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?

Op I put on about 4 stone over two years after similar stress. I also had plantar fasciitis and it wouldn’t shift, I had it for three years. I went on a low carb diet and lost the weight and it disappeared almost straight away. Partly because of the weight loss but also because of the anti inflammation effects of no sugar etc. I did Keto because I couldn’t even exercise and I needed some rapid weight loss. Next thing I did was hit the rower and cross trainer because it’s non impact on painful joints and feet. I was so bad I couldn’t walk after a ten minute car journey and now I can run and run.

It’s miserable and I feel for you and it’s awful but I wouldn’t have bothered with all the physio etc if I had known I just needed to reduce the pressure on my body.

my advice:

1. supportive shoes even from the moment you get out of bed.
2. supportive trainers as much as possible.
3. exercise your feet as soon as you wake up and before you stand.
4. aquafit once you’re able to get to the pool from the changing room.

It’s so lazy for HCPs to dismiss everything as weight related. Obviously carrying excess weight does put a strain on joints but not every pain is directly due to being overweight. I think a man presenting with the same history would get an examination and not have a lot of pain dismissed in the same way.

Is there another GP at your surgery you could see? Or could you make another appointment and take someone with for support so that you can ask for more input. At the very least they should look at your knees, do some bloods, check that your foot pain actually is plantar fasciitis and advise you as to how to manage it. It’s not on to send you packing when you are hobbling about in agony. As you say, not everyone carrying some extra weight is in this state. It should be investigated. The back pain could be caused by how you are needing to walk to cope with the knee and foot pain. I really hope you can get some a more constructive appointment. It sounds really miserable.

What kind of shoes do you wear?
I had plantar fasciitis a while ago but it faded and resolved when I threw away all my cheap crap slipons and heeled shoes and started only wearing really good supportive shoes with orthopaedic insoles. I also run regularly despite being quite heavy I haven't knackered my knees but I spend a lot on very high quality running shoes with excellent shock-absorbtion and replace them every 700 miles of running (should be 500 miles but I am on a budget too).

You could make sure you use proper walking shoes or boots, buy some implants (the support soles you can by) - I walk reasonably regularly but get aches if I don't use my usual walking boots. At least use thick soled trainers.
But if you are doing a daily brisk walk you should be getting stronger and fitter and have less pain.
I read that plantar fasciitis improves if you walk on irregular surfaces - like tufty grass on a hillside.

I've checked your BMI and you're not just overweight, you're obese. I don't think I could carry all that extra weight all day everyday without it affecting me. It's a lot of weight to be putting on your already knackered knees so I'm not surprised you're in a lot of pain, especially when you're so active.

I'm sure there will be people along shortly who tell you they are 5ft 2, weigh 20 stone and run marathons and do cartwheels around Sainsburys but that means nothing to your situation.

You said you'd already knackered your knees when you were younger, that along with carrying so much extra weight probably means you need knee replacements.

I'd go back to the GP and ask to see someone less sneery. Ask them for support with losing weight and explain about how your knees were already causing you problems before you gained weight.

What shoes are you dashing around in? If they're flimsy things like converse or sketchers you need to sort that out.
The good thing is that as you are active you are in a strong position to lose the weight. As you age it won't get easier.

Definitely see an osteopath. Meanwhile if you could get bike maybe that would be easier for the school run.

If your mother had rheumatoid arthritis I would definitely be going back and making a big fuss.

There are treatments: methotrexate is the usual starting treatment and then there are biologics as well if that doesn't work.

Maintaining good control over the disease (i.e. the pain) is very important because that's what minimises overall damage to your joints.

If they try to say it's just your weight then complain. Maybe it is but they can't know that with a family history of rheumatoid arthritis and no examination.

I mostly wear DMs, all my pairs are quite old. I did buy some Scholl orthotics and tried them out but the knee pain was unbearable with them in so took them out after one day - I was honestly in tears with it. I guess I probably need to have custom ones to do any good.

What would be good shoes to wear to relieve the pain? I understand Docs and Converse (the bulk of my footwear) aren't good due to the flat bed... But I've worn them for years with no trouble!!!

Have you mentioned to the Dr that your mum had Crohn's disease? It's an auto-immune disorder, which places you at higher risk of auto-immune disorders, such as rheumatoid arthritis. Do you suffer with anything like asthma/eczema/paoriasis?

My mother had Crohns. I developed a fortunately temporary form of arthritis after getting the flu. I was like an old woman for about 6 weeks, hobbling around the house and taking 5 minutes to get up or down the stairs. Then it just mysteriously went away again. However, the Dr explained what was going on and said that if it continued free a certain time (can't remember how long now) I should go back as it would need onward management. I haven't needed that and am very fit and healthy, but I'd echo going back for a second opinion. Could you take someone with you to help advocate?

Hope you feel better soon. 💐

Plantar fasciitis is agony. The only thing that helped mine is special socks - knee high with a Velcro strap from toes to knee that stopped the foot drop that I wore at night.
is the knee pain worst first thing in the morning and eases off? Pain anywhere else? RA and other inflammatory conditions aren’r curable but there’s loads of treatment options available and NICE guidelines for RA advise Rheumatology are aiming for full remission (so getting it under control). Lots are linked with plantar fasciitis too. I’d go back to your GP and ask for blood tests to check your inflammatory markers and ask for a Rheumatology referral.

