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Message Number 266357
Status Update View Thread
Posted by Endogenous_Monkey on 7/21/10 at 10:40

Hey Everyone,

It's been a while since I have been on here, so I will give a brief coverall of my situation.
August 3rd, 2009 I was in a car accident. Lots of neck and back issues, lots of narcotics, anti-inflammatories. During this time I couldn't move my neck at all so looking to the sides required me either turning completely at my hips or moving my entire body. Over 9 months I weened off of the narcotics and just used tylenol and advil at max does to manage my pain. I should mention at this point there were NO issues with my feet at all. I finally decide to try acupuncture and to my surprise it worked really well. I could be at a 5 on the 1-10 with no meds at all and I really felt my organs needed a break from all the drugs. Approximately 2 weeks after stopping my medications the numbness, burning, stepping on glass feelings started.

My physician diagnosed TTS in both ankles. He guess was that I had overused them/put too much strain through them while I couldn't turn my head.
Ortopedics sent me to therapy with a total diagnosis of TTS, PF and tendonitis in my achilles.

Eventually things got so bad I had to use crutches because I couldn't tolerate the pain of walking. Crutches helped a bit and I am starting to ween of of them. Starting taking gabbapentin and that has helped me tremendously! The side effects were a little rough at the beginning but for the most part have tapered off except It makes me feel very angry and I do seem to have more violent thoughts. But that could also just be frustration.

TTS pain is limited to just behind the ankle bone for the most part with occasional flare ups. PF pain is mostly in the morning and not very severe. Achilles....well its better than it was, but still an uphill battle.

Thanks for reading this, best of luck to all of you. Also any comments, suggestions more than welcome. Especially if you think something seems off about this. Some people (including myself) are skeptical about how all of this happened to me.

Result number: 1

Message Number 266347

Re: PF and pregnancy View Thread
Posted by Dr.DSW on 7/20/10 at 20:51

Relaxin can make ligaments and tendons more supple, etc., but if you are having plantar fascia issues, Relaxin levels would not be a reason NOT to stretch. I would simply stretch with caution, since the tendons and ligments are theoretically more supple or 'loosened' due to the hormone.

This is even more of a reason to utilize a quality orthotic, and not an inexpensive OTC 'support'. At the very least, a pair of PowerSteps for support should be considered.

Result number: 2

Message Number 266336

Re: Dr. Wedemeyer View Thread
Posted by Dr. Wedemeyer on 7/20/10 at 16:03

'I think my problem is getting the right orthotics that deal with all my issues.'

Nancy this determination while comfortable for you may or may not be in your best interest. The facts as I understand them are that you have had multiple orthoses made from multiple doctors with no positive results. At this point I personally feel that either something has been missed or that foot orthoses possibly may not fit with your presentation as a treatment.

Orthoses have their indications and benefits, as does surgery, medication etc. but none are a panacea and some issues cannot be controlled with in-shoe devices. It is important as a provider to also be mindful of the limitations of any treatment and that the prognosis is dictated by the diagnosis and other factors. Simply reproducing past failures is not a practice in my office and we routinely refer for second opinions.

That is why I offered you a referral to a foot and ankle specialist with whom I have a very high level of confidence in, this in no way suggests that he will rush to perform surgery on you. I know the man and his work and he is above all competent and objective. Because you have had previous surgeries I truly feel that you need another opinion from a physician who performs these surgeries, can review your records, evaluate you and render an appropriate diagnosis.

Again I am recommending that you make an appointment with the ortho and am confident that any future successful treatment will stem from that appointment.

Result number: 3

Message Number 266335

Re: Dr. Wedemeyer View Thread
Posted by Nancy on 7/20/10 at 14:30

Don't get me wrong, I am grateful for the time you are taking with me, but I am no where near thinking about surgery. I think my problem is getting the right orthotics that deal with all my issues.

I would have hoped that a recommendation of perhaps 'THE ABSOLUTE BEST!' biomechanical podiatrist in the area might have come before an orthopedic surgeon. Naturally I would be willing to come to Orange County for that if you say there are more of these doctors there than in LA.

Thanks.

Result number: 4

Message Number 266334

Re: Metarsalgia Capsulitis View Thread
Posted by gale j on 7/20/10 at 14:22

I tried massaging the top of my calf muscle, as you suggested, and it gave almost immediate relief to pain in the ball of my foot and I think even some swelling. I am scheduled to have my second toe shortened in a few weeks and now I am rethinking it. Maybe it isn't just the area of the foot that is feeling pain that is the problem. I am also doing stretching now which is recommended for plantar fasciitis and hoping that this may be a good routine which could make this condition manageable. This site has been an encouragement...I have had 'issues' with my foot since a stress fracture from walking a marathon 5 years ago. I do not think that just staying off the foot is enough to make any difference. I am wondering if I need to strengthen my foot muscles...not let them atrophy.

Result number: 5

Message Number 266221

vein in arch of foot View Thread
Posted by Judith on 7/13/10 at 21:11

Is it unusual to have one's veins (just one vein right at the height of the arch) in the arch of the foot ( bi-laterally) swell after walking or standing for a while? I am 60 years old, no high blood pressure or any other health issues. Is this an old age thing? The vein is sensitive and rubs against my orthotics creating an uncomfortable feeling.

Result number: 6

Message Number 266140

Re: Recess Appointments View Thread
Posted by John H on 7/09/10 at 16:43

Rick: I think Americans are now getting it. On the big issues they have come down against Obama. Health Care, Oil spill and Leadership, Today the most current poll shows Americans favor the Arizona immigration law by 50% support while only 38% favor the lawsuit filed by the U.S. Government. The poll took it even further. It showed the more informed a person was about the Arizona law the more they favored it. Americans by a large majority think the nation is moving in the wrong direction. Americans did not and do not favor bailouts. I do not think you have to be a genius to see that unless Obama changes direction rapidly he is a one term president. How our Attorney General could let the Black Panther spilling his wrath about white people in front of a polling place is a total mystery to me. The Black Panther was right in line with the Reverend Wright. Obama has brought to our White House his version of Chicago politics. We have not by any means heard the last of the former Illinois Governor. One man testified yesterday that the President did know about the Presidents desires to have one of his own appointed as Senator and let the the Governor know about it. This stinks even for Chicago politics. The latest plan as reported in the WSJ is that after the mid terms the House and Senate will have nothing to lose by supporting some of the further issues favored by Obama. Being lame ducks the plan is to then bring up the bills and not bring them up prior to the mid terms as it would be more ammunition for the Republicans. This may be a smart political move but is it the kind of government we want. Just more of the same Chicago style that Obama cut his teeth on.

Result number: 7

Message Number 266133

Re: Haglund's Deformity View Thread
Posted by john on 7/08/10 at 22:25

The Response of Modern Medicine
Modern medicine continues to search for drugs, devices and surgical procedures to eliminate chronic foot and hand pain. Anti-inflammatory drugs have become a billion dollar business. While the drugs may provide temporary relief, they do nothing to correct the underlying condition causing the pain. In fact, in the long run, these medications do more damage than good.

Prolotherapy vs. cortisoneAnother common pain treatment is a cortisone shot. It's also one of the quickest ways to lose strength at the ligament-bone (fibro-osseous) junction. Cortisone and other steroid shots have adverse affects on bone, cartilage and soft tissue healing. Unfortunately, many people suffering from chronic pain look for quick relief without thinking about the long-term, potentially harmful side effects that could occur. The problem with cortisone is that, although immediate pain relief is possible, it inhibits nearly every aspect of healing, making the pain condition even worse!

In simple terms, anti-inflammatory drugs and cortisone shots are anti-healing. They result in long-term loss of function and even more chronic pain by actually inhibiting the healing process of soft tissues and accelerating cartilage degeneration. Plus, long-term use of these drugs can lead to other sources of chronic pain, allergies, leaky gut syndrome and other serious side effects.

Finally, when all else fails, patients who experience chronic pain, particularly joint pain, are referred to a surgeon. Unfortunately, surgery usually makes the problem even worse. Surgeons will use x-ray technology as a diagnostic tool, which does not always properly diagnose the pain source. Plus, decisions to remove cartilage tissue, bone or a disc will most commonly result in arthritis. And so, the treatment of one pain condition simply leads to another.

The Natural Medicine Approach to Treating Foot and Hand Pain
Ligaments of the wrist A better approach to alleviating chronic pain (forever!) is to stimulate soft tissue, ligament and cartilage repair with Prolotherapy. One cause of chronic pain that is frequently overlooked is referred pain, that is, when ligament injury or weakness in one part of the body causes pain in another part of the body.

In the case of chronic hand pain, the source of the problem could actually be in the wrist. Foot pain, on the other hand, is often the result of an injury to the spring ligament, an elastic ligament in the sole of the foot. Treating the affected areas typically eliminates chronic pain in the food and the hand.

Anatomy of the bottom of the foot Most people have chronic pain because of ligament weakness and cartilage deterioration. Here's what happens:

1. A ligament is damaged through overuse or trauma, such as a sports injury or an accident.

2. Because of the ligament's poor blood supply, it does not heal (unlike muscles, which have a good blood supply and heal quite easily).

3. Over time, the injured ligament weakens, like a stretched rubberband that has lost its elasticity.

4. Since ligaments function as joint stabilizers, the injured ligament is no longer capable of doing its job.

5. As a result, the muscles must compensate. They begin to ache and spasm and, eventually, the joint or vertebra in the area begins to compensate as well.

6. Overgrowth of bone occurs to help stabilize the injured ligament, which leads to arthritis, and a whole new level of pain and disability.

This downward spiral of pain can be halted and reversed only by stimulating healing at the source—the ligament. The only proven procedure that stimulates this kind of healing is Prolotherapy.

Prolotherapy is the safest and most effective natural medicine treatment for repairing tendon, ligament and cartilage damage. Prolotherapy stimulates the body to repair painful areas by inducing a mild inflammatory reaction in the weakened ligaments and cartilage. The inflammation causes the blood supply to dramatically increase in the ligament, alerting the body that healing needs to take place. In the simplest terms, Prolotherapy stimulates healing.

Prolotherapy offers the most curative results in treating chronic pain. It effectively eliminates pain because it attacks the source: the fibro-osseous junction, an area rich in sensory nerves. What's more, the tissue strengthening and pain relief stimulated by Prolotherapy is permanent!

Nearly all pain conditions can be successfully treated with Prolotherapy, including:
Osteoarthritis
Tendonitis
Migraines
Sports Injuries
Loose Joints (Hypermobility)
Fibromyalgia
RSD Pain
Temporomandibular Joint Syndrome (TMJ)
Sciatica
Herniated Discs
Degenerated Discs
Degenerated Joints
Chondromalacia Patellae
Osgood-Schlatter Disease
Carpal Tunnel Syndrome
Ligament Sprains
Plantar Fasciitis
...and Back, Hip, Neck, Shoulder, Knee, Elbow, Foot, Ankle, Hand, Wrist, Finger and Toe Pain

To learn more about the Prolotherapy procedure, click here. To read how a man suffering from chronic heel pain found relief with prolotherapy, click here. And to learn why the treatment approach referred to as MEAT (Movement, Exercise, Analgesics & Treatments) is superior to RICE (Rest, Ice, Compression and Elevation) when treating injuries, click here.

If you are interested in more information about Prolotherapy or to schedule an appointment with one of our natural medicine specialists, please contact Caring Medical at 708-848-7789, or online using our contact form.

Click here to receive our FREE electronic newsletter.

Products:

* Prolo Max
* TRMA
* Cod Liver Oil
* Bromelain Max
* MSM
* Pro-Cartilage
* Rapid Response 5
* Rapid Response 1


The treatment regimens suggested here are based on the experience Caring Medical. They do not apply to every case or condition. A person using these recommendations without the aid of a personal physician does so at their own risk.

This information is provided for informational purposes only. It is essential to have your condition evaluated by your own personal physician. For an appointment with Ross Hauser, M.D., please call 708-848-7789. or email us at scheduling at caringmedical.com.Treatment of Foot Pain:

The Response of Modern Medicine
Modern medicine continues to search for drugs, devices and surgical procedures to eliminate chronic foot and hand pain. Anti-inflammatory drugs have become a billion dollar business. While the drugs may provide temporary relief, they do nothing to correct the underlying condition causing the pain. In fact, in the long run, these medications do more damage than good.

Prolotherapy vs. cortisoneAnother common pain treatment is a cortisone shot. It's also one of the quickest ways to lose strength at the ligament-bone (fibro-osseous) junction. Cortisone and other steroid shots have adverse affects on bone, cartilage and soft tissue healing. Unfortunately, many people suffering from chronic pain look for quick relief without thinking about the long-term, potentially harmful side effects that could occur. The problem with cortisone is that, although immediate pain relief is possible, it inhibits nearly every aspect of healing, making the pain condition even worse!

In simple terms, anti-inflammatory drugs and cortisone shots are anti-healing. They result in long-term loss of function and even more chronic pain by actually inhibiting the healing process of soft tissues and accelerating cartilage degeneration. Plus, long-term use of these drugs can lead to other sources of chronic pain, allergies, leaky gut syndrome and other serious side effects.

Finally, when all else fails, patients who experience chronic pain, particularly joint pain, are referred to a surgeon. Unfortunately, surgery usually makes the problem even worse. Surgeons will use x-ray technology as a diagnostic tool, which does not always properly diagnose the pain source. Plus, decisions to remove cartilage tissue, bone or a disc will most commonly result in arthritis. And so, the treatment of one pain condition simply leads to another.

The Natural Medicine Approach to Treating Foot and Hand Pain
Ligaments of the wrist A better approach to alleviating chronic pain (forever!) is to stimulate soft tissue, ligament and cartilage repair with Prolotherapy. One cause of chronic pain that is frequently overlooked is referred pain, that is, when ligament injury or weakness in one part of the body causes pain in another part of the body.

In the case of chronic hand pain, the source of the problem could actually be in the wrist. Foot pain, on the other hand, is often the result of an injury to the spring ligament, an elastic ligament in the sole of the foot. Treating the affected areas typically eliminates chronic pain in the food and the hand.

Anatomy of the bottom of the foot Most people have chronic pain because of ligament weakness and cartilage deterioration. Here's what happens:

1. A ligament is damaged through overuse or trauma, such as a sports injury or an accident.

2. Because of the ligament's poor blood supply, it does not heal (unlike muscles, which have a good blood supply and heal quite easily).

3. Over time, the injured ligament weakens, like a stretched rubberband that has lost its elasticity.

4. Since ligaments function as joint stabilizers, the injured ligament is no longer capable of doing its job.

5. As a result, the muscles must compensate. They begin to ache and spasm and, eventually, the joint or vertebra in the area begins to compensate as well.

6. Overgrowth of bone occurs to help stabilize the injured ligament, which leads to arthritis, and a whole new level of pain and disability.

This downward spiral of pain can be halted and reversed only by stimulating healing at the source—the ligament. The only proven procedure that stimulates this kind of healing is Prolotherapy.

Prolotherapy is the safest and most effective natural medicine treatment for repairing tendon, ligament and cartilage damage. Prolotherapy stimulates the body to repair painful areas by inducing a mild inflammatory reaction in the weakened ligaments and cartilage. The inflammation causes the blood supply to dramatically increase in the ligament, alerting the body that healing needs to take place. In the simplest terms, Prolotherapy stimulates healing.

Prolotherapy offers the most curative results in treating chronic pain. It effectively eliminates pain because it attacks the source: the fibro-osseous junction, an area rich in sensory nerves. What's more, the tissue strengthening and pain relief stimulated by Prolotherapy is permanent!

Nearly all pain conditions can be successfully treated with Prolotherapy, including:
Osteoarthritis
Tendonitis
Migraines
Sports Injuries
Loose Joints (Hypermobility)
Fibromyalgia
RSD Pain
Temporomandibular Joint Syndrome (TMJ)
Sciatica
Herniated Discs
Degenerated Discs
Degenerated Joints
Chondromalacia Patellae
Osgood-Schlatter Disease
Carpal Tunnel Syndrome
Ligament Sprains
Plantar Fasciitis
...and Back, Hip, Neck, Shoulder, Knee, Elbow, Foot, Ankle, Hand, Wrist, Finger and Toe Pain

To learn more about the Prolotherapy procedure, click here. To read how a man suffering from chronic heel pain found relief with prolotherapy, click here. And to learn why the treatment approach referred to as MEAT (Movement, Exercise, Analgesics & Treatments) is superior to RICE (Rest, Ice, Compression and Elevation) when treating injuries, click here.

If you are interested in more information about Prolotherapy or to schedule an appointment with one of our natural medicine specialists, please contact Caring Medical at 708-848-7789, or online using our contact form.

Click here to receive our FREE electronic newsletter.

Products:

* Prolo Max
* TRMA
* Cod Liver Oil
* Bromelain Max
* MSM
* Pro-Cartilage
* Rapid Response 5
* Rapid Response 1


The treatment regimens suggested here are based on the experience Caring Medical. They do not apply to every case or condition. A person using these recommendations without the aid of a personal physician does so at their own risk.

This information is provided for informational purposes only. It is essential to have your condition evaluated by your own personal physician. For an appointment with Ross Hauser, M.D., please call 708-848-7789. or email us at scheduling at caringmedical.com.

Result number: 8

Message Number 265991

Dr. LA area who knows their biomechanical stuff! View Thread
Posted by Nancy on 6/29/10 at 19:47

I need a really, really good podiatrist in the LA area (Pasadena, LA, Glendale) who is a specialist in biomechanical issues. Some podiatrists I have seen don't even touch your feet, or watch you walk, etc!

I need someone a cut above. Please help me.

Result number: 9

Message Number 265979

Re: misinformation View Thread
Posted by King Joe on 6/29/10 at 09:26

I had written a explanatory comeback to both Docs but...remembered what we are 'here' for....and:

Stay on topic. Do not discuss the 'politics' of the message board.
Do not reply to posts that are not nice or on topic.

So with that...

Thanks for your comments both Dr. Ed and Dr Wedemyer. There was no denegration nor derogatory comments in my post. Like yours, they are opinion. And as opinion, I am perfectly in my place to say...'heal thyself' meaning of course, we all have a responsibility to look after our healing and should not depend on others for it. Research, understand, know to the best of your ability what is going on. If you don't like the opinion of a professional, question it.

I 'never have, nor never will' use either orthodics or chiro....and have TONS of positive experiences following the path I have chosen to work to correct problems with exercise and diet. THIS I will continue AND continue to expose the values in taking matters into your own hands and NOT leaving to others, where possible, for your/my well being. My surgical experiences (I have many, many more other than just my heels...tough and rugged life...hah) have pretty much all been positive and I have no issues, persay, with the medical community. I do feel that as a populace, we are too dependant on 'them' and this is propogated by the medical and drug community. Nuff said on that.

I will endeveour to maintain my accuracy of comment WHEN dealing with things that require accuracy. My opinion, my experiences...remain unfazed and unchanged by yours.

Sorry Lynette for highjacking your post with this. Won't happen again.

Result number: 10

Message Number 265973

Re: misinformation View Thread
Posted by dannyb on 6/28/10 at 23:40


OK, I probably started this little debate. Unintentionally. For all those reading this, I offer a few clarifications.

1) I undertook my stretching and foot strengthening program under the supervision of a podiatrist and with the help of a trained physical therapist that happens to specialize in this particular problem. That program alleviated a number of imbalances in my alignment, eliminating hip and knee pain.
2) I have worn inserts in my shoes, but not custom made orthotics. I have had limited success with the various inserts I have tried and used.
3) Prior to surgery, the podiatrist recommended orthotics. Given my level of pain, I opted to have surgery as a next step.
4) I will be sharing all of these experiences with my treating physician and discussing the next best step for recovery and to avoid future injury. He has raised the possibility of orthotics, but given that I am not yet wearing a shoe, the discussion has not advanced.

I am many things, but I am not a Dr. I do not understand the cause and effect between my foot problems and my bio-mechanical issues. I trusted my treating physician with surgery and will collaborate with him on the best course of action regarding use of orthotics.

I will admit to a bias. I am strongly in favor of strength training, stretching, yoga, etc, as a central part of my recovery.

Result number: 11

Message Number 265903

Re: Gym exercises to avoid with PF? View Thread
Posted by Jeremy L, C Ped on 6/26/10 at 11:23

If you have classic biomechanical deficiencies leading to plantar fasciitis (i.e. reduced capacity to adequately dorsiflex the ankle), calf stengthening are not generally recommended. This, I would be hesitant to suggest any. gaining flexibility in the gastroc-soleus muscle groups is far more important than increasing their resistance.

As for common gym exercise machines, I am generally not in favor of treadmills, either for walking or running. In addition to the negative pitch angles most platforms use, the relatively narrow width ofs the platforms also cause issues. Most users subconsciously narrow their base of gait, which in turn leads to more foot abduction during gait and/or greater rates of rearfoot pronation. The comnination of these biomechanical elements also contribute to greater torsional loads in the midfoot. If the individiual's shoes are not made to adequately protect against those loads, it can place the foot into a position where it chronically reinjures the tissue at the heel's insertional point of the plantar fascia.

Result number: 12

Message Number 265901

Re: MD won't refer to Podiatrist View Thread
Posted by tessmick on 6/26/10 at 10:29

Thanks Dr. Wander.

As I posted on the shoe thread the other day, I am doing much better, due completely to the great info available here. At my insistence, my internist did finally agree to x-ray my foot. His diagnosis is that I have a small heel spur (which I know is PF) & tendonitis; his only suggestion was that he could give me a cortisone shot. Not only do I feel I don't need it at this time, and (again with the info here) I wouldn't want him to do it!

Unfortunately due to other medical issues, I have 'doctor hopped' (if you will) several times in the last few yrs., and have been very happy with this doc since then. I'm not ruling out finding a different doc at some point, but I'm on an HMO, which means I'm limited.

Now I'm going to start a new thread about exercise!

Result number: 13

Message Number 265836

"Good Feet" Store and Arch Supports aren't bad! View Thread
Posted by Ken on 6/22/10 at 15:37

I have spent way too much of my employer's time today because I have been reading this post, but feel that I must pipe in my $200 worth here.

In 1995 I found myself on the verge of having P.F. surgery as the doctors had tried 'EVERYTHING' to relieve my pain. I was in Tennessee with my fiance' (now wife) and was at the point of only being able to walk about a half hour at a time at best. The pain was overwhelming. As fate would have it, I wandered into an orthodic pain store and let some lady talk me into some arch support that was supposed to solve all my issues. 'Yeah Right', I thought. Well she was good at her job as she made the sale.

It is now 2010 and I have 2 pair of these inserts and the first pair bought back in 1995 are just now failing. My inserts have no name on them and thus I could never find them anywhere local to where I live now, until I found the Good Feet Store. They are exactly the same, I mean absolutely the same as the classic Alznner's. Same color, same feel, same density, same everything.

My story goes like this: I left this lady's store with the insert in. She told me that it would feel like I was walking with a golf ball under each of my arches. She was right. She also told me that I should wear them 2 hours the first day and slowly extend the time out until I no longer notice them at all. Again she was right. In fact I felt confident because I was limping when I went into her store, yet left able to walk with the golf ball feeling, but the HEEL pain was relieved a lot. Within just a few weeks I never noticed them in my shoes, AND the heel pain was gone. I wear them in all shoes and even got to where I could go without at times. I even began running again and in 2005 I took them with me to training course for my job that also involved daily physical training. These inserts went with me and as time past I was running near ten miles with these inserts in GOOD running shoes.

Folks it's all about what works for you. A coworker of mine called is custom made orthodics a waste of money as well. I asked how and he described the feeling of walking on the golf balls. I told him my story and for what ever reason no one had told him about the adjustment time. The adjustment is not for the orthodic as much as it is to your foot. My arch is higher now and the heel pain is all but nonexistant. My coworker tried his other-brand inserts after hearing about me and he too is now pain free. SO be sure and do your homework and get good instructions.

Lastly, don't by crappy shoes. In fact I could care less if my insert has a money back guarantee, it's the shoes that need that guarantee. I have found that I just can't wear a Nike. Insert in or not, a Nike causes me the heal pain. There is also one brand of work boots I just can't wear, but can wear other competitors in the same price range. After this many years (15) I know the right fit when I put on a shoe with the insert in and I have been fine ever since. I can even wear flat as hell deck shoes, as long as the insert is in there. It just depends. Everyone is different, and if the Good Feet Store insert works, get it. I did and am still happy.

Result number: 14

Message Number 265785

Re: Pain/Swelling on outside of ankle View Thread
Posted by Endogenous_Monkey on 6/17/10 at 17:57

Hmmm, that's not what I was hoping to hear. I'm going to take my first one tonight, if it only makes me tired that'll be good. Even better if it helps. I have some other nerve issues in my right arm (not nearly as painful as my feet) so if it benifits me there, I'll have to call it at least a small win.

The anti-inflammatory didn't seem any different than the advil. I will be so happy when I can go a day without taking a ton of pills.

