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Topic: Exactly HOW does Femara/Arimidex cause foot pain ?

Forum: Hormonal Therapy - Before, During and After — Risks and benefits, side effects, and costs of anti-estrogen medications.

Posted on: Jun 8, 2009 10:59AM, edited Jun 9, 2009 08:46AM by trigeek

trigeek wrote:

Ok I surrender Femara is causing me a stupid foot pain ( when I sit down for a long time or when I get up in the morning the bottom of my feet are hurting like bruised)

It gets worse if I am on my feet for a long time ( let alone start running )

I was not able to find out exactly what Femara/Arimidex does to cause the pain

Does it :

Damage nerves ?

Cause inflammation of tendons ?

Causes arthritis ?

What ?

Help.. going nuts.. I figure that if I know how it breaks them I can take approprioate countermeasures to balance it out.

Comment added on June 9: the similar problem is happening in my hands they are very stiff and even showing signs of trigger finger in the morning so this is not exactly Plantar Fascitis which I fixed by getting www.grastontechnique.com applied by my chiro. But maybe I have a widespread plantar fascitis on both of my feet ( it aches all over) and trigger finger arthritis on my hands.. C'mon they got2 be kidding me I am 46 and never ever had these problems before femara.. not even during taxol./AC what does this med do to our feet/hands. Is it the estrogen deficiency symptom or is it doing something else directly attacking feet/hands

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Jun 8, 2009 01:11PM RIV54 wrote:

I don't know all the exact SE of AI's but I started on Arimidex right after chemo. In about 6 months I was practiaclly cirppled from knee pain. I should say that I had some arthritis in my joints (knees, hips, back). I developed tendinitis in my right thumb. DR switched me to Femara. most pain subsided and tendinitis disappeared after using a thumb splint at night after about 2 months. I've been on Femera for almost 2 1/2 years and was doing well, but recently the joint pain, particulary the back pain (arthritis) is getting worse again. My PCP is trying to figure out which anti-inflammatories will help me the most. I've been on ibuprophen, Voltaren, naproxen, Diovan. Hope this helps.

Gina

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Jun 8, 2009 01:55PM trigeek wrote:

Sorry to hear that Gina .. I just am trying to understand in what particular way it attacks.. hmm so you are suspecting that it causes inflammation right so then antiinflammatory diet along with curcumin and maybe otc ibup might help us ?

Bilateral MX with Recon, DD AC/Taxol Rads,Tamoxifen, oopherectomy, femara, zometa "Live Deliberately !"http://www.aylin-yeahright.blogspot.com/

Dx 8/3/2007, ILC, 2cm, Stage II, Grade 2, 2/6 nodes, ER+/PR+, HER2-
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Jun 8, 2009 02:05PM EWB wrote:

I think it is some how related to the very low estrogen level although I have not yet figured out the specifics. I was suprised how much estrogen played a role in joint/muscle health.

Dx 11/9/2006, 3cm, Stage IV, Grade 2, 0/0 nodes, mets, ER+/PR+, HER2+
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Jun 8, 2009 04:49PM mawhinney wrote:

Could your foot pain be caused by plantar fasciitis and not the meds?  Before breast cancer, I had a great deal of trouble with my feet especially after I sat for awhile. When I got up my toes would curl under and my feet hurt so much I almosted cried.  Turns out the tendons/legiments that run across the bottom of you foot and up the back of your leg tighten and cause the pain. The pain was so bad I almost had surgery to cut the tendon/legiment.  Exercises to stretch the muscle, well cushioned shoes, ice all helped.Hard surfaced floors are a big cause of the problem. Many doctors and nurses and folks that work on hard surfaced floors have plantar fasciitis.  My feet while still not perfect greatly improved after we moved. The floors in my kitchen were 3/4 inch oak on top of 2 layers of plywood. No give at all.  Why don't you google plantar fasciitis for more information.

Dx 5/18/2008, IDC, <1cm, Stage Ib, Grade 2, 0/1 nodes, ER+/PR+, HER2-
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Jun 8, 2009 04:59PM trigeek wrote:

Maw I did have plantar fasc and took care of it with the graston technique.. but this could still be the remnants spread over a larger area that is a thought.

