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?

@herewegoroundthebastardbush I've had severe foot/heel pain for about 6 months and assumed it was PF but after the pain got worse and worse I splurged on £60 to see a physio. Now diagnosed with damaged sciatic nerve near my hip - had no pain in my hip so never considered it. He gave me a session of acupuncture and the pain disappeared for 48 hours until I went out for a walk. Waiting for second session next week (had to cancel this week due to work) and wondering how the hell I'm going to afford it but the lure of being pain free means I would happily spend money on that rather than food right now! Also need surgery on damaged cartilage in my knee which may or may not have been caused by walking weird due to foot pain but thats covered by health insurance through work.
You can self refer for physio through the NHS now.

If the pain is mainly in your feet and knees, it is likely that if you lost weight, the problem would auto sort.

If you have pain in non weightbearing areas like neck and shoulders etc. it might be another inflammatory disease.

In your shoes I would adopt a low carb and fasting lifestyle and cut oxalate foods. Take the pain relief to get over the hump of losing the first stone maybe but they have unpleasant side effects.

My PF and knees issues have gone since I lost 9 kilos (paleo diet). The pains in my elbows shoulders etc. went when I realised I was full of oxalates (see videos by Sally K Norton on YouTube)

PF is awful OP, I really sympathise. Echo what others have said - physio, stretching, correct shoes. Also (not RTFT, someone might have mentioned it) - roll a tennis ball under your foot when you’re sitting down. Unfortunately rest is good for it too, but that’s difficult when you have to pick up the kids, could you cycle instead?

Some pain can be referred pain - I got pain in my other hip and it was all linked to my PF - I was walking in a funny way because of it.

Try to see a sports physio if you can - £60 could change your life.

No, no statins. I don't currently take any medications since I came of my citalopram, not even contraceptive meds.

You need to keep going back to the GP. Your weight is a factor but it is clearly not the only one. Be prepared to complain to the practice manager if they continue to block requests for referrals. You could show willing by also requesting a referral to the weight management scheme in addition to the other support that you need.

I'm sorry, I know it's exhausting but it's the squeaky wheels that get the oil and if private care isn't an option then you have to be prepared to make a nuisance of yourself.

Today, get these Scholl Orthotic Insole Heel and Ankle, Medium, UK Size 7-8.5 : Amazon.co.uk: Fashion
I started using them when I was in so much pain I couldn't walk a short distance home from the station, and had to phone a taxi or be stranded there forever. They'll fix your feet and your knees. Your knees might ache a bit for a few days but that soon passes.

Losing weight is good, of course. Try a no-sugar diet, google 'Yes/No chart, sugar detox diet'. This is life changing. Clears the mind of all fog, contributes to weight loss too.

The biggest issue you have here OP is that you're afraid to ask for help.

You see the GPs as people who won't take you seriously, who look down on you because of your weight and having had a MH issue.

If you went in and said 'I really really want to lose weight, need help, and want to be screened for RA, and support as I'm not over my Mum's death yet' you might find you get the help you need.

Being passive and deciding in advance that they won't help (based on one appt where a GP didn't) doesn't mean it's the end of the road for you.

Take control.

The knees and PF things can very much relate to weight, do you have a small frame?

What’s your plan to lose weight?

Ideally if you can lose even a few pounds and book another appointment to go back in a month you can tell them about the weight loss, if it made any difference and ask for further investigations.
Tell them you have a family history of RA.

At the moment trainers would be be more comfortable for you.

Converse are awful for PF and wouldn’t ever wear them, even for short periods. The DM possibly not good due to worn footbed, but also are poor quality now and made in China. You can still get Solovair boots made on the original press in the U.K if you want to replace your DMs.

If you are replacing shoes, Camper are very good, the ones with orthotic footbeds on offer as expensive, size up unless you have very narrow feet.

Both knees. They hurt horribly on the stairs, they crunch when i bend them, the right is worse than the left and the right foot is where the PF is. Sometimes if I'm kneeling on the floor or walking on my knees (next to the bath say or chasing toddler with the nappy) I will kneel on one just so and it's AWFUL, I will literally scream it hurts so much and it takes ages to settle down. It does feel like it might be the knees are the main problem and the foot is secondary, as I've had slightly iffy knees for 10 years odd; but maybe the knees are just the canary in the coal mine for my crappy feet, and walking wrong? I d have very flat feet, runs in the family.