Result number: 15

Message Number 265744

Re: Sandals for Bunion Pain Relief View Thread
Posted by Cam on 6/14/10 at 14:11

Dr. DSW,

Thanks for the reply. I reviewed my initial post, and I think it sounded too much like a sales pitch. Should have toned it down. And to be honest, I completely forgot that I had a link to my website in the video. Once again, my apologies. I really enjoy the content on this site, and it's obvious to me that you, Jeremy and others take great pride in disseminating useful and relevant information for your readers.

I am a Certified Fitter of Therapeutic Shoes (CFts). We do not do any work with custom orthoses, custom shoe builds, etc. We deal only with comfort shoes and OTC products. If someone needs the services of a C.Ped, we refer our customers to C.Peds that do fabulous work. We also routinely refer our customers to podiatrists and other medical professionals for undiagnosed pain issues.

Result number: 16

Message Number 265715

Re: Tarsal Tunnel Pain - the facts about the success of conservative treatment View Thread
Posted by Dr. Ed on 6/12/10 at 00:49

Conservative therapy can work very well for tarsal tunnel syndrome but it depends on the cause. Tarsal tunnel syndrome, for example, may have biomechanical causes. If that is the case, control of the biomechanical issues can lead to success. Tarsal tunnel syndrome may be caused by scar tissue pressing on the nerve. If that is the case, then modalities that reduce scar tissue may be successful. Tarsal tunnel syndrome may be caused by varicose veins in the tarsal tunnel placing pressure on the nerve. If that is the case, then use of support hose may be successful.

Conservative treatment of tarsal tunnel syndrome is less successful if there is a space occupying lesion in the tarsal tunnel.

Dr. Ed

Result number: 17

Message Number 265706

Re: Just Diagnosed with Bilateral TTS View Thread
Posted by Endogenous_Monkey on 6/11/10 at 16:41

Thanks for this information!!! I have not had an MRI of my lower back done and I am going to ask the next doctor I see for one. I was in a car accident about 10 months ago and I did suffer some damage to my cervical spine. I don't think anyone ever took the time to consider some pain issues I have been having in my lower back because the pain in my upper back was so much more severe. I kind of wonder now if the two are related, I suppose I should write up the whole story and see what the doctors here think. Funny to think some of the best doctors I deal with I have never met, but they take time for us and give it to us straight.

Result number: 18

Message Number 265703

Re: Pain/Swelling on outside of ankle View Thread
Posted by Endogenous_Monkey on 6/11/10 at 15:17

Nope not the same as 061,

I was just taking a break from the internet for a while. Sometimes I get to compulsive with looking for answers. Seems like I missed some stuff here though, YIKES.

I had my first PT session today. Basically the plan is to try some pool work 2x a week and see how that works out. I guess if after a few weeks I'm not doing any better then we will look at crutches/chair.

I saw my neurologist yesterday (for unrelated issues) and he gave me a script for an anti inflammatory called nabumetone to replace my advil and neurontin. I am going to try the anti-inflammatory for a week or so before beginning the neurontin. That way I will know which one does what for me. I'm also not too excited about taking neurontin, seems like a lot of side effects.

Hopefully someone could comment on either of these drugs. Or if one of the docs could comment on staggering the starting of these...


Thanks everyone!!!

Result number: 19

Message Number 265683

Re: TTS and neuropathy type feeling--my 'neuropathy' cure View Thread
Posted by cher on 6/10/10 at 23:44

HI, Dr. Wedemeyer,

I agree that all of these vitamins are important in the right amounts. Some vitamins are safer to ingest in large quantities than others. I guess I would like to say that I would not mess with any of these vitamins (removing or adding) without consulting a physician. Not sure if I made clear that I had my blood serum levels tested for both the B6 and the Vitamin D. It was a neurologist who was concerned with my high B6 levels and my extremely low D.
After researching in books and online, as well as consulting with other physicians along my path, I found that this seems to be an agreed upon belief. That B6 levels that are too high add problems with these nerve issues.
Obviously the Bs are very important. I think one reason my B6 was high is that I was eating a protein bar, plus had the B6 in my multi-vitamin. I have also since looked at the ingredients on food labels to help keep this in check.
I had my B6 levels checked two times in a period of about 2 months. So while it may be water soluable, for me my levels were high both times. With my nerve pain, I was more than willing to address it.
I really cannot say that for sure the lowering of the B6 (which I plan to have rechecked here again soon) or the highering of the Vitamin D are the reasons for my neuropathy feelings going away.
However, because those were the most drastic changes I made personal efforts on (changing my vitamin habits in those areas) and found such a drastic change in my foot/leg sensations--I believe they really are 2 of the main reasons for the positive change. I decided to post, because I would love to help anyone else who is looking for answers.
So may I suggest that anyone reading take the time and money to get your levels checked clinically before endangering your health by taking too much or too little.
Dr. W, it has bothered me when some drs. have assumed I need more B vitamins without even asking or knowing about my B6.
Other drs seem more informed about this vitamin perhaps causing this nerve pattern.
I would also like to add that I have been ruled out for diabetes and autoimmune disorders.
My neuropathy was idiopathic.
Now to get completely rid of the other foot pain.
But I'm in process with that, too.
Lovely to converse with you Dr. and very grateful for the time you take here on these boards.
Much appreciated.

Cher

Result number: 20

Message Number 265679

Custom orthotics = pain :( Advice needed! View Thread
Posted by ian on 6/10/10 at 22:26

When I was a teenager (16-17 maybe) I had pain in the arches of my feet. I have high arches. I got orthotics prescribed. They took a couple weeks to get used to, but then basically worked perfectly for about 10 years. No problems at all.

But after that I started getting pain in my ankle. I think it was because the bottom of my right orthotic was wearing down. Okay, no problem, I will just go buy a new pair and problem solved... or so I thought...

Orthotic place #1) So I went to get my feet examined. The orthotic technologist said my feet were borderline, that is, she didn't necessarily reccomend orthotics, but if I thought they would help, she would make them for me. OK. I showed her my previous orthotics and explained how my pain was from my high arches. She did a thorough examination and casted my feet.

A couple weeks later I got the orthotic. There was no arch support it at all. I was really surprised and mentioned it to her. She told me to try them, so I did. The result was lots of pain in my arch. So when I went back she decided to make a new pair. This time instead of there being no arch support, the whole area under the arch was cut out(?!?!). she said that she was trying to drop my big toe or something. Again, the results: unsurprisingly arch pain.

I think the next time I went to the clinic I saw a different practitioner. I explained how I got two pairs in a row without arch support. So third pair was made. In great comedic fashion this one didn't have arch support either. It almost did, the problem was that the arch curved towards the vertical (like the curve y=x^2 )rather than towards the horizontal (like y=logx, if you're not a math person, don't worry about these explanations ;). Interestingly the practitioner said that nobody makes the orthotics the way my 10-year-old pair were made. He said they were made wrong. Ok... Needless to say this new model caused arch pain too.

There might have been one more pair made, and then finally they tried to copy the 10-year-old orthotic but failed miserably as one of my big toes didn't even touch the ground when wearing it.

After 4-5 painful pairs of orthotics, this company kicked me out the door with a partial refund.

orthotic place 2) I decided to hunt down the doctor who had made my 10-year-old pair of orthotics. Surely he could do a better job...
the result:

Pair 1) no arch support (among other issues)
revision 1) finally some arch support but way too much and caused pain
rev 2) the outside of the orthotic was curved up and caused pain to the bone that sticks out in the middle on the outside of the foot under the pinky toe. I also need a valley cut because the tendon that runs from my big toe to the back of my foot grinds into the orthotic
rev 3) the pinky toe problem is not fixed. One valley is cut properly for the tendon (although not deep enough). The valley cut on the other foot misses the tendon completely.
rev 4) the doctor remembers the pinky problem (although the outside of their orthotic is not ground down enough so still causes pain. My tendon from my big toe still cuts into the orthotic near my heel (although I think it might be cutting into the flesh as well... I really can't tell anymore)

and now I am about to go in again for rev 5 :-(



I really don't think my problem is that unusual, it seems quite simple to fix
1) high arch (needs support)
2) the tendon from my big toe digs into the orthotic (although with my 10-year-old pair this was never a problem as the bump in the orthotics never even went out that far)

3) the pointy bone in the middle of the outside of my foot (under the pinky toe) digs painfully into the orthotic. (This was never a problem with the 10-year-old pair as the orthotic never went out that far).


Some of the problems with my new orthotic
1) it's about a 1cm wider than the old pair. The doctor says this can't be changed but:
a) the pointy bone in the middle of the outside of my foot always digs into the orthotic, even though the doctor has grinded it down a fair bit
b) because the orthotic is so big, my feet move around a little bit so I think it's impossible to expect my tendon to stay in the valley (even if in valley is made perfectly) in the orthotic...

I'm completely frustrated and have no idea what to do anymore. This doctor has gone to a new orthotic making company/process so he says it's not possible to make them like how my 10-year-old pair was.

Frustrating... it's been 1 year since I tried to replace my orthotics. 2 companies about 5 different pairs and 3 revisions of orthotics... and always feel pain and can only walk short distances.

Anybody have any words of wisdom for me?

Thanks,
Ian

Result number: 21

Message Number 265677

Re: No Doctors to Answer. But anyone else can View Thread
Posted by Tony M. on 6/10/10 at 22:00

No Lower Back issues.

I cannot get a second opinion unless I pay for it. Although WC has sent me to a total of 3 doctors to ensure that surgery was needed.And all of them agreed with what I had and it was needed. And no to acupuncture.

Result number: 22

Message Number 265676

Re: No Doctors to Answer. But anyone else can View Thread
Posted by Laurie C. on 6/10/10 at 21:57

Has the doctor done any type of injections to help break up the scar tissue? Have you tried acupuncture? Have you gotten a 2nd opinion from another doctor? Is there a possibility that you could have some low back issues contributing to the TTS?

Result number: 23

Message Number 265673

Re: Future issue's from TTS View Thread
Posted by Laurie C. on 6/10/10 at 20:30

Tony,

I think the question has been answered. Again, Linda stated what some consequences could be, Julie did as well as I did. Dr. Wedemeyer stated that it also depends on your overall health and your genetics.

For example, if the TTS is not treated and you become a life long sufferer, I suppose you could reduce activity levels and all the natural consequences of that. A list of possible comorbidities could include weight gain due to inactivity, possible diabetes (depending on your genetics), depression, heart attack, and stroke. You could also suffer from the effects of altered gait (which I also mentioned already) - injured knees, hips, lower lumber, thoracic and cervical issues. I mentioned any problems with gait can impact anywhere up the kinetic chain. I suppose if you were looking at the very unusual presentations that someone may have if their TTS is not treated would be lack of sensation, possible foot ulcers, infection, gangrene, amputation etc. etc.

I'm sure though that the above mentioned comorbidities are not a common occurrence so it really needs to be addressed by your doctor in relationship to your health.

The point is not what could happen, but what could happen to you based on your health and genetics which is unknown to this online community.

Result number: 24

Message Number 265672

No Doctors to Answer. But anyone else can View Thread
Posted by Tony M. on 6/10/10 at 20:24

Since I seem to be attacked for my question in my previous post and it was stated that I Should say if I wanted a doctor or someone else to answer, I will stick to someone else.

If you have has TTS for a while know, what other issue's has it caused you?

My TTS is work related (do to an accident) and I have had surgery, pain meds, PT, rocker boot, other meds, cortizone shots and other Misc stuff that has done zero to help me. After my surgery, going on 6 months ago, it has gotten worse.

I am coming to a point know where I have a few options:

1.) Have a spinal cord stimulator implanted and deal with those issues and have my monetary pay from WC run out.

2.) Settle with Workers Comp. and worry about my future medical myself.

3.) Don't Settle but stay on Workers Comp. and loose my monetary pay (do to State Limits on WC) and be unable to work and end up loosing my home.


SO I am using this site to assist me in determining what other type's of issue's may or may not arise from having TTS.

My complaints currently are:

1.)Toes going numb.
2.)Feeling like someone jabbing me with a sharp knife in my toes.
3.)Same sharp knife being dragged down from the top of my arch to the bottom of my foot.
4.)Numbness on bottom of foot.
5.)Pain on inside of ankle.
6.) New issue with the back of my ankle hurting when I walk.
7.) Electrical zaps or what ever you want to call it in my foot.
8.) I feel as if I have no padding on the ball of my foot.
9.) My knee hurts about every other day know...From limping I think.

I cannot put my foot on the floor but for a few minutes and I cannot stand but a few minutes without it being extremely painful.

I am between a rock and a hard place.


I am collecting any information I can to help me.

If anyone who has TTS or had it can help me answer my question, I would be great full.

If all you plan on doing is attacking my question, then feel free to put a sock in it.

Result number: 25

Message Number 265667

Re: Future issue's from TTS View Thread
Posted by Dr. Wedemeyer on 6/10/10 at 17:47

One potential problem with the written word is that the tone and inflection in face to face verbal communication is not present. I know Dr. Wander personally and I can tell you that he is a compassionate physician with a very no nonsense approach. I prefer that in my doctor, even if he/she were to ask me to rephrase a question so that they could understand it.

Mo offense to Tony but his question was very vague in my opinion:

'an anyone inform me of what other problem's can come from having TTS?

Such as with limping on the bad foot, relying on your good foot too much and so on.

What kind of future issue's will TTS cause if you are stuck with it for the rest of your life?'

These are questions to ask your doctor regarding your individual prognosis. Not all TTS cases have the same symptoms and there are far too many factors to be considered to intelligently answer his question in an open forum. Had he asked more specific questions such as 'will I need crutches, will I also have low back pain from the crutches, will I gain weight because of my inability to walk due to drop foot....etc. I still do not know how anyone can answer these questions other than his doctor. Tony did not specifically ask that a doctor answer him and you may not care for the manner in which Dr. Wander answered but these are issues that belong on a social board and not a website where there are professionals to answer medical questions I feel.

We as providers see a question such as this and justifiably believe that you want a professional to answer. If not, you should preface it with 'I would love to hear from anyone else suffering from TTS...'. Otherwise it is likely that both doctors and readers will answer. Make sense?

Tony, your Activities of Daily Living such as your employment, walking, brushing your teeth, driving etc. can all potentially be affected by chronic TTS. This is also something that should be addressed by your doctor who has seen and evaluated you and knows the extent of your injury and prognosis. Not all TTS arrives at a surgical solution although many do. The mechanism of entrapment (mechanical, systemic, trauma etc) is an important factor. The length of time the insult is present, your age, weight, general physical condition, contributing medical history, congenital factors...all play a role in the development of TTS and your recovery.

Instead of angering the good Dr. Wander, who's contribution here and in his own office is heroic, could you please think about specific questions, start a new thread and specify who you would like to address your inquiry? I am sure we can move beyond assailing my good friend and colleague and answer Tony's questions sans the vitriol and treat him with the respect that he merits.

Fair?

Result number: 26

Message Number 265652

Re: Future issue's from TTS View Thread
Posted by Bill C on 6/10/10 at 09:54

John C., I will preface my comments with the usual 'every case is different' statement. You ask a very important question.

As an 18 year sufferer of TTS I will tell you how it has impacted me. 18 years is roughly one third of my life. I finally had surgery as a last resort 2 months ago and have noticed some improvement a specific type of pain, but still have some annoying symptoms that I hoped would go away but have not. One of these symptoms is the skin around my medial malleolus is very sensitive and anything touching it, like shoes, pant leg, etc. is very annoying. That problem is unrelieved.

I was very athletic when I was younger and continued to be into adulthood. I played very competitive hockey as an adult, even with this problem, until I was 48 years old. I am able to “play in pain” which is something athletes and learn. (Having a metal rod placed in my neck finally ended my hockey career) As a result of maintaining activity, my weight is normal and I am still in reasonably good shape. I continued to lift weights (not legs) starting five days after surgery.

With that being said, I think the impact of TTS with me has been significant. I have emotional fatigue, pain fatigue, obsession over footwear, a financial burden from buying multiple shoes and gimmicks including orthotics, magnet insoles, braces, wraps, creams, acupuncture, ect. I also have toenail fungus on the big toe and 4th toe. I find it interesting that I only have it on those 2 nails and have had it since my symptoms began. Both toes have some numbness. All the other toes with normal nails have normal sensation. When I look at pictures of me when I was young, the first thing I look at is what kind of shoes I was wearing.

There are other issues where people think I am a hypochondriac, a whiner, a malingerer, etc. Example: My father has known about my ankle problem for years and still acts like a jerk if the problem is mentioned. Not long ago when he found out I was having surgery, he asked me, 'What’s wrong with your ankle?' I have explained my symptoms to more than 10 different doctors over the years. Some looked at their watch, others became glassy eyed, almost all said to “try these orthotics”.

I think the problem can also evolve into other issues like a Morton’s neuroma, back pain, and so on (it has with me). My calf on the affected side is one inch smaller than the other. My affected foot has shrunk causing me to wear 2 different size shoes.

If you ask me in ten years, when I am 28 years into this, I will probably have even more issues.

Result number: 27

Message Number 265649

Re: Future issues from TTS View Thread
Posted by LindaW on 6/10/10 at 06:14

Some people are blowing this all out of proportion. I thought that I had answered Tony's question for what I understood the question to be, but I guess that isn't the case. Believe me Annette, I do have compassion, because I too had bilteral TTS, had the surgeries and at that time never saw the light at the end of the tunnel. I suffered with TTS for years and still have my problems now and then. I have been looking for a job now for 2 years since my last surgey and am totally depressed, but to go off on people on this board who thought were answering the question to their best of their ability is rediculous to me. I also am not a Dr., but in the medical field. Do you know how many interviews that I have been on since December of 09? Well I will tell you, 56 and still can't land a job. I have become fat, depressed and haven't been happy for a very long time, so do not go off on people like that. We are all trying to help people on here the best way we know hoe.

Result number: 28

Message Number 265648

Re: Future issues from TTS View Thread
Posted by Annette on 6/10/10 at 05:46

First of all, thank you Julie--that is exactly the type of answer that will help. (walking through the entire gait cycle makes alot of sense, even if I have to do it slower). I really cannot believe the responses to Tony's question! Give the guy a break. He is in extreme pain and is going through hell if some of you had bothered to look at his past experience with this. What happened to compassion? If you haven't experienced the pain this condition creates for a long period of time, then you can't even imagine the desperation it can cause when you don't see any end in sight.

When it's 2am, you haven't slept because pain never really escapes you, the last thing you want to do is come on this board and be ridiculed. I don't have a Ivy League education, but I DO have some compassion for people in pain--because I have been one of them. My sciatica has been hurting for 3 days. I can't sit for very long and the pain is just running from the back of my hip down to my foot. I'm stretching and doing my exercises, but it sure is killing me. I'm pretty sure it's due to the way I walk (or limp).

I really get great advice and suggestions when I use this board. I try to be kind and also help others that I know are going through the journey. I'm not a dr. nor do I pretend to know everthing--but I DO think it was clear that Tony wanted some simple answers or suggestions to his questions. Walk or limp in our shoes for ONE freaking day or heck 5 years with pain you can't even describe--THEN just maybe you have the compassion or knowledge to respond. I'm very dissapointed with this thread--Tony didn't deserve it. So if you don't have something nice, helpful, or constructive to say--keep it shut. There are amazing people on this board and also some caring doctors too. Long term pain needs compassion and help.

Result number: 29

Message Number 265647

Re: Future issues from TTS View Thread
Posted by Julie on 6/10/10 at 01:34


I thought your question was pretty clear too, Tony.

One future issue is likely to be that limping to favour the painful side will have musculoskeletal consequences - on postural alignment, and specifically on the knee, hip, and lower back on the opposite side. So try not to limp. Easy to say, I know. But try. When I had PF years ago I found that by walking very slowly, and allowing the painful foot to go through the entire gait cycle, I could avoid favouring it to a great extent.

I hope one of the doctors can give you a fuller answer to your question.
.

Result number: 30

Message Number 265637

Re: Future issue's from TTS View Thread
Posted by John C on 6/09/10 at 21:14

I think the question is pretty clear. Allow me to rephrase what I believe is the meaning of the question. Please Tony correct me if I am wrong.

Although I understand that every case of tarsal tunnel syndrome will present in it's own unique way, what are the likey secondary issues/injuries that someone would most likely encounter ASSUMING that they will suffer from TTS for the rest of thief life.

I hope that is an accurate rephrasing. I suspect that possible answers will include: tendon injuries, hip misalignment, depression....

Dr DSW, being rude and pointing out how well educated you and your wife are seems to contradict the overall intention of what you have created here.

Tony, I hope I have helped and not made more of a mess here. Also, I hope you find some answers to get at least a little relief. Be strong.

Result number: 31

Message Number 265633

Re: Future issue's from TTS View Thread
Posted by Dr. DSW on 6/09/10 at 17:08

Sorry, but I read and re-read your question several times, and had my wife read your question several times. She has a graduate degree from an Ivy League school in reading and reading comprehension, and neither one of us could really determine the difference between your two statements:

'But my question doesn't ask what WILL my future issues be. No one would know because we can't see into the future..

I just want to know what issue's could arise out of having TTS for the rest of my life.'

Maybe if you re-word your question so it actually makes sense it will be answered accurately.

Result number: 32

Message Number 265629

Re: Future issue's from TTS View Thread
Posted by Tony M. on 6/09/10 at 13:38

I guess no one read my question....

I just want to know what future issues can someone have because of TTS?

I know that everyone's issue is different, I have read that a million times.

But my question doesn't ask what WILL my future issues be. No one would know because we can't see into the future..

I just want to know what issue's could arise out of having TTS for the rest of my life.

Result number: 33

Message Number 265623

Re: Sandals for Women, WIDE WIDTH View Thread
Posted by Laurie C. on 6/09/10 at 10:51

Jeremy,

I told you I had bought a new pair of Merrill's Bassoons. I'm wondering if they could have caused some issues that I'm now having. I do have a history of bilateral hip arthroscopy for labral tears and an ITB release, however, I've been recently having groin pain that has been diagnosed as psoas tendonitis which is completely manageable, but the issue is that my SI joints are getting out of whack and it's extremely painful to walk, turn over in bed, get up from sitting etc. The only thing I've really changed are those shoes. Do you have any thoughts?

Result number: 34

Message Number 265621

Re: Tarsal Tunnel Pain/Sensations View Thread
Posted by leslieg on 6/09/10 at 10:46

There is only one person that can tell you if you have (or they suspect) TTS and that is your dr. There are so many issues that can happen to the foot and everyone is different. I wrote a rather long post a few days ago that talked about my journey with TTS and symptoms. Good luck!

Result number: 35

Message Number 265489

Re: Another Issue starting.. I think View Thread
Posted by Bill C on 6/02/10 at 23:16

I am not sure what you meant when you said that the chiropracter 'helped it out of her' in regards to her Morton's Neuroma. I am not an expert on chiropractors, but I believe they perform spinal manipulations to alleviate back pain. I have gone to a chiropractor occasionally for back issues. The results are about equal to waiting it out. Doctors used to call this a 'tincture of time'. I even told the chiropractor about my neuroma and he pulled on my foot and clicked it with his clicker a few times. Surgery was the only thing that helped me, and I dealt with the pain for more than 5 years. Ultrasound, orthotics, steroid injections, and PT did not relieve the problem. I wish it had been that simple as going to a chiroprator.

Result number: 36

Message Number 265472

Re: Adventitious Anterior Ankle Bursa from Skating View Thread
Posted by Dr. DSW on 6/02/10 at 07:29

If conservative therapy has not worked, and you obviously do not want to end your skating career, surgical excision of the bursal sac may be a viable option, especially if there is no joint involvement.

In my opinion, there is less chance of recurrence if the bursa is isolated and does not involve the joint (which would be more indicative of a large synovial cyst/ganglion).

However, I would 'assume' if you have been seriously skating for this number of years, you are wearing a very high quality skate. Therefore, I would also 'assume' that the shop where you purchase the skates has an expert fitter that has probably dealt with some similar issues in the past. He/she may have some suggestions for modifications to the skate and/or lacing system to help reduce the problem or reduce the probability of recurrence following drainage or surgical excision.

If you skate shop can not help, you may have success finding a quality cerfified pedorthist. I know a local Cped who works with the Philadelphia Flyers to trouble shoot problems the players have with foot issues they have with their hockey skates.

At the very least, you may want to speak with your doctor about seeing if any Silipos products are available to reduce the pressure betweeen the interface between your anterior ankle and the skate. Silipos produces silicone based 'cushions' that buffer the area to prevent pressure. Although I'm not sure if they make any products specifically for this area, I'm confident that they make a product that can be easily adapted.

The only negative is that the cushion obviously takes up space, which in essence has the potential to make the skate tighter, therefore put MORE pressure on the area. Therefore, if your doctor does find a Silipos pad that does provide pressure relief, you will obviously have to adjust the lacing on your skate to accommodate the slight thickness of the silicone padding.