I took a 2 week femara vacation and the pain subsided substantially I went back on Femara voila.. crept back in, even if this is PF then does Femara/Arim cause PF ?

Bilateral MX with Recon, DD AC/Taxol Rads,Tamoxifen, oopherectomy, femara, zometa "Live Deliberately !"http://www.aylin-yeahright.blogspot.com/

Dx 8/3/2007, ILC, 2cm, Stage II, Grade 2, 2/6 nodes, ER+/PR+, HER2-
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Jun 9, 2009 08:22AM mawhinney wrote:

In the June 9th Charleston SC paper there is an article on plantar fasciitis.  You can find the article at www.postandcourrier.com.  The article also references a Harvard Medical school site www.health.harvard.edu/adviser

I've had plantar faciitis for almost 15 yrs.  It improves for a time but then returns.  I have had the est relief from shoe inserts. can't go without them. Unfortunately they only fit in clunky, sneaker type shoees.

Dx 5/18/2008, IDC, <1cm, Stage Ib, Grade 2, 0/1 nodes, ER+/PR+, HER2-
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Jun 9, 2009 03:56PM KJohnson wrote:

Hi, I have been on Arimidex for two years. About a year ago the bottom of my feet started hurting, I could barely walk after a few hours.  Podiatrist took xrays and said I had calcium deposits on the bottom of my feet.  The doctor didn't know whether this could be caused by the medication, but I didn't have the problem before BC.  He suggested orthotics and physical therapy.  I am wearing shoes that take some of the pressure off my heels.  I haven't gotten around to physical therapy as yet.  Good luck.  KJohnson

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Jun 9, 2009 04:23PM AnneW wrote:

Tri,

I had a similar, horrible experience with pain when on Arimidex. I changed to Femara and had no problem. Aromasin has been fine, too. We all react to meds differently, but could you and your onc consider a trial of a different AI to see if you'll have less problems?

Anne

2002 IDC stage 1, grade 1, rads & AI

Dx 9/18/2007, ILC, <1cm, Stage I, Grade 1, 0/1 nodes, ER+/PR+, HER2-
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Jun 9, 2009 07:46PM Seashell49 wrote:

Hello,

 I was on Arimidex for 3 months and was in terrible pain, hands, shoulders.  When I stood up or woke up...felt like I was 90!  My Onc switched me back to Tamoxifen and I feel great!

<3 Cast all your anxiety on HIM because he cares for you! (1 Peter 5:7) :)

Dx 10/5/2012, DCIS, 1cm, Stage 0, 0/2 nodes, ER-/PR-Surgery 10/26/2012 Mastectomy (Both)
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Jun 9, 2009 07:53PM mawhinney wrote:

KJohnson ~ You can find the exercises for your heel pain online.  Just type plantar fasciitis in a search box.  The exercises are easy to do without assistance from a PT

Dx 5/18/2008, IDC, <1cm, Stage Ib, Grade 2, 0/1 nodes, ER+/PR+, HER2-
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Jun 9, 2009 08:58PM, edited Jun 9, 2009 09:00PM by BMD

I was 45 when I started Femara. I will be 48 this week. I had so much pain in my left foot in the first few months that I saw a podiatrist. The x-rays showed nothing. He wanted me to pay $300 for something to put in my shoe but since I live in S. California I wear sandals all year. Anyway, 2 weeks later it completely went away. I still have pain when I first stand up but nothing like the constant pain I had then.

The carpal tunnel syndrome is a Femara SE. I read something once about the way estrogen helps to keep your joints lubricated. When you don't have the estrogen supply the nerves in your joints are some how effected. It feels like a pinched nerve if you ask me. I had CTS so bad in the beginning I couldn't even drive without my hands falling asleep. It still have problems with them when I sleep or talk on the phone or if I drive a long distance. Some of the women here have gone so far as to have surgery to relieve the pressure.

About 6 months after starting Femara my right knee started acting up. I would be walking along and suddenly it would feel like I was electrocuted in my knee. Stairs were unbearable. Now both knees just ache when I stand up.

