aware I am so much luckier than so many people.

But I am struggling, I really am, it may be subjective but it is my reality, and the fact I get up (feel a lot of pain, but hobble on to the shower anyway), get dressed, go up the stairs to my kids' room (more pain), get them ready for school and nursery (more pain as have to tackle youngest to the floor most days to get her clothes on her), go downstairs for breakfast (two flights, more pain), all the while feeling a lot of feelings I can't express to anyone, trying to cope with all my own anxieties, often in a hideous hormone storm which makes me feel like I'm going to burst into tears at nothing, suppressing that so I can be an involved and fun mummy, walk to work (more pain)...

It's nothing, really, it's just life. But form the bottom of this pit I'm in it feels like too much. Everything does. But I still do it! I do it every day, I haven't stopped functioning, I haven't let anything drop. I know, I know, what do I want, a cookie? For just living my life?

But that doesn't correlate with me, that continuing keeping on, with someone who is defeatist and 'can't do'. I am doing. I'm doing what I must, and what I can, every single day. It's just so hard to find that extra bit of something in me to make the extra effort to start chipping away at some of these entrenched problems. It's only now that all my usual bridges and quick fixes are failing that I know I really have to.

I have found this thread so helpful, so many good ideas, and my checklist is as follows:

1. self refer to physio - sounds like this will likely be a long wait so will get this done today.

2. Go back to the GP (via the ghastly system) and state clearly I want bloods to investigate RA (cf family history), low iron/B12/vitD, and thyroid function - will also ask if they can blood test for perimenopause/other hormone issues but I expect that is not easy to do given how women in full menopause struggle to get adequate treatment. Will also ask them to test for type 2 diabetes/prediabetes because I am so overweight and feeling generally so shitty - it's worth a punt, and if I do have pre-d maybe they will consider me for the weightloss drug (really don't want to go down that road but obvs things are getting a bit desperate).

3. Separately ask the GP to refer me to any weight loss clinic available in the area/online, or ideally specialist services for BED. I fear a lot of the weight loss stuff will be about calorie counting and basic nutrition, which i know already, but at least will show willing and it can't hurt.

4. get some cocodamol and start taking it. Use the (hpefully) painless time to accustom myself to my scholl orthotic insoles and see if they help.

5. sell my DMs on eBay and use the money to buy a pair of good orthotic trainers/hiking boots.

6. look up some physio exercises for the plantar and start doing them under the desk at work.

Phew. It feel like a lot. But I can't go on like this!

A small thing which may help ....high doses of vitamin D

Well done! And… try not to buy the crap. I know easier said than done.

Having a toddler and daily pain sounds like a special kind of hell .

@herewegoroundthebastardbush great list but replace the co-codamol with ibruprofen, alternating with paracetamol if necessary (keep a note of what you take and when so you don't have too much within each 24 hour period). Co-codamol can become habit-forming after more than three days.

Great list and I’d add ‘get second hand folding scooter’

If money is really tight, these won't break the bank, I got them during lockdown when seeing a professional wasn't an option. They helped me for overpronation-linked pf. PRO 11 WELLBEING Plantar Series Orthotic Insoles for Plantar Fasciitis Knee Pain Back Pain Fallen Arches (5/6.5 UK): Amazon.co.uk: Fashion

It isn't normal no. I am the weight you were previously, a similar age and a runner and need to do a lot of weights to not have sore knees, but they work and I am fine.

It is a shame that the GP suggested weight loss rather than building up strength in your legs to see if that might work. I would consult a physio if you can afford one. Even if the problem is your weight, you still deserve treatment.

OP: a colleague had these symptoms a couple of years ago and it turned out to be a chronic Vit D deficiency. He needed a proper GP prescription… and was also told to lose weight. The dual approach worked miracles. Ask your GP about Vit D deficiency? (It wasn’t linked to usual things like not getting enough sunlight… he did. Was always outdoors etc).

Also, I had slightly cranky arthritic knees, and various aches and pains. Increasing low impact exercise and introducing strength training was transformative. Our joints need good muscles to support them. Start some weight training or a class like Body Pump?

I wouldn't bother going through the GP for things like this - quite frankly they are normally useless as they don't specialise in such issues. Get booked in for a session with a good qualified physiotherapist

@herewegoroundthebastardbush my heel pain improves when I'm wearing walking boots that support my ankle too. Unless they are very worn out/old/knackered I would have thought your DM's would be ideal?

For what its worth, I don't take painkillers on a regular basis - I do if its keeping me awake at night but find they don't really do much.

Put 4 Stone on your bathroom scales to give you an idea of the strain on your joints and heart. It's shocking. You would struggle to lift 30kg but expe t your heart and joints to just lug the extra weight around. You can easily get Ozempic or other treatments.

Ibuprofen and cocodamol work well together actually. I know as I take various painkillers depending on the level of pain each day.

OP ask for the strongest dose of cocodamol when you speak to your GP as it will give you scope to adjust the dosage depending on the severity of the pain.

That sounds like a really positive list, OP, but please stay away from the painkillers with the opiods. That could be a whole new world of pain.

Stick to the ibuprofen, ibuleve gel etc.

In case the list becomes overwhelming, it might help to pick a couple of specific times a week when you follow things up.

I have been doing a beastly piece of bureaucracy involving healthcare and education services and that works for me.

Advocating for yourself and yout needs is great practice for when those toddlers grow up.

I would give any weight loss clinic a go too. It will be more than just calorie counting or a diet. I don’t think I am a stupid person, I know about nutrition and calories and yet I have always struggled with my weight. It is so much harder than anyone saying “just lose weight”. Do they ever wonder why many people cannot succeed? So any help is worth it. Plus good shoes!! And anyway, the weight is a bit chicken and egg for you - walking is painful so no wonder you are gaining weight.

I really, really will try. Definitely the hardest thing of all, but probably also one of the quickest, cheapest and most in-my-control things that would help the most.

Good list OP, well done. I think unfortunately sometimes you have to hit a low point to moved forward.

What about starting a thread in the weight loss section to get some ongoing support on here whilst you are sorting everything out?