Result number: 37

Message Number 265427

Re: surgery or not? View Thread
Posted by Cher on 5/30/10 at 16:06

Looking back, due to what this dr. says,
I'd of pushed for an MRI before surgery.
My dr. only went on the nerve conductivity test.
I had no masses or soft tissue issues.
My MRI which I had post-op confirmed that.
So I was not a good statistic for success from the get go.
But being in as much pain as I was/am in, I just had to give it a try. On one side anyways.

Result number: 38

Message Number 265366

Re: Surgery tomorrow View Thread
Posted by Holli on 5/26/10 at 03:18

Thanks everyone! I am home from the hospital now. I'm having some serious pain issues but I'm planning on calling the doctor tomorrow to see if we can try something different. He put me on Darvocet and Ultram and it's barely touching the pain. I have been in bed since I got home and they told me to not get up any more than I have to the first week. It's hard with little kids at home, but my hubby is doing a good job filling in, as well as my in-laws who are here taking care of all of us. I'll keep you all posted on my recovery.

Result number: 39

Message Number 265356

Re: What do you guys think View Thread
Posted by marie:) on 5/25/10 at 18:46

'By pure accident I was in Selma when Dr. King and his marchers crossed the bridge.'

So was my father.....although he was questioned because he was middle aged, white and from out of town.They had so many Klan members pouring in that they questioned everyone that matched a certain profile. As I recall our past discussions were specifically about voting.....because discrimination isn't a Southern thing but voting issues are.

BTW: Father Hesburgh marched with Martin Luther King in Chicago.

Result number: 40

Message Number 265345

Re: What do you guys think View Thread
Posted by marie:) on 5/24/10 at 21:10

I may be mistaken but I do recall having some discussions with you on voting. We discussed the South and the voting issues there. I'm not sure they had voting issues like they did in the South. I hale from the South so I have had and continue to have a pretty good feel for the topic and the comparison. While you were in school inIllinois I was hiding under the dashboard on the floor because my ride home from school dared to support the Civil Rights Movement......actually he's one of the most staunch Republicans I had the pleasure of knowing. He never ran from what was right or wrong in this world. A stand up guy...and was in served Vietnam by choice. Of course the white kids with baseball bats on the street corner who threatened to bash out our car window looked pretty stand up to me to....so under the dashboard I went. ;)

Maybe you were just feeling defensive for the South. I don't recall you ever saying that you yourself had discrimination issues. it's ok I've been guilty of defending the South on occasion myself.

Result number: 41

Message Number 265333

Re: What do you guys think View Thread
Posted by John H on 5/24/10 at 12:09

Rick: You also have the right in most state to have 'Employment At Will' agreements:

At will employment describes the employment relationship between employers and employees in almost every state. At will employment means that the Company does not offer tenured or guaranteed employment for any period of time to any employee without an employment contract or written direction from the CEO/President.

In at will employment either the Company or the employee can terminate the employment relationship at any time, with or without cause, with or without notice.

This does not mean that employers can arbitrarily fire employees without good faith communication, fairness, and non-discriminatory practices. Employers must demonstrate a good faith effort to correct the employee's performance or the other issues that led to employment termination.

Result number: 42

Message Number 265310

Re: Another Issue starting.. I think View Thread
Posted by Annette on 5/22/10 at 18:45

Hi Tony--I'm sorry you are still experience issues--ugh! I started having issues with my 4th toe area after my PF Release surgery 2 years ago. I thought having the TTS surgery would get rid of it, but it has come back just as bad. I have tingling, throbbing, and extreme pain, right under and over the 4th toe. My surgeon said that this would go away after my TTS surgery 8 weeks ago..but no such luck. I'm wearing a pad (I think it's called a mortons nueroma pad) in my shoes and it seems to help. It's a rubber pad with a ball thingy, and the ball fits right below the padding of my foot, I guess to lift up the area that is hurting? My dr. is having me put this toe 'sling' on my 4th toe to pull it forward during sleep. He's sending me to a nerve test to see if the sural? nerve is affected or something like that. If anyone even touches around the area, (pulls the 4th toe, massage, etc.), it acts up and I want to die. Having no shoes on feels better too.

So...I can walk, feels like I'm walking on stones after the TTS surgery. If this stupid pain would go away from the 4th toe area, then I think maybe things could get better. It hurts just when I'm laying down...tingling and throbbing right now. I've been trying really hard not to take any pain meds (haven't for two weeks now)--but it's super hard some days. I'm hoping your tingling goes away--I know you've had a rough time and I really pray you get better soon :)

Result number: 43

Message Number 265279

Lump View Thread
Posted by MichelleC on 5/21/10 at 15:04

My 15 year old daughter has been speed training for approximately 7 week (4x per week), plus conditioning for v-ball (2x per week, mostly running) and playing volleyball (2 x per week). Last evening i noticed a lump, sort of like a large marble, on the heel of one of her feet. Any idea what it might be and if it may be from training? She has been having some knee issues, but i bought her a brace and she is icing so that has helped a bit.

Result number: 44

Message Number 265270

Re: Sandals for Women, WIDE WIDTH View Thread
Posted by Laurie C. on 5/20/10 at 22:33

Jeremy,

What do you think of the Merrell Q angle technology? I have been told I have a high Q angle which may or may not have contributed to my hip and peroneal nerve issues. Is this technology more of a gimmick?

Result number: 45

Message Number 265238

Re: Tearing sting in arch. View Thread
Posted by Joseph on 5/19/10 at 14:35

A podiatrist and a chiropractor both looked at my heel a few months ago. The chiro said he couldn't find any evidence of plantar fasciitis and told me it was most likely a bone bruise. Later I visited the podiatrist who also noted I have almost 1/3 the cushioning in my heel as apposed to a properly cushioned heel. However this stinging in the arch happened recently so I have scheduled a visit tomorrow. While I know you can't diagnose me or treat me, I really just would like your thoughts or theories on what it sounds like. It seems to have loosened up some since yesterday but these issues with me usually vary in severity from day to day.

Result number: 46

Message Number 265200

Subtalar Fusions View Thread
Posted by JoannaW on 5/18/10 at 10:20

Good Afternoon,

I have spent some time reading many of the posts on this site, and realise that, for good reason, you are unable to answer questions relating to specific post-operative problems.

While I have had various operations on my foot, I will pass on the details as my question is fairly generalised & hope that you are able to respond to some degree.

I wonder whether you have encountered situations whereby patients have undergone successful subtalar joint fusions, only to complain that the pain and original symptoms are still present - and only aggravated by physio or hydrotherapy. In particular, what could be done if X-ray and CT scans don't appear to show anything of concern?

Many thanks for your time, I will be sure to direct specific issues to my own orthopaedic consultant.

Joanna

Result number: 47

Message Number 265174

Re: Myokinesthetic System - Anyone experience it? View Thread
Posted by Regina R on 5/16/10 at 13:06

I am a licensed massage therapist, and I took Dr. Uriarte's MKT Upper Body class in March 2009. I have been practicing with several different people, and have had remarkable results. I have also had no results with one or two people. Working within a client's range of motion, and using a virtually pain-free therapy, while at the same time relieving myself of the physically taxing use of deep tissue massage, is a preferrable way to treat chronic pain issues. I would recommend this therapy.

Result number: 48

Message Number 265089

Re: post op course variances View Thread
Posted by Tony M. on 5/10/10 at 10:27

Wow...

You just had surgery and your pushing it already.... Unbelievable.

I was hard casted for 10 days and then had stiches removed. I was given motion/stretching excercises that started the same day the cast came off and was non-weight bearing for 5 weeks. I used a knee walker for those 5 weeks. No crutches. Also, Icing, elevation and meds for swelling.

My personal opinion, and its just my opinion, that you are way over doing it and aren't allowing the nerve to properly recover and heal. You can be your own worse enemy in your recovery. Just because today it feels good, doesn't mean you should be out and about. Because that could be hurting your chances for a full recovery of that nerve.

My surgery did not go so well for me. I am almost 4 months post op and my condition has worsened. I am allowed to do minor shopping (in and out) and little stuff around the yard. But I am having alot of pain issues as before with lots of numbness on the bottom of my foot. I take 1200 mg of neurontin daily along with pain meds (oxycodone). I have even considered not driving for awhile because it has become an issue.

My biggest issue is if I put my foot on the floor (sitting position) my foot starts hurting bad and starts swelling and if I stand very long, my foot becomes almost unbearable pain wise. So I tend to sit with my leg propped up most of the time. I have had many a days where after I have taken my shoe off, I have what feels like a million needles poking the bottom of my foot. I also get the same pokes in the ends of my toes.

My doctor talked to me about him going back in and removing scar tissue, which may not even do anything after removed and pain management. He also mentioned neuroma. ( I think thats how you spell it). My doctor is going to give it more time before making any other decision in hopes I just need more time.

You have to be diligent yourself and use common sense. Your nerve needs time to heal. The more time you spend on your foot, the slower and longer the recovery process will be and the more activity you do so soon means the lesser the chance the surgery will be a success.

Take it easy. No concerts, running, long walks on the beach or anything else for a bit. Its your feet and you only get 1 pair, so take care of them.

My doctor wants to give my foot every opportunity to heal correctly and for the surgery to be a success. I won't do anything stupid to ruin my chances even though for me, it isn't going so well currently. But I must try.

Result number: 49

Message Number 265073

Re: Shoes View Thread
Posted by Jeremy L, C Ped on 5/09/10 at 09:07

I'm glad that combination works well for you. I'm sure you're also aware that there is a particular population segment that performs best with that walking shoe. Most often it's those with extraordinary difference in the fit volume relationship between the forefoot and heel. In addition to the firm midsole reinforcement, it uses a neutral midsole construction, which makes it a little more versatile for a broader variety of people. It also has good toe box depth and breadth in order to accommodate bunion and hammertoe deformities.

There are some considerable weaknesses in this product, as well. Like virtually all New Balances, the initial forefoot flex position will eventually migrate back into the arch space. Once this happens, regardless of how much mileage may still exist in the outsole, the shoe needs to be replaced. Anyone with significant lateral column issues should avoid the shoe altogether, as the softness of the midsole compound will accelerate it's compression set. Those with severe rearfoot medial column issues should also void it, as the technical-looking 'rollbar' installed under the heel borders on laughable in it's ability to stabilize that kind of foot.

Result number: 50

Message Number 265032

Re: Question View Thread
Posted by Holli on 5/06/10 at 17:44

Thanks everyone, you all had great advice! This is my third foot surgery on this foot (fourth total, one on the other), but by far my most extensive. I am having the release and three other procedures done with it (torn posterior tibial tendon and blah, blah, blah), and one thing I know is that these foot surgeries are very draining mentally so I always try to prepare as much as possible. I am having surgery in a few weeks and I am really just hoping for some relief. I have been suffering with TTS for almost two years now so I'm trying to be realistic, since I know the longer you wait the less successful the surgery, but since I have other issues to address with the foot I'm hopeful. I have done everything for relief, even having gastric bypass to get weight off of that foot. I am now underweight and trying to gain a little before surgery. I was obese for my other foot surgeries so I'm hoping a lower weight will dramatically help with recovery. I'll keep you all posted! Thanks for so much support and advice!

Result number: 51

Message Number 264983

Re: Heel Pain View Thread
Posted by Dr. DSW on 5/04/10 at 08:29

'Baxter's' nerve issues have been discussed many, many times on this site over the years, but unfortunately the search feature on the site has not been functioning. The website owner has been working diligently to get it fixed.

I'm glad you've finally found relief, and also apparently found a good doctor. As I'm sure your doctor has already informed you, it may take several injections to obtain long term relief.

I hope your pain stays resolved.

Result number: 52

Message Number 264871

my (successful) journey w/ PF--a little long View Thread
Posted by lisa on 4/28/10 at 01:02

Hi all,
I posted this at another discussion, but realized it's sort of broad reaching, and wished I had seen something like this when I was suffereing so badly, so I'm posting it here also.

I've had bilateral PF for over 15 years. I have high arches. I'm 50 years old now, and about 25-35 lbs overweight, I'm female. These are all big issues w/ PF.
The pain has been so bad that walking the short walk from car to work made me cry. I work in a lab, so I'm on my feet all day, on a hard concrete surface, moving from place to place.
I kept bugging my podiatrists, asking them what was new, what should I try, etc etc etc.

I believe each of the following has helped me become pain free today, and as I added each thing to my routine, my feet hurt a little less:

3rd set of orthotics from a Dr. who listened to me and added extra support pads--I also had pain under the ball of my foot. I never ever took a step without my shoes/orthotics, except shower and even in there I have a padded bath mat.

Gently calf stretches off a step.

Injections at regular intervals.

TAPING TAPING TAPING. I found white duct tape to be THE BEST!! the color looks more like medical tape (vanity) and it holds well, but doesn't tear my skin. Tape on those days when you know you have to be on your feet alot. Remove at night and retape next am. Almost kicked myself on vacation when I took a short hike and didn't tape--had to cut it short my feet hurt so badly.

Good shoes that fit my orthotics well (Golden Gate line of Danskos) turns out the lace up type hold your feet to the orthotic better==better support. At least I can have dressier shoes when I need them.

Dr. finally told me to wear only GOOD FITTING running shoes 100% of the time--so I did. Went to a running store, they fitted me w/ Asics 'Gel Landreth'. After looking at the Asics website, I saw that there is a 'pronation guide' to all of their shoes. I bought other pairs that were also heavy on cushioning and with neutral pronation--my orthotics already take care of my pronation. DON'T BUY THE WRONG PRONATION SHOES!!! your feet will hate you.

And FINALLY, in December 2009, what I think really did the trick for me, I bought some knock-off type Ugg boots to wear around the house because the running shoes breathe so well, my feet are freezing in the winter. I put one of my older orthotics sets in them (same type as now, with a minor crack) so I didn't have to change them out all of the time. The Uggs have loosened up fit-wise and are sort of sloppy loose, and have no real support--exactly what they tell us NOT to do. BUT, I was only wearing them around the house--which wasn't very much time. I could tell they were making my feet a little sore at first, but I forgot about it over time, and then came to realize that MY FEET DON'T HURT AT ALL ANYMORE!!! I believe this last step to my recovery helped strengthen and stretch my feet, more like what you'd get if you went barefoot on sand.

I still wear my running shoes or Danskos with orthotics almost 100% of the time. I recently went to the beach and wore flip flops (a brand that you put in the oven and mold to your feet)--NO PROBLEM and no pain later.

I'm not saying that these steps will work for you, but what I'm saying is to keep trying everything!!! Read everything you can. We weren't meant to have such problems with our feet!!!

good luck in your journey

Result number: 53

Message Number 264851

My Birth Certificate View Thread
Posted by John H on 4/26/10 at 12:30

My birth certificate is located at the county seat courthouse in Murphy, N.C. When I was required to get a Top Secret Clearance the FBI did a lot of checking going back to my grade school, high school, friends and of course birth certificate. They brought to my attention that on my birth certificate I had no first name and therefore was officially named 'Baby Holt'. My mother and father were dead at this time so I asked my aunt how that could have happened and she said my mother and father could not agree on a name. My father wanted to name me Ivan. Russian names were popular at that time. My mother wanted to name me John. I grew up being called John. After discussions with the FBI I officially had my name changed on my certificate from Baby Holt to John Holt. My whole life would probably have gone in a different direction if I had grown up known as Baby Holt. Hey, there was Babe Ruth and Babe Didrikson's so I would not have been a total sissy.

Forget race but I still find it hard to believe we would elect a President in this day and age named Barrach Hussein Obama who had a Muslim father. If a white man had run with that name he would have lost no matter what party he ran for. President Obama won partly because he was an African American. I am not trying to make this a race issue but just what I think is factual. It is difficult to discuss these issues because of fear of immediately being labeled a racist. He garnered something on the order of 95% of the African American vote. Clearly much or most of that was because he was a Black American. Of course he received the majority of the white vote but nothing like 95%. The white vote was because of what he promised, his oratory skills, the hatred of Bush and hope things would get better and the promise by Obama to united he parties and stop all the fighting. For sure we have not stopped the fighting as it has only gotten worse. As bad as I have seen in my life time.

Interesting phenomena. We have no Protestant on the Supreme Court now. Kennedy was our first Catholic President. It was rather clear that there had never been a Catholic President because of the fear of having a Catholic as President. Today we would call that a form of racism. Romney who is the current front runner for the Republican candidate for President is a Mormon. You better believe that will factor into whether he wins the primary or not. Currently 17% of Americans say they would have a problem voting for a Mormon President. In he late 1960s those who said they would not vote for a Catholic as President was still in the double digits. Race, religion, color still play a very important part in elections. Call it any thing you want but it is factual.

Result number: 54

Message Number 264719

Who owns Jerusalem View Thread
Posted by Dr. Ed on 4/18/10 at 15:51

Beyond the religious claims here is an excellent legal analysis from a Christian international attorney from Canada about the legal issues surrounding Jerusalem:
http://ctstv.com/ontario/player.php?ctsvidID=17133&show=On#
Dr. Ed

Result number: 55

Message Number 264711

Re: Does anyone here wear MBT shoes? View Thread
Posted by maggie on 4/17/10 at 03:29

I have the same problem ..the plantar facilitis And have pain everyday by evening I start limping and because using weird positions on my foot like limping alot I Have fell a few times. I am looking for something to help me so mbt shoes and sandals ? What are the shoes called just mbts. I would really like your feedback . Spent like $300 on some special inserts and it hurts so bad after a hour. I can't afford to make another mistake my foot issues have been costing me so much money.


thanks
Maggie

Result number: 56

Message Number 264590

Re: Sore and Side of Foot issues. View Thread
Posted by Dr.DSW on 4/09/10 at 19:30

Yes, I have an excellent suggestion. I'd recommend that you pick up the phone and make an appointment with a doctor who can actually see you and evaluate your problems to make a proper diagnosis and then initiate a treatment plan.

Result number: 57

Message Number 264588

Sore and Side of Foot issues. View Thread
Posted by sball on 4/09/10 at 17:47

I have this red rash on the side of my foot and it doesnt itch or burn. I dont have any idea what it is or how to get rid of it. I also have this sore on the left side of my left heel. I have soaked it in epsom salt and hot water and it changes everytime. Does anyone have any suggestions?

Result number: 58

Message Number 264584

Re: need some info PLEASE View Thread
Posted by Tony M. on 4/09/10 at 12:29

I cannot offer you much advice but have you went to any Pain Management CLinics?

I haven't been yet but my doctor did talk about it and if my issues dont get any better by my next appointment, he will be sending me to one.

They can do nerve blocks, different meds and as a last resort, Spine Stimulators.

Maybe you should consult someone about Pain Management....

Result number: 59

Message Number 264453

Re: Medicare Reimbursement Payments to Doctors View Thread
Posted by John H on 4/02/10 at 12:39

Dr. Ed: I would be very much surprised if much more than 30% of the voters vote on the issues. They vote based on their past history, their unions or other forces that influence them. As a people we are incredibly uninformed about just who we are electing and what they propose to do. You can be sure a certain number of people voted for Obama only because he was an African American. I am not just talking about Blacks but many whites who wanted to be part of history. A very large number of people actually vote against their own interest. From my viewpoint the AARP is a left leaning organization that is supposed to represent seniors, many of whom will vote just like the AARP advises them. Long ago I tore up my AARP card as they in no way represented me. I think many union members are misled by their membership as to what is good for them and what is not. I think back to the Air Traffic Controllers who were all fired by the President when union leadership insisted the controllers stay out on strike. My Aunt who is no longer with us grew up in the solid Democratic South. She was a Democrat from Atlanta until the day she died. To even suggest to her she look at a Republican would bring on her wrath. Strange, how the solid Democratic South became the solid Republican South for a period of time. Good government comes from well informed voters who do not vote in packs.

Result number: 60

Message Number 264450

Re: Medicare Reimbursement Payments to Doctors View Thread
Posted by Dr. Ed on 4/02/10 at 08:51

Dr. Z:
It amazes me too how people vote based on historical voting patterns. The percentage of the Jewish vote that went to Obama is incredible but, then again, the percentage of voters who did not have a clue as to what the issues were was very dissapointing. Freedom is two sided coin...freedom on one side and responsibility on the other side. Too many citizens fail to take their obligation to educate themselves about the issues needed to make an informed choice at the ballot box.
Ed

Result number: 61

Message Number 264449

Re: Medicare Reimbursement Payments to Doctors View Thread
Posted by Dr. Ed on 4/02/10 at 08:45

John:
The concept of land for peace is not only a flawed one but is diversionary as it has little to do with the real issues. Modern day Israel has less than one third of land mass of the British Mandate of Palestine. The Kingdom of Jordan was carved out of the portion of Palestine east of the Jordan River by the Brits to be ruled by the minority Hashemites who are related to the Saudi royal family. Why do none of the Arab countries insist that that land be given back to the Palestinians? In fact, the Jordan owned the entire West Bank prior to 1967 and no one was asking for a Palestinian state there. Egypt owned the Gaza Strip before 1967 and no one asked for a Palestinian state there. Yassir Arafat was an Egyptian. Obama is demanding that Israel accept a terrorist state within its own boundaries -- that is insanity.
Ed

Result number: 62

Message Number 264374

Re: Mortons Neuroma and hammer toe View Thread
Posted by Dr.DSW on 3/30/10 at 08:00

The 'sudden' onset of the hammertoe can be a result of the cortisone injection, and is a known side effect. It is no fault of the doctor. This is rare after one injection, and although you did have injections a year ago, I suspect that due to your bunion, you had a pre-existing weakening of the joint/capsule/soft tissue stabilizing structures around the 2nd toe.

Often, when there is a 'bunion' deformity, it places pressure on the second toe and that toe eventually becomes a 'hammertoe'. During the slow progressive process, the soft tissue stabilizing structures around the 2nd toe can become weakened sometimes causing a 'pre-dislocation' syndrome. This often causes the toe to not just look like a 'hammertoe', but to actually deviate medially or laterally.

Cortisone is a very potent anti-inflammatory, but can also cause weakening or atrophy of soft tissue structures, but this usually only occurs with repeated injections. My suspicion is that these structures were already weakened from the 'bunion' deformity causing biomechanical issues with the second toe and the injection simply exaccerbated that condition by causing further weakening of those structures.

Yes, if you require surgery to correct the bunion, hammertoe and/or neuroma, there should be no reason why these procedures can not be performed at the same time.

However, I am a strong proponent of sclerosing alcohol injections and not a strong proponent of 'neuroma' surgery if it can be avoided. My patients have fortunately had tremendous success with sclerosing alcohol injections and as a result it has resulted in most avoiding a trip to the operating room.

Result number: 63

Message Number 264352

Re: ultrasound burn View Thread
Posted by Dr. Wedemeyer on 3/29/10 at 11:34

One of the main cautions taught in using USD is to keep it moving as I described above because it does cause local heating of the soft tissues. USD is capable of literally burning the periosteum which attaches muscle to bone and causing it to separate. You would have to hold the sound head directly to the tissue and on a very high setting for several minutes without movement to do so but yes, you can burn the tissue severely and cause damage.

Is this what occurred, you haven't described how it was used? I would address this of course with the provider who performed the therapy and have a physician look at the area for an opinion.

Result number: 64

Message Number 264331

Re: Please Help!-Still in great pain 6 months AFTER Os Trigonum excision. View Thread
Posted by Kris on 3/28/10 at 12:41

I too am still in a great deal of pain following OS Trigonum removal almost 3 yrs ago at the age of 27. I had a soccer injury that resulted with foot bent back and heard a pop however the problem wasn't discovered with the OS Trigonum until almost a year later after multiple visits to the doctor. I had excellent insurance at the time so I was able to seek out all treatment options as well as the best doctors. After being in a cast 3 different times for long periods of time and the use of a bone healing machine, I ended up having surgery as I was not having any relief. The surgery went smooth according to the surgeon however post op he refused to order physical therapy and told me to just make the letters of the alphabet with my foot. This doctor handles the college football team where I live as well as the arena football league. After repeated visits to see him and getting nowhere with the pain I found another doctor for a second opinion. He asked how many visits of PT I had been to and was suprised when I told him none & why considering who the surgeon was. The 2nd doc immediately ordered PT for me however we were 8 months post op. I went to about 30-40 PT appts and still had no relief. At this point I am still in lots of pain and the only solution I have been told is to go back into surgery to see what is going on as xray & MRI have not shown anything. I admit I am terrified of going into surgery again as I am afraid of what could happen & that I could end up worse than I already am as well as the large deductible on my current insurance. I have lost sleep over this as it cramps throughout the night and can no longer do the things I love to do. I also have to buy bigger shoes due to the swelling in my foot and have lost some of the range of motion in my foot. I have been left with an ugly scar & foot that is disfigured at the surgery sight. I often stumble while walking as the slightest pebble or stick throws me off. Until this injury I was a healthy woman with no medical issues or concerns. At this point I basically have learned to deal with the pain that has now become a part of my life. To the original poster, I hope all is better with you and that you will never have to live the way I have in pain over the last 3 years.

Result number: 65

Message Number 264309

Re: subtaylar fusion View Thread
Posted by Dr.DSW on 3/26/10 at 16:51

First of all, we can not possibly answer all questions. Secondly, I decided not to answer your original question because I rarely comment on post operative issues since I always tell patients to address these concerns to their own surgeons. I am not there to evaluate your foot, nor was I there to see what REALLY occurred in surgery.