Next it was my heal on my left foot. Last summer it just started hurting so bad I couldn't stand to walk. I was actually walking on my tip toes much of the day. 2 months later it was gone.

Now the right side of my neck bothers me almost daily. Sometimes it is just a nuisance and other times it is excruciating. I have chiropractic to help but it always comes back.

I once started a thread here. It may still be around about how the Femara SE's seem to cycle around my body. For 2 1/2 years it just seems like there is always something painful somewhere and I never had this problem before bc. The pain will last a few months and then move on to another body part.

If I didn't have young children I would stop this drug in a heartbeat.

We are all in God's caring hands, BrendaBMD

Dx 7/14/2006, IDC, 2cm, Stage IIa, 0/10 nodes, ER+/PR+, HER2-
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Jun 10, 2009 01:26AM kathimdgd wrote:

I had this problem on Aromasin.My feet felt like i had walked thru fire then on broken glass.It was horrible,my knees hurt so bad,when i tried to get up i thought i was going to fall.I also lost my balance a lot.My legs hurt all the time from my thighs to my toes,and my arms hurt,and sometime i couldn't close my hands,or open my meds.I finally called the dr and he had me go off for 3 weeks and then last week he put me on Femera.

The only thing i noticed so far is that it makes me cough,a gagging kind of cough,so i suck on halls,when needed.And at first it made me nauseaus,and light headed.Both of those things seems to have subsided.It's only been a week on it,so we'll see what if anything else happens.

Kathi

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Jun 10, 2009 02:59PM moonwolf wrote:

Sounds like Neuropathy.  This is also a side effect of Taxotere.  I took Glutamine Powder and it definitely helped me when I was on Taxotere.

Dx 6/2008, IDC, 1cm, Stage II, Grade 3, 2/17 nodes, ER+/PR-, HER2+
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Jun 11, 2009 06:07PM Lynne wrote:

I've tried all 4 hormone therapy drugs. Started with Arimidex after my total hysterectomy (didn't bother taking Tamoxifen for the 2 mos between radiation and hysterectomy)at a premenopausal 43. I took it for about a year and couldn't stand the joint pain anymore. Switched to Femara for 6 months, my feet hurt so bad, I had a hard time walking. Went back on Arimidex for another 6 months, join pain came back. Then tried to Tamoxifen. I felt great (just hot flashes, no pains), but my liver enzyme counts went higher. Tried Aromosin, the joint pain and feet pain came back. I lasted 4 months on it, just finished the bottle a couple of weeks ago. I'm done. My oncologist is ok with it. I'm stopping a year and a half early, and can't wait for the aches and pains to go away (it takes a couple of months). I had my ovaries removed so there is only the estrogen from the adrenal glands. I'm 47 and was sick of feeling like 80.

Good luck everyone!

 Lynne

Mets in spine, lungs, and liver. Carpe Diem-Live for Today

Dx 5/26/2005, IDC, 1cm, Stage I, Grade 2, 0/1 nodes, ER+/PR+, HER2-Dx 6/26/2012, Stage IV, mets, ER+/PR+, HER2-Surgery 06/06/2005 Lumpectomy (Right); Lymph Node Removal: Sentinel Lymph Node Dissection (Right)Radiation Therapy 06/30/2005 ExternalHormonal Therapy 12/20/2005 ArimidexHormonal Therapy 12/18/2006 FemaraHormonal Therapy 03/20/2007 AromasinHormonal Therapy 12/19/2007 TamoxifenHormonal Therapy 07/20/2012 FaslodexRadiation Therapy 07/30/2012 External
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Jun 13, 2009 12:20PM greenfrog wrote:

I also have this foot pain as a major side effect of Arimidex. It is pure agony when I first get up in the morning, or when I get out of the car  - or at any time really when I've been off of my feet for any length of time. Thing is that once I have walked a little the pain subsides completely and I am fine. I remind myself of my grandma who used to say that she was ok once she got going.

I have no idea what is causing it other than complete deprivation of oestrogen. As side effects go it is not enough to make me quit Arimidex.