I hate that so many GPs take this attitude towards overweight people - they risk missing cases of serious illness. It's all very well telling the OP to lose weight, but she needs help now and losing weight takes time. The best suggestion I have is to go to a different GP in the same practice and hope for a better outcome.

Just to say again I'm so grateful for all the answers and suggestions and I'm doing a list for myself (turns out you can self-refer for physio in my area so no need to go back to the dreaded GP, at least at first!)

I really can't tell you how much it means to me that people have replied at all. I can't really talk about it to anyone IRL, as my partner doesn't have much sympathy due to my weight, and I don't really see my friends much so when I do I want us to have a nice time and not be a downer IYSWIM.

Had pf three years ago when overweight. Think mine was exacerbated by wearing awful boots from a supermarket which I bought during lockdown. Your joints sound badly inflamed, the weight is a factor too, but it's hard to exercise when in pain. Can you try calorie deficit diet for quick weight loss (maybe people have issues with these, but they are recommended for medical conditions I believe) and pay privately to see a foot specialist? They can analyse your gait and offer insoles and products to help you walk properly. My pf cleared up when I did this and lost weight but I also have to be v careful about shoes now. Some trainers are designed for pf, google them. I hope you get help because it's a brutal condition, and it makes you feel ancient - the stairs are the worst thing as you say.

You need to get bloods done by your GP. If they come back normal except for a slightly raised ESR (inflammation markers) you need to be referred to a rheumatologist. That level of pain isn't normal, and to have it in both knees implies it autoimmune. If it is autoimmune then it's very fixable, so don't despair. Either way you need to push this because your quality of life is being compromised and you don't deserve that no matter what your weight!

You need a new Dr. Even when doing the he sceptical "it's a over zealous Mom" look, he'll always examine the kid, has squeezed me in to see him etc. Because he's not a patronising idiot. And the new young Dr keeps telling me I'm not old so I like her too

I’m not sure if it’s already been mentioned but what about being peri menopausal. I was around a similar age. I had what I called an old lady shuffle in the mornings, oestrogen gel made a huge difference.

I’m also over weight and have an auto immune problem but I was very lucky that I had a go finally listen and take me seriously.

A blood test would surely help as it could be so many different things but it would show hormone levels and Rheumatoid factor (RF). If you can get one.

i live with chronic pain and whilst I wouldn’t wish this life for anyone, there are still some good times so please don’t despair x

Ask the GP to refer you to NHS joint person.
I am even fatter than you and had similar issues but have managed to negate them but not a quick fix and I must admit I have paid for private but you can access some services on the NHS.
Yes Knee pain is made worse with weight but is often a result of your hips being out. If your budget can stretch to it I would go to a chiro a friend recommends to you. Sometimes you can tear cartilage in your knee and steroid injection can help with inflammation (NHS can do these).
Your feet is likely two things - you are not walking heel to toe due to pain and it gets into a vicious cycle. When you walk start on your heel and roll your foot until you lift from your toes to lift your foot for next step.
Also sleep issues (possible pre menopause) can cause foot pain if you are not getting into a deep restorative sleep phase.

I'm the same height and weight as you. No that pain is not normal. Definitely go back to your GP.

Really sorry to hear of all the difficulties you are having, OP. Without at all wanting to undermine the fact that what you need is a proper comprehensive intervention from approppriate NHS specialists, I just wanted to mention a few coping strategies I have with my painful knee (I'm sixty, a former jogger, top of my healthy BMI and have wear-and-tear issues, on a waiting list for an MRI on my knee).
I know they all sound like crap minor strategies that won't cure anything, but they might help at the edges of the problem.