Your explanation is the perfect example. You stated that you have screws, metal plates and 'bolts' in your foot. There is no such thing as 'bolts' being used in a subtalar arthrodesis.

It is never 'normal' to have a lot of pain following any surgery, but it is normal to have continued discomfort following a major surgical procedure such as a subtalar fusion.

However, if you have any concerns regarding your post operative progress, you should address these concerns to your surgeon, not to anyone on this forum. And once again, one of the reasons I avoid answering these questions is because of inaccuracies when patients describe the procedures performed or what was used in surgery, etc. As previously stated, this surgery never includes the use of 'bolts'.

Result number: 66

Message Number 264255

Re: Flantar Fasciotomy Recovery Question View Thread
Posted by rm on 3/24/10 at 05:25

I had the plantar faciotomy surgery about 7 weeks ago, and i experienced the same pains that you did. I have read all of these, and i noticed two issues that may or may not be different for me. The first is that my doctor has told me flat out that it will be at least 3 months before it will be healed enough to start strengthening it. I was off it completely for 3 days, then in a boot with limited activity for 6 weeks. Now i am gradually working my way back into shoes, but still needing to wear a boot if i am planning to do a lot of moving around. I should be back into shoes full time in about another 2 weeks, but with the understanding that i have to gradually increase my activity over the next month. Then at about the 3 month mark, i can start increasing intensity to SLOWLY strengthen the foot. I am also stretching/massaging/and getting PT during all of this time. In most of these blogs, it seemed like others either tried to get back to full strength too quickly, or stayed off of it too long. The second is that many of these blogs did not mention if those that had problems had any other health issues, like obesity, or other underlying conditions that would hamper a recovery. Personally i do not, and my recovery seems to be moving on track.

Result number: 67

Message Number 264248

Re: High-top Pronation Protection.... Does it exist? View Thread
Posted by Jeremy L, C ped on 3/23/10 at 21:40

For the most part, no, these kinds of shoes hardly exist these days. It used to be that the major manufacturers categorized basketball shoes into models intended for low post players and perimeter players. These included the original Nike Air Force and Flight collections, respectively.

Now, there are two issues working against the consumer. Brands take great pride in advertising that the same shoes worn in the NCAA Tourney and the NBA are the ones also at your local Footlocker. While it makes for a good hook to the consumer, the support qualities are typically lacking because premiere athletes get several pairs of shoes per season (if not per day!), Eliminating necessary midfoot support elements allows the manufacturer to reduce costs without effecting the performance of their key product heroes.

This has had serious ramifications. One example of this design concession was the Choparts amputation made to a basketball player at a local college. Given his size and weight, had he been provided shoes which were adequate to his physical requirements, this tragedy could have been avoided. Don't even get me started on NFL players now getting Lisfranc fractures!

You do have an option. Orthotists or C Peds can adequately modify existing basketball shoes with extended shanks or other midfoot reinforcements to help gain the support you may need. Just be sure it is a model that has a broad sole base, and not one that simply has a lateral flare (like most available shoes have).

Result number: 68

Message Number 264226

Limb length discrepancy View Thread
Posted by Dr. Ed on 3/23/10 at 11:33

Mike:
I have not been following your thread but would like to clarify the concept of limb length disrepancy. There are 3 categories of limb length discrepancy:
1) melanogenic, 2) podogenic, 3) positional or functional
Melanogenic limb length discrepancy refers to a discrepancy based on the actual respective length of the legs. This can be measured with a tape measure, often from an area on the pelvis known as the ASIS (anterior superior iliac spine) to the lateral malleolus (outside ankle bone). This can be measured more precisely with an x-ray study often called a limb length study.
Podogenic limb length discrepancy refers to a discrepancy created by positional/biomechanical influences of the foot. For example, if there is more subtalar joint overpronation on one side, that side will appear shorter functionally (during gait analysis one will observe a hip drop on that side during the midstance phase of gait).
Positional limb length discrepancy refers to discrepancy due to a change in position of the leg often measured on the exam table as a short limb. Positional influences can include scoliosis, hip and low back alignment issues, muscle spasm...Dr. Wedemeyer could likely supply a more complete list.

Treatment of a limb length discrepancy must not only take into account recognition of the above types but the biomechanical influence of various treatments. For example, one would be more likely to treat a melanogenic limb length discrepancy with a lift than a positional one.

Dr. Ed

Result number: 69

Message Number 264217

Re: ultrasound burn View Thread
Posted by Dr. Wedemeyer on 3/23/10 at 01:09

Ultrasound diathermy (USD)heats the soft tissues so yes you can burn a patient if you do not apply it properly. This means keeping the sound head moving an appropriate diameter relevant to the treatment area and intensity the machine is set at.

Since the hands and feet are composed of very thin tissue and irregularly shaped bones, I place the limb in a tub and disperse the sound waves through the water (subaqueous). This is the safe and comfortable method to apply ultrasound to the extremities. It is difficult and potentially unwise to treat the Achilles tendon with USD directly in my experience.

Result number: 70

Message Number 264215

Re: TTS release--scar tissue issues---and general comments about nerve pain and recovery/rejuvination.... View Thread
Posted by p daly on 3/23/10 at 00:01

I had TTS surgery on 12/09 and I've had 2 more surgeries because the incision did not heal totally first it was 'we have to clean it out and a 1' hole became a 2' hole it never closed, I just had another surgery on 3/10 this time I got 12 staples and the opened it to a 6' scar only 1' smaller than the original surgery, I have been on crutches for months because of the surgeries. I hate to think what other pain I am gonna have I'm not even sure how the original surgery work since I had 2 more within 2 months and pain each time so I have no idea how long this one is gonna take

Result number: 71

Message Number 264116

Re: Subtaler fusion years later View Thread
Posted by Alan R. on 3/18/10 at 14:32

I had cartilage issues and like flipping on a light switch, got up one morning and could not walk - any weight bearing at all was unbearable. Had a subtalar fusion. And after going through the normal no weight bearing at all for a couple months, then to a removable boot for a month and partial weight, then full walking. I consider the operation a complete success. Of course lost the side to side flexing, but that's it. The only time that is noticeable is hiking on side hills. Have to make some adjustments in style to do that. Everything else is great. Up and down stairs, not an issue. I can walk for miles with no discomfort.
One would normally never suggest surgery to a friend, but if the subtalar joint is your problem, and surgery is suggested, I would recommmend it. It was a complete success for me, and I would do it all over again if needed.

Result number: 72

Message Number 264115

Re: told I need a subtalar fusion View Thread
Posted by Alan R. on 3/18/10 at 14:29

I had cartilage issues and like flipping on a light switch, got up one morning and could not walk - any weight bearing at all was unbearable. Had a subtalar fusion. And after going through the normal no weight bearing at all for a couple months, then to a removable boot for a month and partial weight, then full walking. I consider the operation a complete success. Of course lost the side to side flexing, but that's it. The only time that is noticeable is hiking on side hills. Have to make some adjustments in style to do that. Everything else is great. Up and down stairs, not an issue. I can walk for miles with no discomfort. You would never suggest surgery, but if your issues are with the subtalar joints, and surgery is suggested - I would recommend it, and do it again if asked.

Result number: 73

Message Number 264114

Re: another issue (LLI) View Thread
Posted by MikeM on 3/18/10 at 14:27

I just got back today from an x-ray of both legs. While he needs to wait for the radiologist to measure the bones, he now thinks that it may perhaps be an actual leg length difference. As far as what is a lower extremeties specialist, I have no idea, here is his title:3
MS, PT, CSCS
Supervisor, Rehabilitation Services and Athletic Medicine.

What confuses me is, if this is an actual leg length difference, then why I am just now having issues at 34 years old? This has become very frustrating. I had a lot of confidence in this guy but now I am beginning to have my doubts. Do you or Jeremy know of anyone in the Metro Detroit Area who would be beneficial for me to see? Weather it's an Ortho, a podiatrist, or some type of expert, I need to get this thing taken care of before it takes over my life.

Thanks

Result number: 74

Message Number 264111

Re: plantar fasciitis - where to get Hivamat treatment.. View Thread
Posted by Mary F on 3/18/10 at 01:56

Hi Chris

If you contact Physiomed in the US www.deeposcillation.com they will tell you who has the Hivamat in the United States (I am assuming you are in the US, rightly or wrongly!) If not contact me in the UK www.physiopod.co.uk - Planter Fasciitis responds very well to this treatment. I just did a search on my apps for a ref from the States regarding this and came up with these two. Many high profile establishments are using this form of gentle, yet powerful, long lasting treatment alternative. In the UK it is placed within the Premiership Football League too.

'We have had great results, especially with the treatment of edema and the reduction of pain. We have implemented the use of DEEP OSCILLATION® into our treatment protocols and have had great results, especially with the treatment of edema and the reduction of pain. We have used DEEP OSCILLATION® on everything from acute knee sprains to patellar tendonitis, high ankle sprains to plantar fasciitis and it has helped to limit the time lost due to sport injuries. The hands-on treatment time required is far outweighed by the treatment benefits and the therapeutic effect of a hands-on treatment.

Michael O’Shea MA, ATC, LAT
University of Houston

and this one:

“If you have muscle strains, inflammatory conditions like whiplash, Achilles tendonitis, plantar fasciitis tennis elbow, sore shoulder just to name a few, there is a machine called a Hivamat that has been in the States 18 months. It has been in our area for about 6 months” Besides the Tampa Bay Devil Rays, he’s the only person to have this equipment. He says “the Hivamat smoothes your connective tissue and deep muscle tissues. You hold an electrode in your hand; he holds an electrode in his hand, both of which are connected to the Hivamat. Then he places vinyl gloves over the electrode on his hands. An electrical current flows through you, the trainer and the machine creating a resistance flowing into your tissue creating a vibration ridding these areas of waste products. You may feel results after your first treatment. Some people need as many as 5. A treatment can last 20 to 30 minutes depending on your condition”
Larry Mayol, Athletic Trainer, CEO of Star Care Inc. http://www.about.newsusa.com


Chris I hope this helps. The chap in the US is William Griffith, if you want to email me via our contact section of the website I can give you more information.
It is worth knowing that also there is now a DEEP OSCILLATION PERSONAL SPORTS which can be used at home by the individual.

Right, back to work now, have a great day and I hope you get some relief from this awful pain very soon. Best Regards.

Result number: 75

Message Number 264087

Re: what if PF comes back after ESWT View Thread
Posted by Julie on 3/17/10 at 11:46


Wouldn't it depend on whether or not you'd addressed the biomechanical and other issues - shoes, etc - that led to the PF in the first place?

Result number: 76

Message Number 264052

Re: 23 Year Old PF sufferer; on track to permanent disability? View Thread
Posted by Dr.DSW on 3/15/10 at 19:38

Edward,

I would not worry too much at this point regarding becoming totally disabled. I've been in practice well over 20 years, and can count on one hand the number of patients I've enountered with true plantar fasciitis that ended up with total disability.

First of all, IF you are still performing the 'wall stretch', it is my personal opinion that you should stop this stretch. Although the 'wall stretch' and 'stair stretch' are often prescribed by podiatrists, orthopedists and therapists, in my significant experience treating this condition, I have found these stretches to often contribute to prolonged symptoms and preventing patients from moving forward in the healing process.

I am opposed to most weightbearing stretching for this condition, and strongly prefer the non weightbearing 'plantar fascia stretch' demonstrated on this website.

There are a plethora of treatments for plantar fasciitis. I noticed that you never mentioned any 'cortisone' injections. Yes, 'cortisone' injections are often dreaded and get a bad 'rap'. They are misunderstood and are the victim of a lot of wive's tales.

First of all, 'cortisone' injections do not 'heal' anything. However, they are a very potent anti-inflammatory that can often result in dramatic relief and can augment other treatments. In addition to other treatments addressing the problem (such as biomechanical issues), the injection treats the symptom and can break the pain cycle.

However, 'cortisone' also has the POTENTIAL to cause problems if not used judiciously. It is generally recommended that one area should not receive more than 3 injections in a 12 month time span to prevent the possibility of soft tissue atrophy, tendon/fascia rupture, etc. However, these POTENTIAL complications are very, very rare when the medication is used judiciously and correctly.

There are those that will argue that you would no longer benefit from an injection. Theoretically, plantar fasciitis begins as an inflammatory process (hence the 'itis') and after a prolonged perior (greater than 6 months) begins to become a degenerative process and is therefore more accurately called plantar 'fasciosis'. The fascia becomes degenerative and thickened. Therefore, it is no longer inflammatory, and in theory oral anti-inflammatory medications and/or 'cortisone' injections would no longer be beneficial.

But in my opinion, it still might be worth a shot, literally.

There are other options such as cast immobilization via a rigid cast, or removable cast. Units such as the DynaSplint which brings night splints to the next level by adding a passive constant load stretch to the fascia. There are oral anti-inflammatory medications such as the NSAID's, Medrol dose packs, ESWT, Topaz surgery, etc.

But since you have not responded to conservative care, your doctor should also possibly re-think his/her diagnosis. Diagnoses that must be considered are calcaneal stress fractures, tears/partial tears of the plantar fascia, nerve entrapments, sero-negative arthropathies/rheumatic disorders, etc.

Therefore, some testing may be in order, including but not limited to; diagnostic ultrasound, MRI, nerve conduction studies/EMG (if you have symptoms that would warrant an EMG/NCV), blood tests or a rheumatology consult.

I would say that approximately 90% or greater of the patients I treat have SIGNIFICANT relief by the 9-18 month mark, and as I stated, only a very few over a greater than 20 year career ended up with permanent disability.

And surgical intervention is something I do NOT recommend.

Result number: 77

Message Number 263950

Re: Contract With America View Thread
Posted by Dr. Ed Davis on 3/09/10 at 22:14

John:
I agree that there is a crisis of trust in government. I do not want the Obama administration to take over health care nor do I want the GOP to do it by corporate proxy. The Medicare drug benefit passed by Bush and the GOP, while good in principle, is rape of the federal budget as I see it since the drug prices are not subject to negotiation by goverment. The VA can and does use negotiating power as a large buyer; why not Medicare. We worry about Obamacare limiting or denying services to the elderly but the Bush Administration already did that by promoting so called Medicare Advantage Plans and other Mangled (I meant 'managed') care plans taking over Medicare benefits at a higher cost to taxpayers but who routinely deny necessary services to seniors. I see the GOP and Dems offering us much of the same on domestic policy. The only remaining difference tends to be in the area of foreign policy and defense policy where I favor the GOP. Nevertheless, defense spending will be hard to maintain if the economy and domestic issues are not addressed.
Ed

Result number: 78

Message Number 263938

Re: Contract With America View Thread
Posted by John H on 3/09/10 at 15:34

Dr. Ed: I believe only three of the stated goals of the Contract with America were ever passed. What I would like, be it Republican or Democrat, is the concept of putting out there in writing your stated goals if your party is elected. I would almost like this to be mandatory. We have party platforms but they are gob-lee goop. Real goals with real substance that we can all understand. Americans seemed to like the idea of the Contract With America. It could be understood and measured.

Obama campaigned on many issues that he has done just the opposite on. In plain terms he just lied. In one of his speeches, as a Senator, he severely criticized the idea of reconciliation. Now he is pushing it. He wanted to pull out all the military in Iraq and opposed the surge. Now he is taking credit for the success of the surge and the move towards a more democratic nation in Iraq. He said he would immediately close Gitmo. Gitmo may never be closed. He promised better work across party lines. It has never been worse. He and Nancy Pelosi promised to clean out the cesspool of corruption and drain the swamp. I cannot even count the number of House Members who have ethical problems and are under investigation. Obama promised openness and to put on C Span debates on health care. Instead we have it all done in secret behind closed doors with no Republican participation. Every thing was to be open and clear to the public. That could not be further from the truth. Our candidates running for office seem to lie, cheat, or do anything to get elected. We have bribes being offered, in public, for votes. The Nebraska offer to pay no taxes on something that ever other state has to pay. The Louisiana purchase. The deal to cut the start up date on taxes for Union Members who have golden health care plans. Some of these things like Nebraska seems not only unethical but criminal. No wonder the Congress has a public approval rating of something like 16%. I do not trust these people. Do you? Giving this group control of health care would be one of the great mistakes of all time. What has happened to our Government?

Result number: 79

Message Number 263932

Re: JAMA: 10 Great Public Health Achievements Since 1900 View Thread
Posted by Dr. Ed on 3/09/10 at 12:31

David:

Yes, it is true that only about 29% of MDs belong to the AMA. Most MDs are more reliant on membership and advocacy by their specialty organizations (eg. American Academy of Family Practice, American Academy of Orthopedics Surgeons, etc.) for representation. Unfortunately, MD groups have been set in competition between themselves by the insurance industry. I have been a member of the American Association of Physicians and Surgeons ( http://www.aapsonline.org/ ) which allows non-MDs to join as associate members and represents the rights of those in private practice who still feel the needs of the patients come before that of government and insurance companies.

I am not sure I agree with you about the example of the AMA's opposition to Kaiser Permanente is purely an issue of marketplace control. I have major issues with the manor in which many such HMOs treat patients an what I consider violations of the doctor-patient relationship and Hippocratic oaths by such organizations.

The AMA squandered valuable resources opposing non-MD doctor groups while ignoring the real threats to private medical practice from the insurance industry and government. Unfortunately, the AMA still has not learned from such mistakes as it controls the provisioning and definitions of procedure codes (CPT codes) for not just MDs but all practitioners. The bottom line is that practitioners who practice biomechanics have virtually no CPT codes to describe what we do, rendering such services un-reimburseable. Podiatry has evolved away from biomechanics of the lower extremity (what it used to do best) to a surgical specialty due to manipulation of the reimbursement system. There is no question in my mind that the numbers of posts detailing treatment failures would be substantially lower if that did not occur.

Ed

Result number: 80

Message Number 263879

Re: Earth Shoes View Thread
Posted by Jeremy L, C ped on 3/06/10 at 18:04

I think your comment on doctors' diagnoses of plantar fasciitis is unduly harsh. Heel pain can come from a wide variety of biomechanical deficiencies. Partially due to the limited definitions provided by insurance companies, doctors are also limited in the 'official' diagnoses they can use.

As for how Earth shoes relate to all this, there are several deficiencies that commonly fail with this shoe brand. Most notably if the individual in question presents with less than 10 degrees of available, balanced dorsiflexion at the heel, he/she should NEVER consider this brand. Even Birkenstock would be a challenge for this patient population. For those with lateral column issues and reasonable amounts of saggital plane motion, Earth is a very reasonable choice.

Result number: 81

Message Number 263877

Re: Alcohol Injections / Morton's neuroma /Cryosurgery, for Will View Thread
Posted by Dr.DSW on 3/06/10 at 17:12

I believe that this particular post is filled with misconceptions. The first misconception is that the alcohol injections 'leak out' and can damage other tissues. If the injection is performed correctly, the medication does not 'leak out'. The interspace that is being injected has a very limited amount of anatomical structures to be damaged, and there is significant damage that can be performed inserting a cryotherapy probe 'blindly' into the same interspace. Even if ultrasound guidance is utilized, the probe can still freeze destroy blood vessels and/or instrinsic muscles, etc.

As for the statement that 'many have reported extreme pain' from these injections. Well, many have reported extreme pain from NOT having these injections, many have reported extreme pain following traditional surgery, many have reported extreme pain following EDIN procedure, Kobyguard procedures and cryotherapy procedures. So you simply can not isolate alcohol injections as the only culprit as having the potential of causing extreme pain.

In my opinion, after only 25 years of practice, the sclerosing alcohol injections have the best potential outcome vs. potential risk. There is very little realistic risk for complication. Cryosurgery, as safe as it may be is STILL surgery. A probe is being inserted and there are freeze and thaw cycles. Once again, there is the potential for damaging healthy tissue, and there is the potential for scar tissue/fibrosis along the probe tract that has been created. And naturally, with any invasive procedure, there is always the potential for post operative infection.

I have performed cortisone injections, I have performed surgical excision via a traditional dorsal approach and a plantar approach, I have performed the EDIN procedure, the Koby procedure and sclerosing alcohol injections, and have witnessed, but never performed cryosurgical procedures on many occassions.

I have had significant success with all of the above procedures, and with my years of experience, my treatment of choice at this time is still sclerosing alcohol injections, since MY patients experience the greatest relief with the fewest complications. And that's how I judge success.

Result number: 82

Message Number 263876

Alcohol Injections / Morton's neuroma /Cryosurgery, for Will View Thread
Posted by brianpk on 3/06/10 at 16:50

Having suffered with Bi-lateral Morton's for over 1 year I have had (1) cortizone injection 1/09 which made my pain almost intolerable. I had cryosurgery perfomed (bi-lateral) by a POD in the South who advertizes heavily. This procedure was partially successful but I believe that the technique and equipment was a little off so my relief was not as significant as hoped for. I have spent over $2500 on Orthotics. None of which I believe to be correct. I had a second Cryosurgery performed in 12/09 by a Cryosurgeon in AZ (only one foot this time). This Cryo was much more successful in relieving my pain. Pain relief is not complete but I can make it through the day on my feet, on concrete, without feeling like I want to cry at 6pm.
I strech my calf muscles and hamstrings several times each day, take some Motrin or Celebrex as required, and try to take my shoes off whenever possible.
I am contemplating a second round of cryo on the same foot to try & get more relief but, before I do that I need to get proper orthotics to help correct the mechanical deficiency in my feet that caused this problem in the first place. I chose cryo over the alcohol because the alcohol injections change the texture of the nerve. The sclerosing solution can leak out and damage other tissues in the foot and many have reported extreme pain with the shots. I had very little discomfort with the Cryo both times. The cryo has been used in pain control for nerve pain in other parts of the body for many years. It is relatively safe and has the least potential to cause long term damage of any 'more agressive' treatment. Whatever path you choose, I recommend that you move slowly. If you choose any surgical route it cannot be undone. If one looks down just a little int the 'ask the doc' section of this forum there is someone who had Morton's surgery that is suffering more than before the surgery. Note that the doctors did not reply to this post. In almost no other circumstance is it ever recommended that a nerve be removed from the body. It will always try to grow back, sometimes as a 'Stump' which is more painful than the original neuroma. Many report no problems with this procedure but published reports show recurrence rates as high as 50%. Some report complete relief for 5-8 years then terrible re-occurences. It is your body, choose your path wisely once any true surgery is performed it cannot be undone. Patience, time, an understanding of WHY THIS HAPPENED TO YOU is very important. Local talent may not be able to adequately solve the problem. Do your research, take your time, make an informed decision, these are your feet. You can find plenty of horror stories of people that have had their life ruined by foot surgery. Best of luck, may your relief come quickly.

Result number: 83

Message Number 263872

Re: Concerning Chiropractors View Thread
Posted by Julie on 3/06/10 at 12:45



'I think we need a lot more investigation into why this is happening and fast. I'm sure that we all feel this way.'

Absolutely: no-one could disagree with this.

I would just add that there are issues involved other than whether or not immunization with the MMR vaccine causes autism in a small number of individual children. The risk of a large number of individual children contracting a potentially fatal illness due to fear of immunization has to be measured against that (relatively small) risk.

Also: assuming that it is possible to eradicate a disease through immunization (I don't know if you would accept this, and I put it forward as a premise that seems to make sense, even though I don't know the answer myself) it works only if an entire community is immunized (e.g. the proposed effort to wipe out polio in Africa). Poor take-up and patchy use of a vaccine within a community can lead to the spread of the disease (as has happened due to the MMR scare in the UK).

PS to my friend John: the most significant factor in the eradication of a number of communicable diseases such as cholera has been the provision of clean water, at least in the fortunate, developed countries. And there is no doubt that improved public hygiene has also been a huge factor.

And yes I certainly remember the scariness of polio during our 40s and 50s childhood and teenage years. In 1960 I couldn't believe there could be a vaccination to protect against polio, and thought of Jonas Salk as a hero.
.

Result number: 84

Message Number 263852

Re: Are posters treated with respect and understandings View Thread
Posted by Dr. Wedemeyer on 3/05/10 at 19:05

So neither Dr. DSW or myself was incorrect in how we read your post apparently. I am not a happy camper about your little foray into sensitivity training one little bit, whether you meant me or not.

Since you have decided to cross the line with respect to inter-professional communication I am going to post this here. You have in my opinion crossed the doctor/patient boundary numerous times in the past with the old ESWT parties at your office, giveaways etc and with posts like these on the social board where there is no clear delineation who is your patient and who is your buddy from heelspurs. A very troubling trend Dr. Zuckerman. I wont admonish you but just state my concern that this may one day land you in hot water.

I do not disrespect my patients nor the posters on this site; in fact I respect them enough not to divulge anything personal about them online or to anyone else not privelege to their concerns, Likewise I feel that any personal issues that you have with another provider should be addressed to that provider or the group.