Dx 5/2008, IDC, 1cm, Stage I, Grade 3, 0/19 nodes, ER+, HER2-
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Jun 13, 2009 07:20PM London-Virginia wrote:

I might be able to help a little bit:

 I've had a lot of bother in the past with plantar f.  can you buy greek-style (or Roman) sandals to slip the orthotics into?  I know it is a real drag always wearing trainers etc.  If you also get moretons syndrome (hurts on ball of foot) you can try spreading the matatarsals by using one of those little things that you stick between all your toes to varnish your nails.  Sounds daft butit works.  I do this before going to bed or in spare moments of the day.  You'll find it gently spreads the toes and muscles.   I have been doing this for a few weeks and it has fixed things.  There is a thing you can buy called Yoga Toes, but they are quite expensive and I found the above as good.

 I expect you all know about helping the pain with bags of frozen peas to take down inflammation.

use tennis ball to massage bottom of foot.

If not familiar with various exercises to do, google plantar fasccitis/moretons' syndrome; there are some good things on youtube showing you exactly what to do.  Don't wear flatties all the time.  Change shoes frequently - it keeps different muscles etc flexing.

I really sympathise - plantar troubles and carpal tunnel are very painful - someone who hasn't had either wouldn't be able to guess how bad.

Good luck ladies -

Virginia.

Dx 5/9/2009, IDC, 2cm, Stage IIb, Grade 3, 1/2 nodes, ER+/PR+, HER2-
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Jun 13, 2009 07:21PM London-Virginia wrote:

I might be able to help a little bit:

 I've had a lot of bother in the past with plantar f.  can you buy greek-style (or Roman) sandals to slip the orthotics into?  I know it is a real drag always wearing trainers etc.  If you also get moretons syndrome (hurts on ball of foot) you can try spreading the matatarsals by using one of those little things that you stick between all your toes to varnish your nails.  Sounds daft butit works.  I do this before going to bed or in spare moments of the day.  You'll find it gently spreads the toes and muscles.   I have been doing this for a few weeks and it has fixed things.  There is a thing you can buy called Yoga Toes, but they are quite expensive and I found the above as good.

 I expect you all know about helping the pain with bags of frozen peas to take down inflammation.

use tennis ball to massage bottom of foot.

If not familiar with various exercises to do, google plantar fasccitis/moretons' syndrome; there are some good things on youtube showing you exactly what to do.  Don't wear flatties all the time.  Change shoes frequently - it keeps different muscles etc flexing.

I really sympathise - plantar troubles and carpal tunnel are very painful - someone who hasn't had either wouldn't be able to guess how bad.

Good luck ladies -

Virginia.

Dx 5/9/2009, IDC, 2cm, Stage IIb, Grade 3, 1/2 nodes, ER+/PR+, HER2-
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Jun 17, 2009 06:36PM mb2226 wrote:

Hey Trigeek - I don't think its plantar problems. I have the exact same issue on femara -- really sore feet especially in the morning.  I did 2 things. first, i keep crocs next to my bed and they help in the morning. 2, I went off femara for 3 months -- the foot pain completely went away (of course) and then when i went back on, I started taking vitamin D3 (1000 IUs a day). so far - no foot pain.  It's been a few months. I'll let you know if it starts up again. I was D3 deficient (my onc did a D3 test) and you might want to check your values too... they say that some of the aches/pains on femara may be heightened if you're vitamin D3 deficient.... good luck, the sore feet really stink,,, best, embee

Dx 10/10/2005, IDC, Stage I, ER+/PR+, HER2-
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Jun 17, 2009 06:42PM, edited Jun 17, 2009 06:49PM by apple

i second the frozen peas suggestion if you have plantar fascia.. (so painful).. i developed a case on my left foot after frequent springboard diving while coaching at age 51.  

frequent icing and plenty of anti-inflammatories if you can take them.   my case cleared up quickly but i iced my foot for up to 3 hours daily.

peace and love, apple - ..... Mary Magdalen

Dx 4/10/2008, IDC, 5cm, Stage IV, Grade 3, 4/9 nodes, mets, ER+, HER2+
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Jun 17, 2009 06:55PM, edited Jun 17, 2009 06:56PM by kt57

I''ve had plantar fascitis.  The pain in my feet with Arimidex sounds just like greenfrogs, feel it at first, goes away with activity.  It is definately different than PF.

