Feet pain, ankle cracking, hand pain, heart burn and constipation

[JMcB2]

A year ago, I experienced feet pain; an achiness in the bottom of my feet.  I was tested for Lupus and Rheumatoid Arthritis.  However, all three tests proved negative.  Over the last several months, my feet, especially the left foot and outside ankle area, crack or feel the need to crack/pop.  My hands also experience this.  It is occurs often in the morning and the evening.  Also, I notice it is more prevalent when I am constipated, or have indigestion, with/without heartburn.  In fact, several weeks ago, I ate some yogurt after which I did experience heartburn with an immediate onset of pain in my hands (not feet though).  The pain in my feet and hands is similar to the sensation I have when I feel the need to belch, pass gas but can't, or feel the need to move my bowels but cannot.  Constipation runs in my family. I am in late 40s, petite and weigh 115 lbs.  My health is good, but for the problems I've explained herein, and a shoulder injury occuring last year that is still healing. I do not drink or smoke, eat a fairly healthy diet, and get moderate exercise via walking. I feel that there is a connection between all of my symptoms, as mysterious as they may seem when taken in combination. What do you think it sounds like I might have? Thank you for your interest and time.  

[Kevin Pho, MD]

These are a difficult constellation of symptoms.  I can't think of a single diagnosis that would unify the symptoms.  

I agree with the rheumatological evaluation.  Imaging the feet and hands can also help with the diagnosis - I would start with plain films first.  More extensive imaging, i.e. with an MRI, can be considered if the pain continues.  

Some types of inflammatory bowel disease can also present with muscle and joint pain.  Ruling this possibility out, i.e. with a small bowel series or colonoscopy, can be considered.  

I would consider a referral to a rheumatologist if the symptoms continue.  Regarding the feet symptoms specifically, a podiatry evaluation can be considered.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
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