You're actually trying to encourage dissent among the posters for the unceremonious job that Dr. DSW has taken responsibility for in maintaining the ethical due diligence of the web board and that i applaud and support him for.

Please take a step back and think about what I am saying to before responding.

Result number: 85

Message Number 263835

Re: Concerning Chiropractors View Thread
Posted by John H on 3/05/10 at 13:58

Dr. W: I am not a scientist and what I think is based on scientific articles and non scientific articles. I would not advise a parent to vaccinate or not vaccinate a child. I am not qualified to make such decisions. I am qualified to have an opinion. After all I have read I came to the conclusion long ago that vaccinations far outweighed he risk the vaccination going wrong. I respect any parents right to make their own decisions where it agrees with me or not. I also expect that my rights not be trampled on when it comes to exposing my family to various diseases. States each make their own laws about vaccinations. I am a guy who tries to follow the law but once again understand that some people do not want to vaccinate their children as required by state laws. I really am not so sure about a lot of things I do but we all make our choices when possible and live with the consequences. People generally do not change their minds on such issues as vaccinations, religion, right to life, etc. I generally do not try to change their minds. For many decades I held a view on he debate over Right To Life. On that issue I actually changed my mind about 30 years ago so sometimes views can be changed. I am not an activist and do not disclose my views on this as I know that 50% of the people will disagree with me. I respect your views although I may not agree with them all and find I learn something new nearly ever day from people I may not even agree with. Julie and I have been on this board many years and we disagree generally on some political matters but we have always remained friends. I will say the same thing of Wendy and Kathy. I do not think any of us change each other views but we hopefully get a new take by our discussions. I would love to have these Progressive ladies as my neighbors as we could have some lively debates and even throw rocks at each other (just kidding).

Since 1900 life expectancy for those living in the U.S. has increased by 30 years
(From JAMA). We must have been doing something right. Following is one of the reasons JAMA thinks why. That is a respected medical journal in my opinion.

Their first report on the reason why is the eradication of Smallpox, elimination of polio, control of measles, rubella, tetanus, diphtheria, Influenza type b, and other infectious diseases in the U.S. and other parts of the world. I find it difficult to make a case against this information.

I think I need to understand where you and I really disagree. I do not think you are against all vaccinations so you must then be against only certain ones. Which ones are your against or is this even where we may disagree. I sort of sensed you were against most vaccinations but may have totally misinterpreted your stance.

Basically I believe in vaccinations of all the ones recommended by the medical community and National Department of Health. When new vaccinations emerge I may wait a while to see if there are any downsides but if none appear I am on board. I had both the standard flu shot this year and the N1H1. Apparently the N1H1 was over hyped but that is OK since it caused me no harm. I also had a Shingles shot this year as i really want no part of shingles and this is supposed to be about 75% effective. If I step on a rusty nail I will go get a tetanus shot if mine is out of date. If I have some sort of infection and my Doctor suggest a shot of antibiotic I am good to go. While spending 2 two years in Southeast Asia I would hate to think what would have happened to all the young GI's without penicillin as they had all sorts of venereal diseases. The morning line for these shots would amaze you. I think I have beat this horse to death and you have a grasp of my beliefs on immunizations. Now I need to really understand where you are as I really do not know. Maybe we are largely in agreement or worlds apart. As you know, first things first and that is to define what we may be disagreeing or arguing about. Many disagreements turnout to be nothing much at all because the disagreements are never clear to either party. Each of us may read into someone's post that is not intended.

Result number: 86

Message Number 263766

Re: When Did We Become a Service Economy View Thread
Posted by Rick R on 3/02/10 at 15:11

How did that 'Service Economy' idea look once the service jobs left for India? We drove the factories and jobs away by regulations, taxes, tolerance for foreign tax incentives, value added tax manipulation, dumping, you name it. We have to release our ankles and stand up for the U.S.A.. No doubt there was mismanagement in industry but I would argue mismanagement has been the scape goat which allowed us to ingnore structural and policy issues.

We have to be willing to put our own interests above those of Europe, China, Japan.... When Japan targeted the auto industry their national strategy involved restricting auto imports to accelerate the development of their own industry and leverage the volume their own demand represented. Did we stop doing business with them? Nope, yet we are afraid to counter the practices of our trading partners to level the playing field. Now we have an administration more interested in our image than jobs. Not to imply that the previous administration had a clue when it came to industry and trade.

Rick

Result number: 87

Message Number 263765

Re: Numb toes - negative EMG View Thread
Posted by Dave S on 3/02/10 at 15:11

I'm age 42, about 200 pounds. I haven't had low back pain in probably 15 years or mores (I see a chiropractor occassionally, but usually for neck problems). I get zero pain in the toes. Some discoloration... they changed from white to blue right in front of the doctor when I removed shoe. I saw a chart where that nerve includes half of the second toe, and it's as if half that toe is numb while smallest one is completely numb. My Dr. thinks he can send me to a pain mgmt Dr for another EMG as he thinks this guy will be able to do the test better for that nerve than the neurologist he sent me to. I'm concerned about wasted time (and money) in doing so. I think my Dr. did x-ray my lower back, but he also had me get a cat scan and last month of the whole left leg and some kind of ultrasound and no issues there. The EMG the neurologist did 3 months ago left my Dr. saying there were no issues from the lower back that could be causing it. As I type this, no numbness. I do notice that when sleeping (on my left side) those toes invariably always go numb to some degree for part or all of the night. It varies during daytime.

Result number: 88

Message Number 263742

Numb toes - negative EMG View Thread
Posted by Dave S on 3/01/10 at 11:39

Small toe and the toe next to it in left foot are numb. Numbness comes and goes. I get it standing, sitting, walking, sleeping (almost always when sleeping). Sometimes it persists for days; other times comes and goes through the day at varying levels. No pain, just numbness and can still feel with the toes. This problem has existed for several years. Had an EMG and said no issues but that Dr. said the nerves are too small to test down at that level of the toes. Is that true? Family Dr. thought maybe Raynauld's. He wants me to get EMG from another DR (a pain mgmt dr). Blood work and cat scan and ultrasound he sent me for all indicated no circulatory problem. Can they test those toes? Who should I go to? How do I know if a neurologist can do such a test since the first one said he couldn't?

Result number: 89

Message Number 263651

Re: Shoe Advice Please Jeremy - Finally got my mechanics figure out! View Thread
Posted by Mark R on 2/24/10 at 01:31

Thanks for your feedback and it will be interesting to see if the neutral shoe truly does work. I believe I will give the Glycerine a try and will definitely report back with my impressions.

I have tried on lots of Ecco shoes and felt them no different than most other dress shoes...hard and painful! I currently have some Johnson & Murphy's that I enhance with an extra gel sole which seem to be better than most but still much worse than wearing running shoes. Any specific models in the dress or trail running category that have the lateral flare & cushion type you mention?

It looks like there is also a store, Foot Solutions, not too far from me in Orange, CA that carries the Neil M as well as Spira with wavesprings, which I saw discussed here as well. In the casual category, there is the Sierra...what do you think about this one and the spring concept in general for my issues? I have seen them, as well as the gravity defyers, in Skymall and always wondered if it typical Skymall garbage for lazy people with too much money.

Thanks again in advance for your feedback and I will let you know the results...

Result number: 90

Message Number 263597

Re: TTS syndrome & recovery View Thread
Posted by Dr. Ed on 2/20/10 at 00:01

Tracey:

There are a number of entities that can mimic symptoms of tarsal tunnel syndrome such as L5,S1 disc disease and perhaps some forms of peripheral neuropathy. Ideally, the differential diagnosis need be part of the workup before surgery.

No one has a 97% success rate in tarsal tunnel surgery. Period.

Lets assume for a moment that the diagnosis of tarsal tunnel syndrome was correct. Tarsal tunnel syndrome involves compression of the posterior tibial nerve (the nerve that gives sensation to the bottom of the feet) on the inside (medial side of the ankle at a canal in the laciniate ligament. How does such compression occur? Here are three categories of causes...
1) Space occupying lesion (growth) in the tarsal tunnel placing pressure on the nerve. That could include varicose veins in the tarsal tunnel.
2) Fibrosis (scar tissue) in the tarsal tunnel.
3)Biomechanical issues, that is, mechanical entities causing the tarsal tunnel to compress or stretch excessively. Subtalar joint pronation, as seen by the back of the foot rolling in stretches the laciniate ligament placing compression on it contents, ie. the tarsal tunnel. How can any competent practictioner 'not believe' in orthotics when such devices are an invaluable modality to reduce overpronation.

Definitely time to seek another opinion.

Dr. Ed

Result number: 91

Message Number 263586

Numb toes - negative EMG View Thread
Posted by DaveS on 2/19/10 at 13:18

Small toe and the toe next to it in left foot are numb. Numbness comes and goes. I get it standing, sitting, walking, sleeping (almost always when sleeping). Sometimes it persists for days; other times comes and goes through the day at varying levels. No pain, just numbness and can still feel with the toes. This problem has existed for several years. Had an EMG and said no issues but that Dr. said the nerves are too small to test down at that level of the toes. Is that true? Family Dr. thought maybe Raynauld's. He wants me to get EMG from another DR (a pain mgmt dr). Blood work and cat scan and ultrasound he sent me for all indicated no circulatory problem. Can they test those toes? Who should I go to? How do I know if a neurologist can do such a test since the first one said he couldn't?

Result number: 92

Message Number 263573

Re: Help View Thread
Posted by Dr.DSW on 2/18/10 at 19:55

Mike,
No offense, but I've been in practice for over 20 years and don't really need anyone to explain to me what 'cortisone' injections really mean.

No one ever actually injects 'cortisone', it's a generic term like saying 'Band-Aid'. Every doctor that injects 'cortisone' is injecting some form of a cortico-steroid. It's the equivalent of your doctor saying, 'it's not 6:30, it's half past 6'. It's the same thing.

So I COMPLETELY disagree with your doctor. Injecting cortisone or 'cortico-steroids' once a month for twelve months is extremely dangerous and can/will cause atrophy of the soft tissues and possible rupture of the plantar fascia.....if it hasn't already.

So to answer your question, no this does not sound correct.

Result number: 93

Message Number 263550

Re: other pain after heel pain? View Thread
Posted by AndrewUK on 2/18/10 at 06:57


Dear Dr Wedemeyer,

Thank you for your reply.

Inflammation of the large joints - when I first had heel pain back in early 2008, I had some very mild knee pain for about a week. The pain was under the knee cap and it wasn't swollen. My doctor said I probably had Osgood-Schlatter disease (I was 29). Three days after I wore a pair of Crocs RX ,the heel pain disappeared. And the knee sharp pain disappeared as well. (I also told my doctor I started a new job which required standing. And I had had sedentary lifestyle before changing to a new job.

In 2008 I also had increased urination and all the blood tests were normal -- my doctor said I have a sensitive bladder.

I haven't had any of the above symptoms since mid 2008. (The only symptoms I have is sometimes I have sore eyes if I spend too much time at the computer. But it's very mild and all I have to do is not to use my PC for a couple of hours. It's never very red)

Admittedly, I am starting having soreness in the back of my heel. (the back of Calcaneus? under the achilles tendon) But it's very mild and I suspect that was from taping and excessive weight bearing stretching....

The exact words from the specialist is that 'plantar fasciitis isn't that painful as this. You may have Reactive Arthritis'

The pain I have is that I simply cannot walk much.. I can probably walk to the bathroom and kitchen for simple task. And I haven't been able to do any shopping.

This time the heel pain (both heels) appeared two weeks after I changed to another standing job in Oct 2009. In Jan 2010, I started to have sharp pain along the fascia whenever I walked after rest. The midsole pain gradually decreased but the heel pain gradually increased 4 weeks ago. As the pain in the heels increased, I also started to have soreness and discomfort around the joints of phalanges and metatarsal bones. (no discomfort around the toes and no sausage toes)

They did blood test in 2008 for liver and kidney function and blood glucose. All came back normal.

The tests they have done this time are
1) 27 Jan 2010 - X ray Calcanei: Report says 'Normal appearances in both calcanei. The suggestion of a small traction apophysis at the insertion of the achilles. No other abnormality has been seen'
2) Ultrasound 9th Feb 2010 - plantar calcaneal bursitis. Plantar fascia is 3.4mm. No bone spur. One ultrasound guided steroid injection at the right foot was done on Feb 9th but I haven't noticed any difference..

That's all. They haven't given me any blood test this time. This doctor (specialist) is a GP who has special interests in sport injury and musculoskeletal issues.

I am just curious if they are on the right tract... I am currently waiting for an appointment in a hospital and I don't know if they'll do any test.. I don't even know if I should see a podiatrist, orthopaedic doctor, sport injury specialist or a rheumatologist.

Many thanks for listening.

Best wishes,
Andrew

Result number: 94

Message Number 263539

other pain after heel pain? View Thread
Posted by AndrewUK on 2/17/10 at 16:11



Hi everyone,

I have been reading this message board for a couple of weeks and it has so much information.... And thank you especially to those doctors, Jeremy (shoes advice) and those members who share your valuable information.

I am wondering, after first experiencing heel pain or just fascia pain, do you develop other pain as well? such as neck ache or back ache?

My doctor is saying I may have Reactive Arthritis because when he checked my fascia under ultrasound, it is not thickened (3.4mm) But he found two bursitis (plantar calcaneal bursitis...)

However, I do not have any skin, eye or GI issues commonly seen in Reactive Arthritis..

So I am very curious if any of you has other stiffness or ache after a period of heel pain?

And is it certain that if my fascia is not thickened, then I am not having plantar fasciitis?

Your opinions will be much appreciated....

Yours in pain,
Andrew

Result number: 95

Message Number 263528

calcaneal osteotomy View Thread
Posted by stact on 2/16/10 at 21:59

I have not been on this forum for a few months as my mom had a stoke and I have been balancing work, family and issues with my mom. In a nutshell. I had a modified kinder/hyprocure. 6 weeks later, I had a hyprocure removal as it backed out. I had a slow and frustrating healing process. 5 months post op, the toe of my sneaker caught on the floor and the pain in the surgical foot was about a six or seven for the rest of the day despite icing and resting. The next few days, pain was less so I figued all was fine. 4 days after the incident, I was having difficulty making it through the day and my ankle felt as if it was collapsing. I also noticed that the post surgical arch appeared to have flattened somewhat. I called to see the doctor. The doctor who did my surgey was out for four days but one of his partners was in so I saw him. The partner did a complete exam including watching me walk, stand, rise on my toes and took new x-rays. He looked at the digital images and superimposed a line from the heel to the forfoot. After looking at the films, he said that the allignment of my foot was the problem and alluded that he would not have don modified kinder alone. I had to stop pt because my tendon was VERY swollen. I an wearing a brace whenever I walk to try to calm things down. If things calm down, then I will be able to start pt up again. So far,I have been wearing the brace for 3 weeks. When I wear the brace, I can make it through a day at work, but as soon as it comes off, my foot throbs and becomes painful just walking to the bathroom. I feels as if my foot collapses and that my ankle pronates. The doctor feels that due to the allignment of my foot, without the calcaneal slide, I will continue to have problems. The other option is wearing a custom made brace for the rest of my life. He would also clean up the posteior tibial tendon and repair any new tears that have occured. I am SOOOOOOOOOO frustrated. Two surgeries later, I am left with two numb toes from the hyprocure (not painful but annoying) and ongoing pain from the the origional problem. It appears that the origional surgeon did the surgey correctly but not the correct surgery. In trying to be conservative, he may not have done enough to correct the situation. I am not happy about the possibility of a third surgery and part of it redoing part of the old surgery. I do have an appointment to have someone else look at my foot. The partner had no problem with me getting another opinion and infact said that he would do the same. What can you tell me about the calcaneal osteotomy? Pros cons etc. Any insights you can offer would be appreciated. I HAVE to be able to walk/work as due to the economy I am now the main breadwinner. I don't want to go from the fire into the frying pan.

Result number: 96

Message Number 263514

Re: bilateral TTS? View Thread
Posted by Laurie C. on 2/16/10 at 10:11

I have had bilateral TTS as well as bilateral peroneal nerve palsy. I have no back problems as demonstrated by MRI and lack of symptomotology. I have had all the work ups three times over for any rheumatological problems by two different rheumatologists as well as seen three neurologists (one from a university level medical school) and they can't explain why I have had these issues. My most recent peroneal nerve palsy was surgically fixed last week - I went from having 0 movement of my ankle and toes in dorsiflexion to normal movement within 24 hours of the surgery. There was a very tight fascial constriction on my nerve which I understand as simply choking off my nerves' ability to communicate with my foot muscles.

I'm healthy otherwise - exercise 4-5 times week. I weigh 134 and my only vice is chocolate and diet Coke.

Result number: 97

Message Number 263434

4 week Follow up View Thread
Posted by Tony M. on 2/12/10 at 20:06

I had TTS Release 4 weeks along with a ganglion cyst removal from my tendon in same ankle and had my second follow up today. My hard cast was removed 20 days ago and beside the surgery pain, It felt good. But,for the past 2 weeks I have some numbness on the bottom of my foot, alot of pain around my ankle and some tingling.

I still have swelling on the side of my ankle where the TTS Release was done. I continue to ice my ankle and keep it elevated.

During my doctors appointment the doctor said that with me not having any issues when the hard cast first came off (besides surgery pain), that the surgery went very well and the issues that I have know are more then likely do to the continuous swelling of my ankle.

I will continue to be non-weight bearing for another 2 1/2 weeks and he has put me on MethylIPREDNISolone Tablets 4 mg for 7 days and then Naproxen for awhile. All to help with the swelling.

That was the 3rd time to have to have the Ganglion Cyst surgically removed and the first surgery to remove that went great. But I also had alot of swelling that lasted longer then expected. So this amount of swelling was expected.

The doctors only concern at this time is the swelling. He talked about the scar tissue becoming a possible issue if the swelling continues for to long.

I trust my doctor 100% and have followed his every direction to the T. I will continue to do as he says.

I have heard the stories of people having the surgery and doing things they shouldn't be doing and not following the doctors orders.

Luckily my wife has been Great these past few weeks and has helped a lot.

I hope to have good news when I do my next follow up in 2 1/2 weeks.

But till then, I will do everything as the doctor orders because I will not be one of the people who's surgeries was a failure do to there inabilities to follow the directions of the doctor.

I think that no matter how successful the surgery is and no matter how good you follow directions, there is always a chance that it doesn't get better.

I will continue to fight TTS with every option I can get my hands on.

And I will pray that everyone does have relief either with surgery or with time.

Result number: 98

Message Number 263349

Re: DR. DSW View Thread
Posted by Dr. DSW on 2/10/10 at 09:51

VB,

It may be related to you TTS, it may be indicative of other medical issues, but I can not accurately comment since I have never evaluated you in person. Please discuss this with your treating doctor(s).

Result number: 99

Message Number 263312

Surgical options for running-related recalcitrant PF? View Thread
Posted by Dan K on 2/08/10 at 17:21

I am 50 yrs old. I ran cross country in college in the early ‘80s and developed plantar fasciitis in my right heel during the summer of my senior year. I always trained and raced in orthotics. When PF set in, I tried to first train through the pain and then race through it. I was in so much pain after my last race that I needed crutches for three days and the condition didn’t finally resolve until about 10 months later, with no running whatsoever and the end of my collegiate athletics.

I resumed running in my late 20s and didn’t have any problems with PF. In my 30’s I got one on two bouts of PF but was always able to resolve the condition with rest, usually after a few months off from running.

When I turned 39 I was competing in running races and duathons and I got another case of PF. This time I tried rest for almost 2 years and while the condition felt almost completely resolved, it came back almost immediately when I resumed running. In the 11 years since, I have not been able to resume running without almost immediately triggering a recurrence of PF.

I have tried most conventional therapies over the past decade and worked with a number of different professionals including podiatrists (2), a sports medicine chiropractor and an acupuncturist. Included in what I have tried are the following treatments:
• Rest, ice, ibuprofin on and off through the decade
• Many pairs and types of shoes including motion control and stability shoes
• Orthotics, 3 different pairs ranging from really stiff to modestly stiff
• Calf and hamstring stretching – on and off through the decade
• Foot/arch taping 2007
• Night splint 2007
• Acupuncture 2007
• 1 cortisone injection 2007
• 1 ESWT procedure 2006
• 2 needle fasciotomy procedures 2007/2008
• 2 Platelet rich plasma treatments 2009

I know from experience that my PF condition will resolve itself over time with rest so long as I completely quit running. For example, I ended up taking off almost 18 months off following the ESWT treatment because I also had a knee problem. When I resumed running my PF condition felt completely resolved. However it returned in about 3 – 4 weeks of modest training (20 – 30 mi/week). However, I AM a runner and not running is not a very acceptable outcome.

After reading “Born to Run” a year ago, I decided I had nothing to lose by shedding my orthotics and switching to a mix of natural motion running shoes (Nike Free, Ecco Bioms) along with some barefoot running. During this time period I also had the PRP treatments. During this transition away from orthotics to minimally-supported shoes, I had to work through a number of calf, foot and achillies pains/injuries but all of those issues are now resolved. However, much to my chagrin, I still have the PF-related heel pain. It’s not worse from making the aforementioned changes, but my condition persists. My heel pain has always increased with both mileage and intensity. As before, I could probably run 12-15 miles a week and keep the PF condition manageable, but any more running than that will really start to aggravate the heel pain.

My question is this: Based on this history, are there likely any surgical procedures that would help me resolve my PF condition?

Thanks for your feedback!

Result number: 100

Message Number 263238

Re: recommended shoe brands for kids? View Thread
Posted by Jeremy L, C Ped on 2/04/10 at 19:00

There's evidence suggesting both sides of the 'eternal argument': to place kinds in supportive shoes or not. Here are some things to keep in mind:

1. Just because you're having foot problems does not necessarily mean that your kids will. Many times, foot pain in adults comes from poor selection of footwear over the span of many years. Kids feet are especially malleable, so there's often less permanent issues regarding footwear selection. That said, really bad shoes, worn extensively and universally could certainly promote poor development in growing feet.

2. Genetics does work. If there are signs of egregious deformity (i.e. the inside of the foot and ankle is totally pancaked to the inside), then professional assistance is in order.

3. The bones in a child's foot do not fully develop for many years. It's important to allow the intrinsic and extrinsic musculature to develop and strengthen naturally (unless there are clear signs of trouble). That occurs by going barefoot.

I can't see any reason why you would have to rush any of your kids to a DPM for evaluation unless you suspect significant developmental problems. Your best first step is to visit a store with a solid, professional staff who specialize in kids shoes (i.e. NOT department stores or your local Footlocker, et.al.).

One other thing that I can relate is regarding the popularity in Crocs (and their many copied versions). Few footwear items stem natural development in kids feet as well as those do. As we like to say, kids Crocs are good for business.

Result number: 101

Message Number 263216

Re: Cryosurgery View Thread
Posted by rob8647932 on 2/03/10 at 16:19

Laurie,

His success rate is ~85%. I am doing the cryosurgery due to some other more major health issues that prevent me from having the Dellon Surgery at the current time. Thanks for your comments and concersn though.

Result number: 102

Message Number 263173

Re: Cryosurgery View Thread
Posted by Rob Wilson on 2/01/10 at 09:05

Dr Dellon does the open TTS surgery. Spilken is going to do the cryosurgery or cryoablation which is just a probe. I need to stay away from surgery due to some other issues I am having.

Result number: 103

Message Number 263133

Could this be early sign of Venous Ulcer? View Thread
Posted by Barbara L. on 1/30/10 at 19:16

Hi Dr. DSW,

It's me again: 'Vascular problems + Avascular Necrosis after Bunionectomy' and 'Erythromelalgia: cause of heat-related foot swelling?'

The past 3 evenings, I got a bright red patch in the area of the lower part of the scar from the bunionectomy. It's round, about the size of a 50 cent piece. I was getting a little exercise (walking) before it appeared. I've thought that it was the beginning of my whole foot swelling, so I elevated, and it faded away in about 30 minutes (each evening the same). The rest of my foot was cool; the red patch slightly warm. Last night, I pressed on it, and it did not blanch. I thought that was weird, so I did my usual online research. With all the vascular issues (cold alternating with swelling) I've had going on in this foot, I'm wondering if it could be the start of a venous ulcer?

I have emailed my podiatrist with an attached photo and will call him Monday; I will also email the Vascular specialist. But, of course, I wanted to see what you thought. Can an ulcer, in the earliest stages, start out by appearing and disappearing? I'm really scared now -- I've learned how serious ulcers are, especially if your circulation is compromised.

Thank you!
Barbara

Result number: 104

Message Number 263117

Advice sought for "Diffuse Myofascial Pain" with detailed history View Thread
Posted by Mark R on 1/30/10 at 01:44

Hello and first off, this is a great site with tons of good info, I am surprised it took me this long to find it. Thanks in Advance! So I am 31 and have been suffering with foot pain for about 4 years. It varies between 1-3 when manageable and up to 8 when bad. Its always there (never 0.0) and is getting very, very old. My pain is all over the bottom of my feet, between the bottom of the heel to the metatarsal/toe joints. Pain in the arch tends to be from the midline of the foot to the lateral sides. Pain increases with being up, when standing the whole sole and heel hurt and when resting more in the front as an aching/burn/tingle/throb.