Kathy

Dx 11/11/2008, IDC, <1cm, Stage I, Grade 3, 0/4 nodes, ER+/PR+, HER2-
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Oct 29, 2009 01:52PM vpiazza wrote:

lynn,

thanks for this.  i took tamoxifen for 5 years, with only minor and livable pain.  i had a recurrence at 7 years, and after chemo, surgery rads, started on the AI train.  femara first.  i cried uncle after 3 months.  i took a break for a month, started on aromasin.  i'm now 2 months into it, and called my doc to cry uncle again.  i really really hope that arimidex doesn't cause this pain, because i really want to be able to take something, but i can't live in this pain, i just can't.

Dx 8/2008, IDC, 5cm, Stage IIIb, 1/6 nodes, ER+/PR+, HER2-
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Nov 22, 2009 12:29PM trigeek wrote:

Thought I would give an update. The foot pain has been living with me and I stopped running(cause I also gained weight) However a friend got me orthaheel flip flops which felt really uncomfortable first but I have been wearing them all day long and my foot pain seems to be minimal. Of course I also stopped wearing any normal-good looking shoes dr suggested that I wear shoes with wide toe box with no heels. bye pumps (at least for now)

Bilateral MX with Recon, DD AC/Taxol Rads,Tamoxifen, oopherectomy, femara, zometa "Live Deliberately !"http://www.aylin-yeahright.blogspot.com/

Dx 8/3/2007, ILC, 2cm, Stage II, Grade 2, 2/6 nodes, ER+/PR+, HER2-
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Jun 7, 2010 02:21AM Linda_from_NewJersey wrote:

I take Femara.

 I've have developed trigger fingers on both hands. Lately my palms are aching.

 The bottoms of my feet hurt and burn. It is very painful to walk on them first thing in the morning.

 I have had problems with my shoulders and have bouts with tendonitis in both arms.

One of the worst problems is that it extremely painful to sit because the backs of my legs (behind my thighs) feel like the tendons in them are stretched tight as a guitar string, and the pressure of sitting on a chair feels like a knife is about to cut them.

 I am no wimp and have a high tolerance to pain (I have had 2 drive through mastectomies - in, in the morning and out by noon, with no need for take-home pain meds), but this pain I have from the Femara is getting be too much. 

 A pain doctor put me on Cymbalta which helped a little for a while, but now it seems to have lost its effectiveness on the pain.  Maybe I will ask the doctor to increase the dosage, though I really don't like the idea of being on the Cymbalta for pain.

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Jun 7, 2010 09:20AM trigeek wrote:

Things are looking up and I thought I owe an update to you all after being on Femara for 19 months...

I have been taking fish oil, Cosamine(from costco), curcumin.. vitamin D3.. and my hands started recovering, the foot pain remained tho..

 Then came another suggestion and I went Gluten free in my diet.. it was tough but within 3-4 weeks my fingers miraculously got rid of the triggers (which were even there before I had chemo !) the foot pain decreased 80% almost gone..

The stiffness I had and bending over like a 90 year old when getting up GONE !!!

So my suggested regimen would be:

1 - Cosamine (from Costco) twice a day

2 - Liquid fish oil

3 - Gluten free diet.

Now I have to figure out how to get rid of this 25 pound tire around my body which is a gift from surgical menap+chemo+femara...

I am hopeful !

Bilateral MX with Recon, DD AC/Taxol Rads,Tamoxifen, oopherectomy, femara, zometa "Live Deliberately !"http://www.aylin-yeahright.blogspot.com/

Dx 8/3/2007, ILC, 2cm, Stage II, Grade 2, 2/6 nodes, ER+/PR+, HER2-
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Jun 7, 2010 01:33PM momand2kids wrote:

I am celebrating my 1 year of taking femara (along with a monthly lupron shot b/c I was pre-menopausal).....I also had the foot and hand pain in the first few months--what has helped me is the glucosmine chondriton, vitamin d (2000iu) and exercise--- yoga, swimming,boot camp, elliptical training.  I have not yet started running again--- I have been holding off---but I find the more I move, the less I feel stiff-- I almost feel "normaL"... but I do remember the beginning as very rough.....