Keep going back to the GP - even if your weight is contributing it sounds like there might be other stuff going on too.

As for losing weight, I know you didn't specifically ask this so ignore if you want, but swimming/water walking might help. It's weight bearing, might help you lose a bit here or there as it's also good exercise, and might even help with pain reduction. It's good for the mind too. I know you said you're busy but even a couple of half hour swims a week might help.

Good luck, yes you are overweight but that's not an excuse for GPs to write everything off to that!

Thank you all SO MUCH btw for the replies - I feel like such a whiny fat girl with all this, telling my kids I can't carry them and boring my partner shirtless with my moaning - it's so so nice to have people listen and try to help, im genuinely welling up xx

Sorry, missed that about plantar fasciitis in the OP. I had that once, I had to stop wearing flat shoes and start wearing shoes with a very small heel, which helped. No thin soles. I think I also took anti-inflammatories for a short time, too.

I wear vionic shoes or shoes with an arch support insole. Without them my feet are in agony within an hour or two.

Your family history of rheumatoid arthritis and Crohns put you at increased risk of auto immune disease.

Go back to the GP and ask if RA is a possibility. Some initial blood tests would help to rule it in/out as a factor.

Stiffness and pain in the morning lasting over half an hour is a symptom. Being overweight is a risk factor as is a family history.

Can you self refer to a musculoskeletal service if the GP can't help ?

In some areas you can self-refer to a physio, so it's worth checking whether yours is one of them.

I have a suspicion that walking every day in that much pain is probably exacerbating the problem. I wonder if you properly rested and gave your knees some time off the pain would lesson and eventually possible even resolve itself.
Also it wouldn't hurt to try and lose weight. I don't think it's the cause of your problems but it would definitely relieve some of the pressure on your knees.

It may be somewhat to do with the weight but that doesn’t mean you should be utterly dismissed. I damaged my back a few years ago, and over 10 years the pain became worse and worse until every step I took was like an electric bolt in my lower left backside. I was 14 and a half stone and had kids - I’ve begged for an mri (I can physically feel something there but just got the usual ‘do stretches’).

I did lose weight, 2 stone. The pain has lessened a lot. It’s still there and still should be investigated but not to the point of interfering with my life daily. So personally, I’d absolutely chase the doctors but I’d also try and reevaluate your weight as it could help with some of the pain management.

I'm also somewhat overweight. Self-diagnosed myself with plantar fasciitis a few years ago - turned out to be my vitamin D levels were very low. Worth asking GP for vitamin D bloods.

Ouch, that sounds really tough OP.

Truthfully some of it might be linked to weight as people tend to say their knee and foot pain resolves when they lose weight.

You are in so much pain that there must be something else going on but the likelihood is that the weight is exacerbating it. Excess weight is linked to inflammation and so one begets the other and a vicious cycle occurs.

Other things like low Vit D levels can contrite to this inflammation. It wouldn’t hurt to ask your GP to run some basic tests on Vit D, B12, thyroid and inflammatory markers just to rule out the obvious reasons.

My dh had horrendous knee pain when doing exercise for years. He got his gait tested at a running shop and given the right trainers and never had a problem again. My ds has pf and again we have to be very careful with shoes, not too heavy, wears Orthotics, supportive up the sides. If he veers away from that into something else it comes back. I would imagine a lot of your knee pain is from your feet being misaligned. I find that if I've not been doing any strength exercises like squats for a while then my knees go a bit weak too, so maybe try adding a few gentle strength exercise in each week too....in the right sort of shoes.

I've had PF & bad knees & chronic back issues. The solutions were all trial & error for me, and for almost everyone I speak to who also had PF, bad knees, back pain. I'm not / was not overweight. NHS can do very precious little for these problem areas unless you actually need a knee replacement. Back surgery isn't a reliable fix.

For back, You can try exercises & stretches on Youtube esp. for back & pay attention to good posture. Heel lifts have been the best thing for my PF.

Weight may not be the cause but losing weight would help a lot with all of those. Waiting lists on NHS take forever. You can start losing weight now and start stretching your back now & start trying things that might help with the knees & PF now.

It sounds as if there's a couple of things going on here.

Firstly I'd definitely look at the shoes you're wearing when you're doing your fast walking. Good trainers definitely needed. Are you pushing a buggy too? Leaning forwards and walking fast can cause back pain. Try standing up straighter and tightening your core a bit? Your knee pain will probably be related to trainers / walking. Try stretching your quads @# they support around your knees (lie on your front and pull your foot towards your bum). You should be able to get your heel to your bum. If your quads are tight this will hurt!

Your foot pain sounds like plantar fasciitis as others have said. If you have a golf ball roll that under your foot. Again it will hurt but it will release it.

As others have also said the GP isn't the best route. I'd try a physio and self pay if you can at least for one appointment. Your weight will be putting extra strain on muscles and ligaments but is absolutely not why you're in such pain.

In the meantime definitely try some stretching and look at your footwear. I really hope it improves soon as it sounds v painful.

Could it be menopause? My hips are agony sometimes and I read the menopause causes pain and discomfort.