I am slightly bowlegged and have tended to walk more on the forefoot and side, but try to consciously correct this. I do not have the telltale PF pain at the heel in the AM, except for when I press on it or do massage. I am in great shape, 5’11 and 180lbs with lots of biking and swimming but no running with a bad knee. In a cruel irony, I have a knee that hurts when I sit too long and feet that hurt when I stand too long, it basically blows. I stretch, pull, massage, ice, and etc for over an hour a day on my feet and/or knee - something has got to give!

Medically, an MRI indicated mild flexor tenosynovitis, bone scan showed PF more than metatarsalgia, ultrasound showed normal plantar fascia (not thickened). My PT says soft tissue issues of the foot and calf, and another PT says lack of foot joint flexibility. My best foot doc says “diffuse myofascial pain” where the muscles and plantar fascia hurt together due to tightness. I have always been very tight and stretch alot to try to help.

Things that help: Graston , which took it from horrible to manageable and I now do myself, the PF stretch and golf ball rolling every morning, sometimes calf massage, very well padded shoes or Dansko clogs, ice, rest, and Vicodin.

Things that don’t: Hamstring stretching, foot strengthening exercises, anti-inflammatories, and all the easy stuff, 4 different custom orthotics, taping. Night splint makes it feel relaxed in the AM but does not reduce pain later.

I have looked into surgery but had not had great luck with surgeries in the past, with 2 knee arthroscopies on the same knee without much help. The best doctor I have seen yet said he does the complete release at the heel insertion and advances the insertion forward. I would like to exhaust all options but am getting desperate.

So a few questions and thanks in advance!
1) Can ESWT be used for diffuse cases when it is indicated more for focused PF pain?
2) Does release surgery help diffuse and forefoot pain problems?
3) Would a partial or complete release be better?
4) Any other ideas of what can help?
5) Any Dr. recommendation for Orange County, CA?

Thanks and if this belongs better in Plantar Fasciitis let me know.

Result number: 105

Message Number 263111

Re: Cryosurgery View Thread
Posted by rob8647932 on 1/29/10 at 15:01

I understand but I am dealing with some other more serious health issues right now and want to try to get some TTS relief without major surgery if possible. I might end up having the Dellon surgery if the cryosurgery does not help. Thanks for your concern.

Result number: 106

Message Number 263080

Re: Foot pain from Yoga...for Julie View Thread
Posted by Jen R on 1/28/10 at 07:40

Thanks again Julie. I'm going to back off the yoga until I get the pilates video...or my feet feel significantly better. In the meantime, I will stick with the yoga foot stretches.

It really sucks that I can't seem to find a solution for my foot pain. I live my life being scared that exercise and doing otherwise healthy activities will cause me to be disabled as I get older...but more scared that if I don't exercise I will end up overweight and dealing with other health issues that would be even worse. At times like this, I think about having my feet amputated and getting prostetic feet. I hear about amputees having 'phantom' pains but sometimes I think it would be worth the risk because I also see plenty of amputees who strap on their prostetic and lead totally normal and pain-free lives.

Anyway...sorry to go off on that tangent. I'll keep you posted.

Jen

Result number: 107

Message Number 263014

Re: neuroma surgery View Thread
Posted by Dr. DSW on 1/24/10 at 12:06

A tourniquet is really standard on most surgery performed on the foot and ankle, if the patient does not have a pre-existing vascular disease.

Unlike your vivid imaginiation, it's not going to cause gangrene, nor is the doctor going to rip off his shirt and tie it tightly around your leg.

The tourniquet is like a blood pressure cuff placed around your ankle or thigh, depending upon the procedure performed and the anesthesia used. The tourniquet is then inflated at a specific pressure which is often based upon your blood pressure.

It is generally safe to keep the tourniquet inflated for up to 1.5 hours before it has to be deflated to let the tissues 'perfuse'. If the surgery is going to last longer than 1.5 hours, the 'general' rule is to wrap the surgical site, and let the tourniquet down for about 5 minutes for every 1/2 hour it was inflated. Then it is safe to re-inflate the tourniquet.

The actual purpose of using the tourniquet in the first place is to allow a 'dry field', which means there is no bleeding during the surgery. This usually allows for a quicker surgery since it allows the surgeon to perform the surgery without constantly having to wipe away blood,etc. It also allows for excellent visualization of the anatomaical structures such as tendons, ligaments, nerves, blood vessels, etc. And of course it eliminates blood loss.

There are some surgeons that prefer not to use a tourniquet during surgery, but the overwhelming majority of surgeons that perform surgery on the foot and ankle routinely and safely use tourniquets.

Result number: 108

Message Number 262970

Cyrosurgery and Tarsal Tunnel View Thread
Posted by Cher on 1/22/10 at 17:49

Hi, I'm wondering the dr's opinion of Cryosurgery for the relief of Tarsal Tunnel Entrapment.
I've had one TTR surgery that a few months later is not responding well. I have bilateral entrapments. I weigh 125#, 5 ft. 6, no other health issues.
Wondering about maybe trying Cryosurgery on the remaining foot to see if it fares better than the TTR on the right.
Also wondering if I did it on the right that had surgery, how long I should wait post-surgery before doing it, if it makes any difference at all.
Finally, could you recommend any Cryosurgeons that really know their Tarsal Tunnels. I'm in IL, but would be willing to travel for the right dr.

Thank you.

Result number: 109

Message Number 262887

An odd question for Dr. Wedemeyer View Thread
Posted by myelverton on 1/19/10 at 14:53

Hi Dr. Wedemeyer,

Hope you're well. I'm continuing my wait-and-see plan for the feet. So far they're mostly tolerable without neurontin, PT or anything else except daily stretching. You might recall that my lingering issues have been intermittent pins & needles and the inability to stand still without pain. I'm happy to say the pins & needles are continuing to occur less and less.

I discovered something bizarre about the standing issue last night that has to mean something and I wanted to ask your opinion. I was at a basketball game in my custom orthotics and New Balance 993 shoes and pretty much had to stand the entire game. When after about 15 minutes of standing brought on the usual intolerable pain (solid aching pain all over my soles, not the pins & needles stuff), I took my shoes off, bundled up my coat and stood in my sock feet on my coat for another hour and a half or more with almost no discomfort. I stood so that nearly all my weight was on my arches, supported by the soft cushy coat. Does this simply mean that I'm not getting enough arch support? It's also notable that I went on a five mile hike Saturday with no discomfort over maybe a level 2 out of 10. Do you have any thoughts about this? Thanks so much. -margaret

Result number: 110

Message Number 262834

Re: Vascular problems + Avascular Necrosis after Bunionectomy View Thread
Posted by Dr. DSW on 1/17/10 at 08:53

The venous congestion can become a chronic problem, but you may want a vascular consult. I would get the compression stockings ASAP.

AVN is usually a result of arterial disruption to the bone, not to venous disruption. As per my initial post, it is a well known 'risk' of any osteotomy, especially an 'Austin'. The 'head' of the metatarsal receives it's blood supply from the soft tissue/periosteum that surrounds the bone. During dissection, this can be disrupted and contributes to the development of AVN.

Additionally, during surgery, part of the procedure often involves releasing tight tissues in the 'first interspace' that contribute to the deformity, and many believe that aggressive dissection in this area also can disrupt the sensitive blood supply and contribute to AVN.

There are also many other factors involved, but once again the development of AVN is usually due to arterial disruption.

Result number: 111

Message Number 262814

Vascular problems + Avascular Necrosis after Bunionectomy View Thread
Posted by Barbara L. on 1/16/10 at 12:26

Hi, I am 47, female, healthy, and not overweight. I had an Austin Bunionectomy 1/9/09, just over a year ago. Didn't have a bunion, but I had early Hallux Limitus, so had an osteotomy to shorten the 1st metatarsal. I was off work for 3 months and followed all doctor's orders. I continued to have swelling, especially when I stand for any length of time and when my foot gets warm, whether it's the weather, a hot shower, my electric blanket, etc.(When foot gets too warm, the swelling comes on very fast.)

In October, '09, I had an MRI, which showed a non-union and AVN (Avascular Necrosis / Osteonecrosis). I used a bone stimulator for 2 months (still using it, hoping it will help AVN). A CT scan Dec,'09,showed the nonunion healed, but showed some sclerosis in the area of the AVN. My doctor wants to see what happens with more time. My fear is it will continue to deteriorate. I, however, just made an apt. with a vascular surgeon because I believe the swelling I get almost every day, once my foot gets toasty, is not from the AVN but from vascular damage done during the initial surgery. My doctor said the veins over the MTP joint are cauterized during surgery. My sense is that when my foot gets warm, and the blood flow increases, that whatever veins are left (that were not cauterized) cannot handle the increased blood flow, so blood leaks into the tissues. When it swells, it starts in the area of the incision and then spreads to most of the foot. Sometimes my toes turn purple. My doctor said it could be arthritis causing this, but I don't believe that...(it was nothing like this before surgery). Also, if my doctor was too 'aggressive' in the surgery and cauterized more than he should have, could that have led to the nonunion and the AVN? And, finally, with these problems, I'm afraid I may have healing issues / complications in any future surgery I may need to have, i.e., fusion of 1st MTP joint if AVN gets worse. I appreciate any feedback. Thanks so much for your time!

Result number: 112

Message Number 262756

Re: Haglund's Deformity View Thread
Posted by Chuck H on 1/12/10 at 11:09

Recovering from my second surgery for Haglunds (First left then right foot) by a very competent orthopedic surgeon. I feel that I could write a book on the topic. Bottom line is the surgery is painful, the healing process long, the recovery (6mo to 1 year for all the swelling to be eliminated) but the results make the procedure well worth the issues.
Unfortunately, once the Haglund cyst is removed, the Achilles is stretched and must be debrided and then re-attached for proper tension to be restored. Not very pleasant but was the ONLY thing I tried that worked (attempted ice, injections, open heel shoes, ultra sound treatments, physical therapy, etc.) Diagnosed with foot MRI.
Someone should write a 'tip sheet' for those going through the surgery.. my tip contribution would be to acquire a set of 'Elasto-Gel'
crutch pads to eliminate sore underarms.. works great and worth the price since you WILL be on crutches for 6 weeks.

Result number: 113

Message Number 262724

Re: itchy left Heel View Thread
Posted by sbks on 1/11/10 at 09:02

Me too! I am 46 and my heel started itching at night about five days ago, and has kept me awake ever since. It feels like it's deep inside my heel, and I don't think it has anything to do with the skin. I don't have any dry skin or calluses on my feet, anyway. It is kind of like a tingle more than an itch.

A couple of things changed recently in my lifestyle: I started using the comforter on my bed in addition to the usual blankets as it has been really cold lately (causing my feet to be warmer than usual), and for the past ten days I have been on a vegan diet (no animal products at all). I exercise moderately, nothing excessive.

I have had sciatic nerve pain many years ago and also have had four neuromas removed from my feet, so with my history of nerve issues, I think it has something to do with that. But after reading some of the previous posts, I now wonder if my feet being hot is causing the itching, or possibly something in my diet (or lack of something in my diet).

I hope we can all find help for this soon!

Result number: 114

Message Number 262714

Re: moderate tarsal tunnel syndrome. View Thread
Posted by Dottie on 1/10/10 at 17:02

I have taken Neurontin since my initial diagnosis in 2002. For me it has been quite helpful. I can say that when I had some other issues and the docs cut my Neurontin dose in half, I realized how much Neurontin DID help. I am on the maximum dosage allowed again. I am in a lot of pain all the time but Neurontin added to my meds is the difference between sanity and insanity. It can make you loopy so be careful driving. Also it used to make me 'chatty' almost like I had had a __tail back when I started taking it. I liken it to a homemade bisquit. Neurontin takes a layer or two off the 'bisquit' of my pain.

Result number: 115

Message Number 262706

Re: Sore arch but not PF View Thread
Posted by Amy on 1/10/10 at 11:29

Dr DSW,

I've had very similar pain to Stevec since April 2006, and doctors are at a loss. It's not PF, as it doesn't match enough of the symptoms. I had TTS release done in October 2008, which helped the TTS symptoms, and a lateral ligament release in July 2009, which has helped with some of the instability issues in my ankle- I'm fairly hypermobile and would sprain my ankle roughly once a month before. However, I still get the pain in my foot. Looking at the sole of my foot, the pain originates from pretty much in the centre width wise, and two thirds up the length of the foot (nearer the toes). No doctor/phyiso has been able to suggest what it could be. I had MRI and ultrasound scans in 2007 or 2008 which were inconclusive. I've tried researching it myself, but found nothing conclusive. My consultant has discharged me, and dismissed my concerns when I brought them up again at the last appointment. Do you have any suggestions at all? Even better, do you know of any doctors you could recommend in the UK? I'm in Lancashire but after nearly 4 years of pain, I'd travel pretty much anywhere in the UK to get this fixed.

Stevec, sorry to gatecrash your post, I have no advice but plenty of sympathy for you!

Thanks, Amy

Result number: 116

Message Number 262700

Re: Morton's Nueroma Post Pain View Thread
Posted by JenniferE on 1/09/10 at 21:30

Arlon- I know this post was from a few years ago but if you ever check it still please respond to me. I have alot of the same issues as you have talked about. Would like to know what came about on your situation. Did you have the cryosurgery and did it work? I too have been diagnosed with RSDS after having a neuroma surgery and have been in pain ever since.

Result number: 117

Message Number 262635

Re: choosing sneakers with orthodics View Thread
Posted by Jeremy L, C Ped on 1/05/10 at 19:08

I actually had several issues in recommending that shoe model to patients, but I'm not going to argue its relative success for you. In order to find a reasonable replacement for it, please remember that it had a few build qualities to it which are not common in most athletic shoes:

1. The molded PU sole allowed this shoe to flex more towards the toes instead of the midfoot area.

2. Although its was classified as a neutral cushion trainer, that PU midsole actually had a slight medial bias to it.

Here are a couple shoes that you can consider that may provide you some relief:

Asics Gel Nimbus and Landreth - These both provide a roomy toe box, as well as come in a variety of widths. Both are neutral platform shoes that have a substantial molded PU shank. They also have a soft internal last construction in the forefoot to enhance cushioning in that area. The 2150 may also be a reasonable choice, but keep in mind that it has a bit more bias to it than your old New Balances.

Garmont Escape 9.81 - I HATE what Garmont has done with most of their shoes, but this model is a revelation for them. It has a gradual TPU shank, again directing flexion towards the toes. The forefoot is roomy, and possesses a very intimate heel fit. please avoid the Escape Race, which has NONE of the 9.81's support features.

Asolo Cross Walk series - These all have a last shape that is pretty similar to New Balance's SL-1 (what your 8505 was built on). They are all more supportive, but also more propulsive, helping to redirect ground force from your trouble areas. The Icarus Is probably the most cushioned of these models.

Keen Targhee and Voyager - These are also trail models, but some of the few Keen models that still provide sufficient midfoot support and targeted forefoot flexion. Available forefoot space will certainly not be a concern, as these are all roomier than your New Balance in the toe box. There may be other Trailhead models from Keen that will meet your needs, but I don't have enough info to recommend any specifically.

That should be enough to get started. Best wishes for you.

Result number: 118

Message Number 262576

Re: No orthotics work View Thread
Posted by Dr. Wedemeyer on 1/03/10 at 12:47

I am going to ask that the moderator not remove Linda and Hillary's posts just this once (this board is limited to responses from doctors and allied professionals). I would like to make a point here and I feel that it is important to leave their posts up for the sake of understanding this thread and my response to it. It is a recurrent theme surrounding a subject pertinent to this board.

First orthotic is a term that is generic and is used to describe most any device, made of most any material, casted from most any method (or prefabricated), by most any profession. It can also refer to bracing of other body regions. Orthoses is a more correct term for a truly custom device.

The three professions where there is actual didactic training in casting, manufacturing and dispensing (and the biomechanical training requisite to understand pathologic gait and the methods to resolve it. Chiropractors receive a full year of biomechanical and gait training but not specific to orthoses) the devices are the podiatric, orthotist and pedorthic fields. The podiatrist is the only one of these who possesses the requisite license to prescribe the orthotic modifications and the device. This is not to say that there are not CO’s and CPed’s who despite lacking the license to prescribe the device, are not more knowledgeable about orthosis therapy than many prescribing physicians. I have encountered MD’s who have actually taken the time to learn about orthosis modifications but they are rare. This makes sense for the orthopedists and physiatrists, though I am not certain that it is taught in their curriculum.

In most cases where there is a biomechanical fault great enough to cause pathology, a custom device that is either functional (or accomodative) is prescribed for the patient. Typically the prescribing physician (often an MD, DO, DPM) writes a script with little or no actual correction but simply writes 'custom orthoses - plantar fasciitis' for example and the entire process is left to the dispensing professional (I have found that podiatrists more often will reference the modifications that they feel are warranted). That script in the hands of knowledgeable, quality Pedorthists such as Jeremy or Brian here on the boards is more than adequate. In the hands of many providers who dispense these items it is simply inadequate as often there is a disconnect between what is truly needed and what is prescribed (or essentially not specifically a prescription), the correction and what the provider is actually dispensing. Often the correction is left to the dispensing professional.

Orthotic prescribing and dispensing are an art based on real science and often a process that requires follow-up and modification. It is an analytical process that is in fact standardized within the biomechanics field and reviewed constantly. The process should always include an oral history and physical examination including gait analysis. I often encounter patients where this process is simply taking a cast and filling the medial arch of the foot and the results vary greatly.

The point is that there is very little standardization in the industry and that there is a vast difference in the quality and specificity of devices among the professions. What was once a science and art and a mainstay of podiatry and based on medical necessity, has now become a service that many different professions provide and at dramatically differing levels of competence, methods and materials. This is especially true of the custom fabricated devices. It is essentially an unregulated practice in most states, excepting the specific laws that pertain to scope of practice. Even then the lines are blurred and you can walk into many retail chains where they will ‘evaluate’ instead of examine and dispense without any consideration to pathology, medical need or scope of practice and referrals to qualified physicians are often blatantly ignored.

The bottom line is caveat emptor or buyers beware. Not all professionals have delved that greatly into the current literature and methods and simply dispense a ‘customized’ device calling it ‘custom’. Even worse are those that should refer orthosis therapy out to those who practice and refine that practice daily or “work in the trenches”. Often there appears to be little thought to foot and ankle morphology, subtalar joint position (axis), how the ground will react with the device, foot wear and of course the soft-tissues being affected and how that will change the patients symptoms. The methods competing providers utilize to dispense truly custom orthoses varies greatly but in the current literature and teaching methods there are several methods and modifications which perform at a very high level to mediate patient complaints. There are a great number of excellent studies and peer-reviewed literature available which validate custom orthosis therapy for numerous conditions.

Unfortunately, not all orthoses (or orthotics) for that matter are created equal and it really comes down to the training, skill level and experience of your individual provider. There are also circumstances where orthoses will not resolve patient’s complaints despite your physician or provider’s best efforts. Medication, therapy and surgery all have a success and failure rate and there are always a small percentage of patients who will suffer chronic pain, disability and illness despite truly competent care. That said, always seek out a licensed and credentialed individual to prescribe your orthoses with the experience and skill to DIAGNOSE your condition and PRESCRIBE the correction. Ask around and do some research before committing to any orthotic procedure as to the methods your provider uses and whether it is a primary form of conservative treatment. This may save you the trouble of having a whole box full of orthotics of no use for you or your particular symptoms and condition.

Result number: 119

Message Number 262478

24 days in cast View Thread
Posted by scott on 12/27/09 at 08:40

hi i am now at day 24 in the fiberglass cast. i have not put weight on my foot at all. it is feeling really good i must admit. the drs plan is to have me stay in this cast non weight bearing untill jan 14th. then she is going to replace the cast with a walking cast, (still fiberglass), for another 2 weeks. does any one know the difference in a regular fiberglass cast vs. a walking fiberglass cast> im tempted to try to walk now as foot feels so good. im praying that this is going to cure my pf issues.

Result number: 120

Message Number 262461

Re: Haglund's Deformity View Thread
Posted by janetf on 12/23/09 at 20:23

I am amazed how long this discussion has been going on. I have had previous issues with plantar fasciitis but about 4 years ago developed discomfort in my R heel that was different. My friend and orthopedic surgeon evaluated and xrayed it. I had Haglund's deformity. Interestingly, the irritation started right after changing brands of running shoe. I was not a big runner just a 1-2 miles 3x a week. I had steroid injections, OT/PT, stretching, orthotics and finally stopped running w/o any relief. Finally, I tried acupuncture. It worked. I didn't resume running. Rather I hiked/walked/swam. Now, I am thinking about starting running again after all this time. I am very nervous and am going to take it slow, heel pads, good shoes, no incline and resuming stretching before and after. Any other thoughts?

Result number: 121

Message Number 262437

Re: pf chronic 5 years bilateral View Thread
Posted by 453 on 12/21/09 at 23:08

Well that's interesting! I live in Ontario, Canada and have never heard of that. I guess I hoped if the orthotic helped to take the pressure off the fascia by correcting the overpronation my PF would eventually go away. However what Im learning is the feet, or my feet it's not that simple. The most frustrating part is if I had the orthotics I have now in the beginning instead of the crappy ones that were made for me I do believe I could have resolved this, but now five years later I keep developing other issues. Unfortunately also I seem to be developing a pattern with podiatrists who think they can help me. I bring all my history, provide lots of information with me, and do honestly feel I know a great deal about PF. I diagnosed my own nerve entrapment before my EMG. I have heel spurs which were detected also by a bone scan in the early stages of this nightmare. BUT as soon as I say oh I need an adjustment or these dont seem to be helping in a very nice way, they get their backs up and say... well that's all I can do for you quite agitated actually and I feel like Im right back at the beginning again. I really appreciate your feedback. thanks.

Result number: 122

Message Number 262435

Re: plantar faciitis & bunion surgery View Thread
Posted by rhodeeho on 12/21/09 at 21:12

Thank you. Waiting on the bunionectomy until the PF healed was what I thought made the best sense. I have custom orthotics already - I'm finding they cause more discomfort (heal & arch stay extremely sore / tender). I'm sticking with them for now.
I also was recommended (early on in course of treatment) to use a walking boot for a period of 3-4 weeks to provide additional 'rest' for the foot. I'm wondering if this option should be revisited. My doc said the benefit of doing the bunionectomy would be to 'slow me down' enough to give PF a solid rest period.

Also, for reference, I had a bunionectomy & tailor's bunionectomy on my right foot last Dec following similar pain / mobility issues but no PF on the right foot. The PF started on the left foot during rehab for that surgery. Got a little better with conversative course of therapy and then really got bad after the injuries this past August.

Result number: 123

Message Number 262419

pf chronic 5 years bilateral View Thread
Posted by Linda S. on 12/21/09 at 09:36

PF: Treatments I have done: ultrasound, cortisone injection-1, nightboot, don't have tight calves though. Im on my third pair of custom made orthotics, big correction for overpronation, and ankles rolling inward.(subtaylor joint), exercises and stretching to strengthen feet,hips etc.. accupuncture-helped with inflammation, anti-inflammatories-don't address the problem which are gait issues, how I walk. severe pronation,ankles rolling inward. ART techniques, active stretching, have had MRI, do have calcaneal nerve entrapment in left foot, but appears to have resolved at least the symptoms of it are gone(left foot only) RIGHT FOOT has always been my worst foot and where the orignal problem started.
I have no more morning heel pain, have not had that in a couple of years, I wear shoes right out of bed. I know I need the orthotics due to gait issues, overpronation, but is this as good as it gets, I still have issues with prolonged standing, and when I work out inflammation and swelling of feet especially right foot. Is this the best I will ever get? After 5 years and being chronic will I now always have PF, I feel the orthotics are addressing the overpronation, but my life is still not totally back. I used to be very athletic, I would do everything!!! Just need to hear from someone is this as got as it gets???? Thanks for your time. If you need anymore info, please ask. I FEEL IM DOING EVERYTHING RIGHT< IM SOOO CAREFUL BUT CAN'T SEEM TO RESOLVE THIS COMPLETELY! Linda.

Result number: 124

Message Number 262374

Dr. Wedemeyer - I have an update View Thread
Posted by myelverton on 12/17/09 at 15:31

Hello Dr. Wedemeyer,

It's been a month or so since you sent me off to the orthopedist. I've actually seen two, and both found no orthopedic reason for concern. They advised medication (neurontin or lyrica), trying new orthotics, consulting a rheumatologist, or just accepting that it's the arthritis and/or a mystery neuropathy. One of them commented on tightness in my ankle with dorsifexion but didn’t give me any direction on what to do about it. I also went to a pain specialist who recommended the above medications and another round of iontophoresis to tackle the continuing inflammation. And of course to rely on ibuprofen, etc., to target the arthritis. No one had a very good idea of what might cause the standing pain other than the inflammation which they couldn’t explain.