1. Knee rehab exercises. I had a crisis a few weeks ago - an accident which crunched and twisted the cartilege and had me hobbling to A&E. physio gave me some very basic rehabilitative exercises and they really did help. If you google NHS knee rehab or some such you will find similar.
2. Pilates (I know! But bear with me). I've only just started doing this and it is a long haul, but I really do believe that streengthening and correcting my core is helping with a range of aches ad pains. Don't let your weight make you feel demoralised about exercise. In yoga and pilates classes, weight doesn't correlate AT ALL with level of performance and I see loads of women whose BMI might be above healthy but who are way more advanced than me.
3. Avoiding inflammatory foods and eating patterns. I sometimes binge eat, out of sadness and stress, and I find that the times when I control this do correlate with some improvement in aches and pains. What I mean to say is that you don't need months of healthy eating and a significant weight loss to feel a bit of improvement. Just a few days or a week can bring just a little bit of improvement because eating badly creates short-term increases in inflammation. I always find that a motivating reminder, because it is just too grim always to be thinking of the longer-term goal of weight loss. Five Days to Fabulous is the mantra I prod myself with.

xxxx

@herewegoroundthebastardbush you're Going to have to be persistent with GP.
And there are treatments for RA. Whatever made you think there weren't? Your mum's experience ?

You’ve had some great advice here OP and you sound like a dynamic person so I’m pretty sure you’ll take it!

I had PF and it got a lot better when I started wearing Fit Flops, including the slippers. No flat shoes EVER, no DMs (sadly), and I never wear the same shoes two days in a row. Finally, and I know it sounds weird, vitamin D tablets helped.

Absolutely all of this!
You have to start to help yourself and you’ve had some excellent suggestions on here.
Best of luck.

Also agree with pp who mentioned oestrogen deficiency. OP a bit on the young side for perimenopause but can't be ruled out - yes, that dreadful soreness on rising from bed and having to walk downstairs SIDEWAYS! A body that runs out of oestrogen is like a car engine running low on oil.

It's not that I don't want to mention my mum, I just don't want to go back to the GP, for several reasons.

First I don't want to be shamed about my weight again, I know it's their job to point out the obvious but I am very aware and doing my best and it hurts.

Second I believe through experience the GP thinks I'm overanxious and melodramatic because of my mental health issues. On the odd occasion I have seen her or taken my kids to her, she tends to ignore what I'm actually there for and focus on my 'anxiety'. Which again I know is her job but it does make it pretty pointless going to see her about anything else.

Third there is the process of actually GETTING an appointment, which is now Byzantine to the point of making you want to scream, and I usually only engage in it of I'm actually quite worried about one of my kids (and even then, I often leave it longer than I should, for all the reasons above).

Currently to get an appt at our practice, you have to:

a) fill in an online assessment questionaire. If you are not careful to answer the questions a certain way, you will hit the NO screen where it tells you to call 111 instead and you can't progress to an appointment.

b) once you have sent a form, you have to wait for them to call you back, which they say the will do any time in the next two-three days depending on urgency. If you miss the call, you're back to square one. I work and have two small kids. I ALWAYS miss the call.

c)If by some chance I do catch the call, or I ring up and plead after a missed one and they put me back on the triage list and I get through, I have a telephone assessment, and if they decide you should be seen (IF), they usually offer an appointment in the next hour or so. I work and have small kids. I can't make the appointment with that kind of notice. So they put you down for another telephone review at some point in the next 2-3 days again. Rinse and repeat.

The only way I have been able to actually attend an appointment has been to literally drop everything and go, so I only do this now when one of my kids is very unwell.

Whereas once upon a time, I would just ring up, or walk in to the surgery, and if it was a sick kid they'd see us that day (you'd often have to wait around, if it was a grown-up problem or a kid one that could wait they'd book you in at some point in the next fortnight. It's so awful now I just can't face it most of the time.

OP have you been able to address the binge-eating? It can be at least partly the cause of poor MH as well as a result of it. It's something you could start addressing almost immediately, eg cutting down/out your binge foods. Look up anti-inflammatory eating plans. Maybe look for counselling to help identify stressors and a strategy.

Losing weight is hard because of my binge-eating disorder. Which, to be fair, from the sounds of some of the PPs, may also be behind my pain due to inflammation/excessive sugar. So yes, my first port of call really needs to be getting that under control to see if losing weight/improving my diet makes things better (hard to see how it couldn't really!), but in the meantime I'm in a ton of pain so I need to find a way to manage every day, right now.