Dx 10/29/2008, ILC, 2cm, Stage II, Grade 2, 0/1 nodes, ER+/PR+, HER2-Surgery 11/25/2008 Lumpectomy (Right)Chemotherapy 01/16/2009 AdriamycinRadiation Therapy 03/23/2009 ExternalHormonal Therapy 06/15/2009 Femara
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Jun 8, 2010 12:20AM karen1956 wrote:

Tri....I've not read all the posts so I may be repeating something that already been said...but AI's do cause inflammation of the tendons.....CTS is a side effect of Arimidex...I developed severe tendonitis bilaterally in both wrists on Aromasin....could the foot pain be neuropathy?  I've been off the Aromasin for over 2 1/2 months and many of the side effects are much diminished (I was on AI's for 3 1/2 years)

Karen in Denver, Dx 02/03/2006, ILC, stage IIIa, ER/PR+, HER2-,

Dx 2/2/2006, ILC, Stage IIIa, Grade 1, 8/12 nodes, ER+/PR+, HER2-Surgery 03/01/2006 Mastectomy (Right); Lymph Node Removal: Axillary Lymph Node Dissection (Right); Prophylactic Mastectomy (Left); Reconstruction: Tissue expander placement (Both)Chemotherapy 03/22/2006 Adriamycin, Cytoxan, TaxotereRadiation Therapy 07/27/2006 ExternalSurgery 10/19/2006 Prophylactic Ovary Removal (Both)
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Jun 8, 2010 09:05AM trigeek wrote:

Karen actually all is almost good now and I have managed to stabilize (or maybe get used to ) all side effects... so I am functioning maybe almost up to 85% of before bc.. chemo... femara.

(see 2 posts above for my  miraculous regimen !

Bilateral MX with Recon, DD AC/Taxol Rads,Tamoxifen, oopherectomy, femara, zometa "Live Deliberately !"http://www.aylin-yeahright.blogspot.com/

Dx 8/3/2007, ILC, 2cm, Stage II, Grade 2, 2/6 nodes, ER+/PR+, HER2-
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Jun 8, 2010 05:07PM kami88 wrote:

I totally agree, I have been on Femara 6 months, terrible knee jt. pain, elbow pain, hands swollen with the trigger finger episode of index finger now.. difficult to bend fingers in the morning. difficult to get up from a chair if sitting for very long.. any reasons why??? any solutions? 

I see there is a study going on in New York about this.. women are taking glucosamine and chondriton with Omega 3..  

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Aug 12, 2010 02:15PM NancyD wrote:

kami, I woinder if that's the same study I just started through Columbia-Presbyterian? I didn't think there was Omega 3 in with the glucosamine and chondroitin, as it isn't listed on my bottles, and the paperwork just lists the g-c combo.

I'm not a complete idiot. Some parts are missing.

Dx 2/22/2008, IDC, Stage IIIa, Grade 2, 4/10 nodes, ER+/PR+, HER2-Chemotherapy 03/22/2008 Adriamycin, Cytoxan, Taxotere
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Oct 27, 2010 12:24PM, edited Dec 4, 2010 02:16PM by catsrule

I took Femara for 6 months, could barely walk.  I had to go off of it.  I never had foot pain before.  I have been off of it for 4 months and the foot pain is still there.  I am going to a podiatrist next.  I think it is what they call heel spurs, but not sure.  It is very crippling, and appears like swollen bumps on the back of both heels.  I am sure the drug caused it, as it started 3 months into it, and got worse and worse.  I had increased pain in other joints as well, severe hot flashes, and thinning skin, serious fatigue...all I wanted to do was sleep...etc.  I tried the other drugs as well and same thing.  My breast cancer was caught very early, so I am not going to worry about it.  Life was not worth living on femara and arimadex.

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