Never a dull moment, I’ve recently been experiencing a very sharp pain (clearly a stabbing nerve kind of feeling) on the outside of my left little toe when I bent my foot to the right. Neither the orthopedists nor the pain specialist had any advice for addressing that, only explanations of the nerve that was likely causing it and an attitude of “sometimes we can’t fix everything.”

I’m able to clearly distinguish what feels like arthritis pain (which isn’t too bad and gets better with movement) vs. the “standing still” pain and the intermittent inflammation, pins & needles, burning type feeling. With the latter in mind, I have begun iontophoresis again with the physical therapist that I saw before – no noticeable change after three treatments. The PT also addressed the limited dorsiflexion and the little toe pain with stretches, but no noticeable changes there either.

My big news is today I went for a chiropractor visit, first one since April. This is the fellow who did active release for me, which was very helpful a while back before the EWST, so he knows my feet history. Upon hearing my status, he immediately suggested that my ankle parts were possibly out of alignment again. I had forgotten that he used to pull on my feet, which resulted in quite loud pops followed by an immediate improvement in flexibility of my ankles, and improvement in my stride. He did his thing today, very jolting adjustments, particularly on the left. He said the talus in my left foot was not right, and the cuboid in my right foot was not right. He further explained that he thought these misalignments were very possibly affecting my gait in a way that resulted in too much (or inappropriate somehow) pressure accumulating in the balls of my feet which might be causing what I’ve been feeling. He also did active release along the left side of my lower leg to help the nerve that was causing the toe pain, and there was immediate relief in my toe (which he thought would be helped by the adjustment as well, as he traced for me how the nerve could be impacted by the misaligned ankle parts).

My walking in the few hours since this visit feels very much more flexible, and I feel no forefoot tingling, which had flared up earlier this morning. There’s the slightest remnant of the toe/nerve pain if I bend my foot just right, but it’s much improved from before. I’m interested to see how long this relief holds. The chiro suggested another tune up in a month or two, depending on how well the adjustments hold. I hope I’m not too optimistic, but I’m at this moment stunned and thrilled at the change in sensations from this morning to now. After all I’ve been through, I’m not daring to think that my foot issues are now miraculously gone, but it does seem that the chiro is addressing my lingering issues in a way that none of the other doctors have been able to.

My plan is to go ahead with the five iontophoresis appointments that I’ve already scheduled before the end of the year, forego the rheumatologist and the neurontin/lyrica options for now, and try to pay attention to whether it feels like my ankles are staying flexible and how that might be related to any more flare ups of the pins & needles feelings and the pain while standing still.

I know this is a wordy post, but I wanted to let you know how my various doctor visits turned out. Also I have to put a plug in for chiropractic treatment and active release therapy. You might recall that prior to my ESWT, the ART really helped me. When that couldn’t do the whole job, ESWT took me past that plateau to a still better place. And now maybe the chiro and ART will finish the job finally (or pretty close!). I can happily live with having to do regular stretching to ward off a recurrence of PF and occasional foot adjustments to keep my stride free if that’ll minimize the burning pins & needles and allow me to stand still for more than a few minutes.

I surely hope I don’t have to come back and report that this was just a temporary delusion and ask for still more direction. So, optimistically hoping that the worst is over, let me express another heartfelt thanks to you and all the participants of this web site who have given me invaluable advice and comments on how to address these horribly frustrating feet problems. Wishing you the best of holiday seasons…

Margaret

Result number: 125

Message Number 262372

Re: Gastron for treating PF? View Thread
Posted by Dr. Wedemeyer on 12/17/09 at 12:27

Tom I feel Graston and ASTYM are more beneficial in the subacute and chronic stages of PF where there is a fasciosis of the plantar tissues. Acute PF is highly treatable to resolution and as there is inflammation in the acute stage of PF, assisted manual debridement may provoke the condition.

Result number: 126

Message Number 262356

Re: Saw the doc today View Thread
Posted by pecos on 12/16/09 at 17:44

Too me lyrica was worthless. I know that is harsh. But it did not do anything for me.

So doc said to try...neurontin...I believe that is what's on the prescription. I will give it a shot.

He said nerve issues will subue with time. Maybe 3-6 months. I am cool with that.

Result number: 127

Message Number 262286

Re: TTS Surgery - A Last Resort View Thread
Posted by Candace on 12/11/09 at 15:32

Yeah I see that the majority of the posters here have had some major issues. I have such an amazing Doctor and since I don't have insurance, he's not charging me what he could be and thank goodness he's kind enough not to charge me for my office visits. I think I've sort of set myself up with looking at pics online of the surgery and reading the bad results. I wish I could afford to be home for a month or so for the recovery but the best I can do is about a week and then it's back to work but with the crutches. Thank goodness my life partner will be able to cart me around and do my bidding as it were. Was your surgery in and out and did were you put under or just local. Since no insurance, my doc is only giving me local so that alone is enough to scare the crap out of me.

Result number: 128

Message Number 262280

Re: Dry Needling was a bust. What next? View Thread
Posted by Dr. Ed on 12/11/09 at 12:49

Mark:

Long term relief is uncertain with many procedures including ESWT. Keep in mind the treatment triad. We can ascertain objective changes in the thickness and tissue quality of the fascia with ESWT and Topaz. What happens after that depends on ongoing biomechanical issues, occupational considerations, chronic inflammation, etc.

I cannot speak specifically to the modifications of the official Topaz website but one need remember that equipment manufacturers and pharmaceutical companies have significant restrictions placed on what they can say by the FDA. Sonorex, a supplier, of ESWT in Canada and the US, a few years back, had to maintain two separate websites - one for US citizens and one for Canadian citizens. The US site contained far less information.

Clinicians will start and stop doing procedures for many reasons. One of the biggest problems I have with Topaz is that it simply does not reimburse sufficiently to make it worthwhile based on a number of insurance carriers in my area. Does that mean I will stop performing the procedure? Probably not as I hope that the word about good results will get around.

Dr. Ed

Result number: 129

Message Number 262249

TARP View Thread
Posted by John H on 12/09/09 at 15:01

Secretary Geithner has extended the much maligned TARP fund program until October 2010. Obama and others have said this fund failed to do what it was intended to do and was used to bailout big business and Wall Street. This may be true. I just do not know. This was done under the Bush administration. What most people do not know is that now Secretary Geithner was working in the Bush administration and instrumental in getting this bill put together. Now he is extending it which may be good or bad. My point is that Obama if he is to criticize TARP he is criticizing his on Secretary of the Treasury who helped create it.

Seems like we just recycle the same old people in Washington over and over. Secretary Gates under bush is now Secretary of Defense under Obama. Geithner worked for Bush and is now Secretary of the Treasury. The former Leader of the House in some of the Bush years almost got appointed to a high position by Obama but like so many had tax problems and did not cut the mustard. He is back to consulting in Washington. If you fail to get re-elected you come back as a consultant to which ever side you choose. Some of these politicians and powerful bureaucrats who have lived and worked in Washington for decades lose touch with reality and the American people outside of the beltway. They get so used to the power they become brain corrupted. The Senate and the House should not be a lifetime job. It was never intended to be that. New blood and new thinking needs to be injected on a much more frequent basis on both sides of the aisle. If you are not a millionaire you are very unlikely to ever get elected to the Senate. The House more and more requires a lot of money. Most Americans do not have a lot of money and are poorly represented in the issues they face on a daily basis. How many of these guys or women have ever had their house repossessed or been $25000 in credit card hell? How many have had to hold down two jobs to survive. Basically they live in a world and grew up in a world that is not in touch with the common man or woman.

In some years past we had a very powerful group of Southern Senators and House Members who kept getting re-elected over and over. They eventually controlled all the powerful Committees both in the House and the Senate. Their power reached well beyond the number of people they represented and the area of the nation they represented. People such as Senator Byrd, Lyndon Johnson, Strom Thurmond, John McCleland, John Stennis, Walter George, etc. Should a Senator serve three, four or even five decades? Some are nearly senile when they leave. Senator Kennedy was in office for over 46 years. If your name was Kennedy for a few decades you could move to any state, become a resident, and get elected. Joe Biden has been in office for over 36 years. 'Power' is as addictive as is drugs and one tends to believe he or she is omnipotent. Will this ever change? Doubtful as these men and women are the ones who would have to vote the changes in.

I do not know if we have any Senators or House members who served in WWII. At one time many more had than had not. They had a very different perspective than those that had not served. I think Senator Inouye is still in office and he was a decorated hero of WWII. One can read about war and watch war on TV but you sure get a very different sense of it if you are actually the one being shot or shot at. Your votes on war issues will likely be different than those who have not been in war. Some of our Presidents like Ike who was our Leader in Europe in WWII was essential a peaceful President. Truman served in WWI. Had he not had combat experience would he have dropped the atomic bomb? We will never know but WWI was a very bloody trench war with gas and no holds bared. Having experienced this my thoughts are he would very much be influenced by his experience as it was estimated we would lose in excess of one million men in an invasion of Japan who vowed to fight to the last man and woman.

Result number: 130

Message Number 262230

Re: health care bill View Thread
Posted by John H on 12/08/09 at 11:42

Under any of our proposed bills there is going to be 20 million or more not insured. These will be by their own choice. You have many young people who feel they are invincible who will not buy it now or in the future. You have the super wealthy who do not need it. You cannot make people purchase insurance. They may tax these people with a penalty but that is still cheaper for them than insurance. There will be the illegals who do not qualify. The bill is over 2000 pages long and will effect 1/6th the entire American economy. This will be the largest most expensive bill ever to come out of our Congress. There are going to be issues just because of the sheer enormity of it all. It is going to take some years to enact it. Projected effective date is 2013. Will healthcare be better or worse? No one really knows. If it is a failure and drives up the cost of health care significantly then we are going to be in more trouble than we are now. At 1.2 Trillion dollars or more we are throwing the dice. I still do not think there will be the Public Option in it as planned so we will not have a pure government run health care plan. Our insurance companies will not be cast aside and our free market system.. Our Government and the American people, more so than any other nation on earth, have evolved into a free market economy. To suddenly switch to a government health care system is just to much for the American people to absorb all at once. A bill is going to come out, there is little doubt about that, but it will not cover all people and it likely will not evolve into a government run system. How the abortion issue will be solved I have not a clue. The only way I see that playing out is to remove the entire issue from the bill and deal with it on the side as Obama wants a bill by Christmas. People who are against abortion do not want their tax money to pay for abortions and those that support abortion want it covered. Neither side is going to compromise on this as we get into religion, God issues, and political and medical issues. This is truly the immovable object against the irresistible force.

I am sorry to hear your husband is dealing with the kidney stone issues. Women who have had kidney stones and babies say they are very similar in pain if you have a natural birth. I can confirm that it was the worst pain of my life. I assume he has looked into the various diets than some recommend for kidney stones. There is no proven scientific evidence that any of them work but there is no evidence that they do not work. Some stones cannot be removed with lithotripsy depending on where they are located but these are unlikely to be causing pain as it is in the ureter than the most pain is created. I used tho think that because the stones had very sharp edges that was the cause of pain. In fact it is the ureter going into spasm. I would assume he is drinking a lot of water. I drank a lot of cranberry juice. Having gone many years now with no stones I must be doing something different but do not know what. I drink a lot less booze. Only a glass of wine every couple of months these days. I guess this comes with not being a party animal that I was when younger. I do not drink alone and my wife has never drank. I will have a beer in the summer when mowing the lawn.

Result number: 131

Message Number 262201

PF Relief for me suprised to the root cause of it View Thread
Posted by russ h on 12/06/09 at 17:27

I use to be on this site several times a day and want to say thanks for all the great information here, great stuff and very helpful. I'm now only really on here a couple times a month.
ME.....

I'm a male 38 years old, 160lbs, and have dealt with pf/foot pain now for about 4 years.
I first started noticing about 4 years ago my feet were aching and tired more. My wife and I started buying better quality shoes like ascis, and new balance, somewhere in the 100 dollar range each. That helped a little but feet just still felt exhausted and achey. About 3 years ago my wife would get up either in the morning or middle of the night and if she got out of bed she hobbled like a 90 year old handicapped, it was just sad. She got with her chiropractor and started back/leg excercises, z coil shoes, plus changed her diet and lost a good 40 pounds. About 6 months later I started noticing my right foot hurting more and it was classic PF, if I sat for too long or first thing in the a.m. all I could do was hobble cause it hurt so bad.
I tried the back excercise my wife was doing for a couple months, z coil shoes and it helped but not real relief.
So I sought out a pod, he xrayed and said yep, you got pf. He shot me up with cortizone and had me back in 2 weeks. After swelling had gone down and foot felt fine he molded my feet for orthotics. Couple weeks later I got the orthotics in and just in time because my left foot now started to give me some problems. I wore the orthotics for a few months and noticed my right foot felt better but my left was getting worse. Saw Pod again and he hit both feet with injections (boy that laid me up a couple days). Both feet felt pretty good for a few weeks but the left came right back. Pod said no more injections he said he would have to do surgery if it didn't heal on it's own. I REFUSED to do surgery, not at my age, weight, and history of never having issues with this.
I then took on my own search for remedy.

I tried all of the following in no particular order.....

The Foot Trainer device..
Physical therapy (therapist had me do intrinsic, toe, calf,halmstring stretches and excercises..
Numerous books I bought and ordered over the internet for more stretches and excercises..
I overhauled my diet, first month, no red meat. No Help. Second month no white meat. No Help. then really got agressive, no food from Nightshade group. No Help. Upped my vitamin intake, made sure to meet and exceed daily water intake. No Help.
Now orthotics were creating more pressure on left foot and making it hurt more.
I saw a second POD and he took exrays of both, examined my heels and said my arch looked fantastic, he also didn't see alarming issues in my exrays but the sensative areas of feet resembled PF He suggested going without the orthotics and see how my feet felt. He gave me another shot in left foot which now had me at 2 in left and 2 in right. I refused to have any more in a 12 month period.
Everyday, excercises, lost about 15 pounds even though I was not really heavy for my bmi.
Tried this tart cherry juice I read about here...
Bought these pinnacle and powerstep orthotics, curbed my prescription orthotics. Slight help...
Bought a body toxin release apparatus that you soak your feet in, althought the water looked nasty, didn't really feet real relief except for a nice soak.
Rolled on ice bottles, golf balls, bought a e stim device. Nothing...
Tons and tons of shoes, from Drew, Newbalance, Asics, orthoheel and I know several others because my closet is full of em. Many gel inserts, foam inserts, etc. No help...

I can assure you if I really spent more time thinking about this I have left out other products. I know deep down I have spent thousands of dollars on products, doctors visits, etc, and up to this point the only thing I had to show for it was a dwindling bank account, barely able to make it through a ten hour shift at work, and I mean the last 3 hours was with my feet up and race home to get ice and electric stim on em. I could no longer walk with my wife who had beat her pf issues, and I had tried everything that I could find and read here and other places plus the physical therapy. At this point I was starting to see a fuzzy light, not pain mind you because my life and feet sucked but a better understanding. You see every time I would go to get a massage with my wife, the massuese would tell me, GAWD you have tight calves and hamstrings, and I said I know and I am stretching them every day, I don't know what else to do.
DING DING DING......
That is when the light went off, the last massuese told me, you need to get with a trigger point therapist and have them work on you.
I looked up trigger point therapy and read til my eyes were on fire. I also luckily found a trigger point therapist in my local area who has a buisness and wrote books, etc. I called her up told her my problems, she invited me up to her office. I was there the next week, she smashed and prodded and had me quivering on that table. Not pain mind you just tight muscles. She gave me instructions and I bought some of her instructions books and dvd, and thought what the heck, I have tried everything else I'll give it a go.
LET ME TELL YOU, with in about two weeks I had drastic improvement. But I was skeptical because I would have very small runs of less pain during my 4 years so I thought yea right we'll see what happens. I kept at it, my excercises in the books, and I started noticing less and less problems, more and more things I could do, like work a full shift with very little discomfort, walk with my wife a little.
I have now been doing this about 9 months and I feel it's time to report to you folks this story because this 9 months was far far better than any of the 4 years of hell I have been going through.

With that said, am cured yes/no, but I do know that I can go a few days without doing my excercises and I'm just fine, I can walk barefoot, I do NOT wear my orthotics, for the most part I just wear my tennis shoes and some ortho heel flip flops on occassion. If I go several days with out excercising then I will feel some tightness and very minor ache, but nothing remotely close to what I use to have.
So what's the secret, well many of you may not know what trigger point therapy is but basically it's when you have a muscle that is in spasms and it's real tight or stuck together, balled up. You go like me and do your calf stretches or hamstring stretches and you pull even harder on an allready tight balled up muscle and what do you think is going to happen. You pull harder and do more micro fiber damage to the tissue which gets inflamed and gets even tighter. I'm not trying to sell anything or be a doctor so please don't medical dictionary me with lawyer talk. But basically I have learned through this process I was doing a lot of right things but not all right and not in the right order. Instead of me just stretching my calves, pf, and hamstrings my protocal now has me start up higher in the trunk, back, pelvis, front and back, hamstrings, calves, and the big player for me on my left foot was the peronials and tibial anterior muscles, which doing calf stretches is going to do absolutely nothing to stretch or work out those muscles.
So the moral of my post is that I have found relief after spending thousands of dollars and I know several of you are like me but you have not found that light bulb yet. I'm not gonna say that a POD, PED guys/gals can't help or cure you because there are some great ones on here but, if you have exhausted all avenues and are still having the same problems, before you have surgery to release the pf from the tightness that is possibly being caused by muscles higher up the leg/back/trunk area, check into trigger point therapy and give it a go for a few weeks. If you still aren't grasping my terminology look up the nursery rhyme of something like the hip bones connected to the leg bone the leg bones connected to the shin bone, the, etc. your foot problems might be coming from higher up and repeatedly stretching em is not gonna fix ya.
Take care and hopefully somebody will get some relief with this....

Result number: 132

Message Number 262184

Re: My experience -- 4 weeks ago View Thread
Posted by Krissa on 12/05/09 at 12:21

I meant, bone spur, of course--not sput!
Do you have any kind of pronation issues structurally or anything?

Result number: 133

Message Number 262175

My experience -- 4 weeks ago View Thread
Posted by pecos on 12/04/09 at 16:05

33 year old male. 6'1' 255lb. Very active. Basketball, Marathon Runner, motorcycles.

Four weeks ago, I had my surgery on both ankles at the same time. Bones spurs front and rear of ankles, scar tissue everywhere, loose bone, damaged cartlidge and tarsel tunnel in both.

I think my recovery has been well. I feel like every new 24hrs I am progressing. Next week I may get out of these boots and start wearing shoes.

The tarsel tunnel procedure has slowed me the most. Left foot is better than the right from a recovery standpoint. In fact there are no issues with the left. I was told that I had more nerves in my right foot, hence why I am having some nerve issues. Feels like I am walking on something on my heel. Like a coin or gum or sock that is folded over....anything. Sometimes feels like something is protruding through my heel. But of course there is not. I would not call it pain any more. Sometimes I do have sharp pains or hot spots or shocks....like being shocked by electricity. I think the pain has subdued. I am taking lyrica for the verves. Not sure if it is working.

I am hoping to be back running and playing basketball in a month or so. Not sure if that is wishful thinking but so far I am doing ok.

Wanted to share my experience. I will report back later.

Result number: 134

Message Number 262156

Re: sharp heal pain View Thread
Posted by chicago22 on 12/03/09 at 20:02

Well, I have horrible insurance... and have had some family issues come up that have left me beyond broke at the moment. If it continues I definitely plan to, once I can afford to get it looked at. In the meantime I was hoping for some simple short term relief.

Result number: 135

Message Number 262136

Re: Police Murders View Thread
Posted by john h on 12/02/09 at 20:33

Rick: I saw the Senator Nelson from Colorado give an interview last night. He said he and another Democratic Senator would not vote for any health care bill that had a public option. Senator Lincoln has also said the same thing. I doubt the Senator from Connecticut will vote for such a bill. These same people will also require stronger language on government money for abortion. Many have other issues with the bill and there are going to be a lot of ammendments put forth by both Democrats and Republicans. I suspect this bill will look nothing like what Senator Reid had put forth. With all Republicans voting against it I just do not see how it will happen. Then we have some strong Liberal Senators who said they will not support any bill that does not have the public option. Something has to give here. There is no slam dunk bill coming out of the Senate. It is going to be a lot different than what Harry Reid has introduced. We are also getting some heavy push back from seniors on cutting Medicare by 500 billion dollars. Supposedly from savings in fraud and mismanagement. There is savings here but no where near $500 billion. The only way to save this much is to cut back on payment to Doctors and hospitals. We already have many Doctors who will not accept Medicare patients due to low payments. Cut their pay even more and we will not have enough to service the patients. From looking at my monthly Medicare statements it appears that Doctors receive around 40% of what they bill from Medicare as payment in full. Seniors of course pay a 20% deductible. I think most private insurance pays more than Medicare. If all of you are lucky you will live long enough to face the problems this could create. If this passes as is, it want take long for seniors to really be upset when their Doctors drop them. Of the so called savings on this bill over half is supposedly coming out of Medicare. One has to be an idiot to think you can save $500 billion from Medicare. The Congressmen know this very well. There is more fraud going on with Congress and this bill than fraud in Medicare. Can you imagine over 1100 pages in this bill and probably not more than a handful of Congress have read it much less understand it. On a TV show they had the supposed fastest reader in the world read this thing. He said it was near impossible to understand as it kept referring back to things on other pages which required you to constantly refer back. Who on earth writes these things. They must be nerds of the first order.

Result number: 136

Message Number 262127

Re: DRX9000 - Finally Paying for their actions View Thread
Posted by Angry Back on 12/01/09 at 18:29

Dec 1, 2009 5:22 pm US/Eastern Attorney General Sues Medical Equipment FirmTAMPA, Fla. (AP) ― The Florida Attorney General's Office has filed suit against a Tampa firm that it said made and sold more than 1,000 pricey back-pain therapy machines to physicians nationwide through 'false, deceptive or misleading advertising.' Most of the doctors were chiropractors.

According to Health News Florida, defendants are Axiom Worldwide, President and CEO James J. Gibson Jr. and Vice President Nicholas Exarhos. The complaint said they co-founded the company and both participated in unlawful sales practices.

Among other misleading statements, the complaint filed Nov. 19 in Hillsborough Circuit Court said, Axiom called its DRX 9000 spinal decompression system 'the eighth wonder of the world.'

Attorney General Bill McCollum seeks an injunction barring Axiom from continuing to market the machine under false pretenses and also seeks a court order forcing almost $100 million in repayment to consumers and the state — the amount that Axiom received for the machine in 2005 and 2006.

Gibson told Health News Florida this morning that he cannot comment on the suit because the company hasn't received it yet.

The DRX 9000 package that is at issue in the suit cost $95,000, or $125,000 if a neck attachment is included, the complaint said.

Among the false statements, the complaint said, were that Axiom had a patent on DRX 9000, that the system was 'approved' by FDA, and that NASA engineers developed it through 'space age technology.'

The chiropractors who bought the system were led to believe that Medicare and private insurers would cover the treatments, when the defendants knew claims were being denied, the complaint said.

Also, it said, Axiom falsely led doctors to believe there were scientific trials showing an 86 percent success rate for the DRX 9000 in treatment of degenerative disc disease, disc herniations, sciatica and post-surgical pain.

The price included materials the doctors could use in marketing the system to the public through brochures and ads. So far, the complaint said, 12 chiropractors who used the Axiom marketing materials have been accused of false advertising by the state health department.

The company's Web site, https://axiomworldwide.com, was not in operation today, but a lot of information was available on a related site, www.AxiomPainSolutions.com.

There, the system was said to 'provide relief of pain and symptoms associated with herniated discs, bulging or protruding discs, degenerative disc disease, posterior facet syndrome, and sciatica.'

The site also offers videos of patient testimonials and a map of practitioners who use the DRX system. In Florida, there are 68 listed.

In July 2006, North American Medical Corp. sued Axiom for trademark infringement regarding DRX 9000, but Axiom kept making false claims, the attorney general's complaint said.

A federal district court in Georgia entered an injunction against Axiom and its executives in March 2007. A year later that injunction was vacated by an appellate court, but the findings of the lower court about the false claims were upheld.

In April of this year, nine chiropractors from other states sued Axiom, Gibson and Exarhos, saying they would never have bought the machines if they had known the truth.

Meanwhile, 11 Florida chiropractors have been fined by the state Board of Chiropractic Medicine for using the misleading marketing materials they received from Axiom. The Attorney General's Office identified them as William LaBonte, of Ormond Beach; Manuel Carril, of Miami; Matthew Symons, of Royal Palm Beach; Sandra Hernandez, of Royal Palm Beach; Richard Rosen, of Boca Raton; Angelo Rubano, of Fort Myers; Joshua Smith, of Jupiter; Todd Bodanza, of Trinity; Brian Reimer, West Palm Beach; Fred Blumenfeld, West Palm Beach; and David Golinger, of Coral Springs.

___

Information from: Health News Florida, http://www.healthnewsflorida.org/


(© 2009 The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed.)

Result number: 137

Message Number 262050

Re: Doctor recommendation in Raleigh-Durham area? View Thread
Posted by mypfissues on 11/25/09 at 22:03

Did Dr. Boehm suggest that you get a CAM walker, night splint, orthotics, do PT 2-3 times a week, etc., etc.? I went to another doctor in that practice and was amazed at the products that he wanted me to buy from his office. He didn't even take an xray! If you used all those products, did they actually work?

Result number: 138

Message Number 261997

Re: fibromyalgia & ESWT? View Thread
Posted by Dr. Ed on 11/22/09 at 16:04

sylviam:

ESWT will only work if you have plantar fasciosis. There are three categories of etiologies of plantar fasciitis/fasciosis: 1) inflammation, 2) biomechanics and 3) tissue quality. I term this the 'treatment triad.' The acute stage of plantar fasciitis is typically not long term so if the problem has been around for 10 years, both biomechanics and tissue quality need be examined. Orthotics are a fundamental treatment for biomechanical issues so I am surprised that you have not had that treatment.

You need a thorough exam by a practitioner who can take a more comprehensive look at the problem.

Dr. Ed

Result number: 139

Message Number 261986

stump neuroma View Thread
Posted by KarinH on 11/21/09 at 19:38

Hi! I had a Morton's Neuroma removed 12 years ago, then I grew a stump neuroma. I had surgery by a podiatrist 8 months ago, and he removed a large neuroma with a plantar incision. I have had a lot of pain and nerve issues since the surgery. The surgeon placed a nerve cap made out of collagen over the nerve so it wouldn't be able to grow another stump. Has anyone heard of this being done before? I had physical therapy for the prevention of scar tissue. I also had 7 treatments with an Iontophoresis patch using an anti-inflammatory medication. This helped quite a bit....temporarily. The last month the nerve pain has been getting worse. I don't know what to do now. I have a follow up appt. with my podiatrist this week and I'm worried that he will tell me that there is nothing that he can do. I would be very reluctant to have surgery again. At this point I don't have even one pair of shoes I can wear without pain, and use a lidocaine patch daily to help remove some of the pain. AT times I can't stand the nerve pain and think I'm going to go crazy. :0 Any suggestions?????? Thank you! Karin

Result number: 140

Message Number 261957

Re: Welcome Back View Thread
Posted by john h on 11/20/09 at 00:37

Glad to see that I was not the only one who thought they had been kicked off the board. Makes me feel less paranoid. Those on the far left and far right had the same issues.

Result number: 141

Message Number 261916

Re: TTS surgery gone wrong View Thread
Posted by Anon on 11/13/09 at 01:53

I read but have not posted. My surgeries went south, too. Sometimes those who have had success don't have compassion or patience for those of us who did not. Those same people don't believe that having TTS, neuropathy or other peripheral pain issues is 'enough' to be justified in their view to be considered disabled. Like someone on another post said, I also get tired of being treated like a second class citizen just because I am on disability. I would give the world to have one hour without pain. Nobody wants this. Trust.

God bless you all.

Result number: 142

Message Number 261887

Re: surgery or not View Thread
Posted by Dr. DSW on 11/11/09 at 16:54

I know you're going to take this wrong, so before you over react, please sit back and think and try to take this the RIGHT way.

You are in pain and obviously in addition to your frustration, you are very angry. In your own words, you are very negative and have a negative attitude, which obviously does not help.

Therefore, in addition to your pain management, it may not be a bad idea to seek professional counseling via psychological therapy, etc., to help deal with your issues.

Don't turn this around on me and state that I'm telling you that 'you're crazy'. That's NOT what I'm saying. I am saying that patients that are in chronic pain sometimes also need counseling to learn how to deal with that issue and the anger that you obviously are harboring toward a lot of doctors and the entire 'system'.

Result number: 143

Message Number 261878

Jeremy View Thread
Posted by stacy on 11/11/09 at 13:18

I now am the proud owner of two new pairs of sneakers
New Balance 993 and New Balance WR1224. I know that you said that the 993 were apporpriate with my foot issues and orthotics. What is opinion about the 1224? They feel so so comfortable so far.

Thanks for you feedback

Result number: 144

Message Number 261782

Re: has anyone had APC injection ot autologous platelet injection? View Thread
Posted by Laurie C. on 11/06/09 at 12:32

I have had APC injections multiple times not due to PF issues into my joint, but have had them injected as any other injection - no meds needed to relax and done in the procedure room under xray.

Result number: 145

Message Number 261775

Re: Letter to the editor View Thread
Posted by Dr. DSW on 11/06/09 at 05:51

Marie,

The foundation of this country was found on only 'Christian' beliefs or maybe some 'religious' beliefs. I wasn't aware that the 'Christians' had a monopoly on ethical and moral issues.

Result number: 146

Message Number 261763

Re: please answer View Thread
Posted by JLO on 11/05/09 at 12:01

Thank you for at least giving me an idea of what to expect on the first visit. I have anxiety issues and it helps to know what I am getting into.

I do, in fact, have peroneal tendon subluxation. They took X rays, did an MRI, put a brace on it and I started PT this morning.

I go back in a few weeks for a follow up.

Again, thanks for easing my mind a bit.

Result number: 147

Message Number 261742

7 States View Thread
Posted by wendyn on 11/04/09 at 18:10

Rick. Dude - 7 states?

10 provinces and 3 territories. In Canadian math - that adds up to 13.

We know lots about America because we learn about a lot of other countries in school (especially our main neighbors to the south) and we get all of your major channels and TV shows. Many Canadians are more familiar with American history, celebrities and issues than they are about those in their own country.

Yes, that's a problem.

If you ever get up this way again you'll have to let me know. We are trying to get back to the Chicago area - maybe next summer. But we'll see. It always ends up being such a busy vacation seeing family - but I love Chicago.

How is the grandfetus now? We are at about 26 weeks and all is well.

My son cracks me up though. At one point he tried to convince his girlfriend to put off an exam until April because 'she'll be home with a baby all day so she'll have loads more time to study.'

When I gave him that look he said, 'What? Newborns sleep all the time.'

I laughed so hard that I almost cried. Parenting is such a fun learning experience.

Result number: 148

Message Number 261722

Tarsal Tunnel Hell View Thread
Posted by Josh M. on 11/04/09 at 09:34

HI everyone,

I just wanted to share my story. I was hit from behind by a small vehicle in summer of 08 and my right leg/ankle started twisting under the cart and I was able to twist myself out before I went completely under the cart. I ended up with a high/low ankle sprain. I did about 19 physical therapy sessions and by the end of that I felt something else was wrong.

My doctor ordered an MRI and found a newly formed Ganglion cyst attached to my tendon. I tried shots, drainage with no relief. He finally surgically removed the ganglion cyst off of my tendon. Well, 2 weeks later it was back. SO again, he tried to drain it. It didnt work.

I had another surgery to remove it. And again it came back. But another problem arose. Tingling of the bottom of my foot, especially if you tap the inside of my ankle. The bottom of my toes go numb along with a silver dollar size numb spot located at the bottom of my foot just under my arch. My foot throbs and throbs. Im starting to have issues with my calf for some reason. Walking makes it much worse or standing does also.

My doctor diagnosed me with TTS. I was hurt at work and WC has yet to approve the surgery for TTR that was set up 5 months ago. My condition has gotten worse and worse.

I do have lawyers and I hope to have TTR within the next 2 months.

Im just worried that the longer Worker Comp waits to approve the surgery, the less of a chance of it being better after surgery.

Thanks

Result number: 149

Message Number 261706

Jeremy View Thread
Posted by Stacy on 11/03/09 at 17:50

I had new othotics made following a modified kinder. Prior to posterior tibial tendon issues, I had plantar fasciitis. I found that Brooks ariel worked well for the plantar fasciitis. Now, the Brooks shoe would provide too much correction with the orthotic. The doctor wants me to get a good walking (stability) sneaker. What are some makes/models that you would suggest?

Thanks for your help

Result number: 150

Message Number 261676

Re: tarsal tunnel View Thread
Posted by als on 11/01/09 at 19:36

I have the same problem! I am beginning to think that I am the only one in the world that has painful, red feet when I am on them for longer than 45 minutes. I too was on Lyrica, but I started gaining weight. My doctor put me on Gabapentin which I think is a generic for a Lyrica type drug. I know that you posted about a year ago, but I was wondering what all you have had done...In hopes of solving my feet issues. I, too, am very active and want to be back to normal! Please let me know if you have solved your issue...and how.

Thanks!

Result number: 151

Message Number 261562

Re: Valgus, Medial Foot Swelling, Tingling; Is that TTS? View Thread
Posted by Dr. Wedemeyer on 10/27/09 at 10:44

This made for an interesting discussion Haisook.

An accessory FDL muscle has been indicated in TTS yes. Inflammation of the plantar fascia has also been shown to have this feature. Having dissected quite a few feet I can tell you that we are not all symmetric and identical in our anatomy. Some PF patients describe numbness and tingling of the foot although this is not considered pathognomonic for PF, it simply renders diagnosis more difficult (I have witnessed this numerous times in rotator cuff injury where the patient also complains of neuritis initially.

You have seen several types of physicians and obviously your complaints do not fit in a tidy clinical box. What bother me is your description of a bilateral complaint. You can obviously have TTS and/or PF in both feet but when patients complain of bilateral neuritis I think it is important to rule out a systemic complaint. You saw a rheumatologist, were any lab tests performed?

Dr. DSW has given you some excellent advice on what should be done from here to help localize your symptoms as well as treat the nerve issues.

Result number: 152

Message Number 261557

Re: Valgus, Medial Foot Swelling, Tingling; Is that TTS? View Thread
Posted by Dr. DSW on 10/27/09 at 07:00

Conservative measures at the present time can include oral anti-inflammatory medication if you have no contra-indications, ice 20 min/hour if you have no medical contra-indications and taking B vitamins which many believe are good for any nerve related pathology. Since the B vitamins are water soluble, you can't 'overdose' on the B's. Therefore, taking a good B complex vitamin may be beneficial.

For my patients I prescribe Metanx, which is actually a prescription. It has gained popularity for diabetics with neuropathy, but I use it for any patients with nerve related issues with significant success.

Result number: 153

Message Number 261532

Re: Dr. Wedemeyer and Dr DSW were right about Scholls View Thread
Posted by Dr. Wedemeyer on 10/26/09 at 18:11

Wearing an insole that does not fill the shoe appropriately can lead to callus among other issues. One option I have for patients who do not need a great deal of correction, just support, is a precut blank I can mold and add a topcover to. I cna also adjust the width readily.

This allows me to charge a price somewhere between a custom and on OTC product, about $200. I know, I know, PowerSteps are around $40 making the price attractive but they lose their shape rather quickly, so add several of these over a couple of years vs. a custom or customized device and you get what you pay for.

Right?

Result number: 154

Message Number 261506

Re: Could it be something else? View Thread
Posted by LindaM on 10/25/09 at 16:36

Thanks, Dr. DSW. I'm reluctant to take too much time off from work all at once, and both of these appointments would need to take place during the work day (in order to use my preferred local doctors). If I want to 'space out' these appointments, which would you recommend that I pursue first.....the EMG or the rheumatologist? I know this may sound somewhat silly, but I just don't want to be out of the office too much with my health issues.

Linda

Result number: 155

Message Number 261457

Re: From the UK on Prez Obama View Thread
Posted by john h on 10/22/09 at 12:44

President Obama was often criticized during the campaign for his lack of any worthwhile experience. His only job was as a community organizer in the city of Chicago and 2 years in Congress. Not much for a President. All this lack of experience is showing. His management style is by letting all his minions such as Rohn Emmanuel, Tim Geithner, and others run the country while he gives more speeches than any President in history. None of these speeches ever gives any real details and are more like campaign speeches. In fact, he remains in the campaign mode even now. He turned health care over to Congress who is run by the Democratic Liberals. He should have submitted his own health care plan. The Congress tried to rush through health care when the members were voting on issues they had ever even read. The people knew less than nothing about what was going on. To me, he has an arrogance about him which often conceals his concerns about doing his job. As a leader, he sure falls flat. What has he really done. We have the largest debt in history, unemployment approaching 10% and still climbing, indecision in Afghanistan and an approaching health care bill that will add over a trillion dollars to our debt and still leave 23 million uninsured Americans. The American dollar is almost half the value of the Euro and still going down. We own car companies, insurance companies, banks and now plan on controlling executive pay. Sure sounds like socialism any way you look at it. Was that his intent? I doubt it as his minions are making the calls as he has no experience in what is happening in our economy. He has killed our missile defense program in Poland and is letting Iran stall long enough to make a nuclear bomb. Jimmy Carter was a terrible President and I voted for him. He never really scared me. President Obama does in fact scare me as I think our enemies will roll him over. Graduating from Harvard does not provide you with wisdom.

Result number: 156

Message Number 261452

Re: tarsal tunnel post op View Thread
Posted by Dr. Wedemeyer on 10/22/09 at 10:46

VB I have previously read the threads that you have participated in where Laurie commented. You misread the tenor of her posts in my opinion. Also knowing her history you must know that no one could ever accuse her of not having endured a great deal of pain and suffering herself, or of being unsympathetic. She has been given oranges and has made orange juice rather than give up. I personally admire her for her positive attitude and tenacious nature in pursuing any and all remedies for her own issues.

You on the other hand continue to try to evoke sympathy and choose to point fingers and do not listen to the advice afforded to you by well meaning professionals and empathetic posters. Food for thought.

Result number: 157

Message Number 261449

Re: Does anyone here wear MBT shoes? View Thread
Posted by BERT on 10/22/09 at 09:53

I bought a pair of MBT shoes and regret it. I never had any issues with my feet until after I started to wear the MBT's. I now have Plantar Fasciitis on my left foot and can no longer wear these shoes. I wored them for about 3 month and slowy started to feel some pain on my heel.

Result number: 158

Message Number 261434

peroneal tendon subluxation View Thread
Posted by JLO on 10/21/09 at 14:17

Hello all. I am currently going through some issues with my left foot. It's hurt for three months and I'm fairly certain it's peroneal tendon subluxation (I'm a biology grad student so I at least have SOME background). I'm not trying to make a self diagnosis but more or less I just have questions.

My GP did not do much except give me a referral to a podiatrist. Mostly I want to know what to expect at the doctors visit (it's in a week and a half). In general how fast is it between visit and diagnosis and action (will I walk out of there in a brace, or what?). How fast is surgery usually scheduled, if indeed it is necessary? Is there anything I can do to alleviate the discomfort until the monday after next? As I said, my GP did nothing but hand me a referral, didn't even suggest an OTC brace I could get for myself.

As of right now I am sticking with rest and anti-inflammatories. There is only so much I can do since I walk to and from school/work and work in a lab that has me moving stations frequently based on whatever experiment I am doing that week.

Any advice, words of wisdom (like stop stressing about it hehe), suggestions are GREATLY appreciated.

-joDi

Result number: 159

Message Number 261422

Re: Graston View Thread
Posted by Dr. Wedemeyer on 10/20/09 at 13:39

Graston is an instrument assisted method of manual debridement of the soft-tissues. It works very well for fasciosis and tendinopathy. it is not a panacea but an option in chronic PF.

Result number: 160

Message Number 261363

Re: Why? View Thread
Posted by AllenF on 10/18/09 at 14:57

LOL. I love the way you mirrored my condescension back at me. It made me smile.

How do you know there are not any women that will 'take my side' on this? How could you possibly know that? Are you some kind of goddess that can tap into the minds of all women on earth with some sort of mystical powers? Its a shame you don't have some special foot healing powers. We would all worship the ground you walk on.

So you want to know why they voted the way they did? I will explain it to you as best I can. Our country, America, has the most litigious society on earth. We have more lawyers per capita than in any other country. People and businesses are constantly being sued. The main reason for this is that we do not have a loser pays civil court system like the vast majority of other countries in the world. In most other modern democracies if you sue somebody and lose you, and in many cases your lawyer, automatically have to pay the other sides legal costs.

In America you can usually sue and sue and sue as many people and businesses you want until your little heart is content and you will rarely ever be forced to pay the other sides costs no matter how many times you lose. All of this litigation in our country can be very harmful to many businesses and individuals which consequently puts downward pressure on our economy.

Arbitration is a form of alternative dispute resolution that was designed to alleviate some of these costs. Companies and individuals add them as clauses to many contracts to protect themselves from frivolous and expensive lawsuits. The arbitration clause by no means guarantees that a business will win a legal dispute. Arbitration is usually carried out by a highly respected third party that issues a legally binding, logical decision in a legal dispute.

Now back to your question. The reason it was a good idea to vote against this law is because it will increase the number of frivolous lawsuits against any company that wants to do business with the DOD. This means these companies will charge the government more for their services which is a cost that will be passed on to the tax payer. It also sets a dangerous precedent in the sense that it could bring more laws extending this law to all parts of the government and not just the DOD.

By the way, nobody forces you to sign a contract with an arbitration clause or any contract for that matter. You can refuse and work someplace else or become self employed or become a pan handler or whatever. What it basically comes down to is freedom. A company or person should be able to put into a contract whatever they want and whoever they are dealing with can decide to to sign it, negotiate for something better, or leave. If you allow people to be as independent as possible most will thrive and a few will wither. Its not perfect but its the best system around in my opinion.

Result number: 161

Message Number 261359

Re: Why? View Thread
Posted by marie:) on 10/18/09 at 07:56

Well i think I responded to your comments in my previous post. Come on Allen I think your smart enough to understand the gravity of rape. I also think your smart enough to know women won't take your side on this one. This, I thought was the most bi-partisan bill to hit the floor in a long time. there are just some issues that call for it. What is the real story? Why would they vote no to this bill? The author of the bill itself only used this case as an example. There are other stories and cases. So please explain to me their votes? Do you know why?

Result number: 162

Message Number 261346

plantar and calf interaction question View Thread
Posted by KevinB on 10/17/09 at 16:06

I'm going through an interesting bout of PF. At first I concentrated on the PF itself, massaging, rolling, night splint. One day I attempted to run a short distance during a workout and my calf cramped up something awful.

What is interesting is that as the calf cramped and got tight the PF went away almost immediately.

So I went to an active release massage therapist and within 2 weeks my calf was nice and loose. Tried a very short run again and immediately stopped as I felt the calf start to cramp. By the next morning the PF heel pain was back in full force.

So it seems as though the formula is:

Tight calf = No PF
Loose calf = Bad PF

I've rolled this ankle a lot in my life but never had any issues running. I'm at a loss as to next steps.

HELP !!!

Result number: 163

Message Number 261289

Re: Dr. DSW, Dr. Wedemeyer? View Thread
Posted by myelverton on 10/14/09 at 07:35

Hi Dr. Wedemeyer,

No, I've never had an MRI, and I find it odd that none of the podiatrists have suggested one - that's the main reason for my question here. Seems to me that it would be helpful. I've never had blood tests either, at least not as part of my foot treatments. I had a regular blood test in July as part of my annual checkup and everything came back normal except I was a little low in Vitamin D. I'm not aware of anyone in my family with Rhematoid or connective disease. My father was borderline diabetic, but I've not tested positive for diabetes. Also, I'm not overweight and in good physical condition, except for the feet.

Please let me know your thoughts on an MRI. And I will also pursue the other issues.

Thanks!
Margaret

Result number: 164

Message Number 261226

very warm foot View Thread
Posted by Brenda C on 10/11/09 at 02:31

I recently posted about being diagnosed with PF in my left foot/undergoing treatment while also getting treatment for a stress fracture to the tibia in my right leg. I had a short leg cast on for six weeks. During the first three weeks my casted foot/toes would occasionally get puffy, red, very warm. I asked the dr about it and they told me it was basically me flexing the muscles in my leg and foot while in the cast would push blood down into my foot especially if I didn't have it elevated and just wouldn't have a chance to drain out properly. I went back this last friday to get a new cast put on and they x-rayed it and discovered I have an OCD lesion on the talus.

The PA who I've been seeing for the stress fracture told me I'd have to consult with the surgeon (same office), so that appt is tues. In the meantime he left the cast off and put me in a walking boot and said no weight bearing. I can remove the boot to sleep, shower. My question is my foot is still red, a bit puffy, and very warm to touch. So what causes the redness and other symptoms? Is it because I'm not walking on it? I feel like I should walk on my foot and get the circulation going. It is stiff from being in a cast for three weeks which I expected, but is this a normal reaction (red, puffy, warm) to being in a cast? I've never had a cast before so I'm not sure. It also feels a bit tingly. Not numb, no burning, just tingly. I really hope this is not the beginning of tarsal tunnel syndrome. From what I've read so far about TTS, I didn't see any mention of red puffy feet. I will ask the surgeon about it, but I'm a little worried I have something else starting too. I want to prevent anymore issues. I've never had this many problems with my feet before. Thank you for any advice.

Brenda

Result number: 165

Message Number 261215

Re: Kooky Left and the Wacky Right? View Thread
Posted by marie:) on 10/10/09 at 09:52

?if by middle you refer to that real middle between anarchy and totalitarianism, then we share a strong bond. We can differ and argue passionately regarding where we should be on that contimuum, but on a fundamental level we are joined in a common cause, the American cause. Those that would attempt to trap you or I in the distorted distraction of what the left and right labels have become, add nothing to the political discourse.'

I agree with much of what you say. I see the polar opposites of our political spectrum as angry narrow minded folks who hate each other just for the sheer pleasure of it. That's why I don't read at many very liberal websites and only occasionally view far left talk shows....although there are times I agree with them on the issues. The 2 groups will never have a meeting of the minds. It's essential for members of both parties to engage in common sense practice to do what's best for their constituents and the good of all. It's unfortunate that the 2 parties have gotten to this point of uncivil discourse and it's time to recognize the damage done by both far ends of each party. It's time for average hard working Americans to be represented.

Result number: 166

Message Number 261156

2010 View Thread
Posted by john h on 10/08/09 at 13:56

From the Kiplinger News Letter. This sounds about right to me barring any thing like a war with Iran or a 9/11 attack on the U.S. on our soil.

Republican 2010 election prospects keep getting better as voters lists
of frustrations expand...lack of jobs, federal bailouts and budget deficits,
health care, climate change, financial market reform plus Afghanistan and Iraq.

The GOP is certain to make gains in congress, picking up 10 to 15 seats
in the House...more if the economy continues to ail. Republicans are also likely
to reclaim enough Senate seats to deny Democrats a filibuster-ending 6O votes.
But there's no chance of a Republican majority in either chamber.

Of the open seat races in the House...so far, 17 that will be vacated by members
who are running for other offices...11 are now held by GOPers. Because open seats
are more easily snatched by the opposing party, that works against Republicans.
Moreover, additional House retirements are more likely to come from GOP veterans tired of toiling in the minority than from Democrats enjoying being in the majority. In the Senate, The GOP has half a dozen vulnerable seats. Democrats half of that.

Republicans are enjoying a bump in fund-raising for this election, though.
Despite industry donations, which typically skew largely to the majority party,
this summer, GOP national fund-raising committees performed as well or better
than their Democratic counterparts. As heated partisann debates over health care
and other issues rage on, the GOP's success is likely to continue through fall.

Result number: 167

Message Number 261146

years of foot pain View Thread
Posted by Jewel on 10/07/09 at 23:31

First let me say that I have some sort of autoimmune disease. I've been to many doctors and none of them agree. The latest being where 2 highly regarded rheumatologists took a look at my records and gave their determination and both completely contradicted each other. The possible diagnosises are RA, Undifferentiated Spondy, CPPD, Reiters/Reactive arthritis, Lupus and fibromyalgia. So, really who knows. I'm partial to the spondyloarthoapathies due to my foot problems.

I've gotten this foot pain on and off since 97. It has come and gone of it's own accord despite treatment. But now, I've had pain in feet constant for the last 5 years. Terrible, excrutiating pain that has now rendered me immobile. No, I wasn't overweight when it started, yes I am now. The one podiatrist I went to kept saying it was PF. I did the stretching, PT, night splints, injections, custom oththodics and none of it worked. He finally said he couldn't help me. Yes, I do have heel spurs - quite large ones. Floated between several other doctors, had EMG's = negative. Finally the one I have now has Dx'd a haglunds (doesn't hurt unless you press on it) and achillies insertion tendonitis. PT isn't really helping much.

The pain is in the back heel in a horse shoe shape - just along the edge of the foot. Yes it hurts when you squeeze the heel. In addition, there's a bone on the side of the foot by the tarsals on one side of the 'tuberosity' and according to the PT and Podiatrist it's where another tendon attaches and its super painful too. The achillies is sore in the ankle areas going up the ankle sides into the calf. The peroneous tendons (?) are very sore from the foot all the way up to the knee.

The ball of the R foot has issues. Podiatrist thought there was a neuroma between toes 2 & 3 as it was super painful too. He injected it there 3 times now (cortisone, over the past 1.5yrs) and it has helped. However, MRI showed no neuroma. Now toe 2 has very quickly deformed curving toward the big toe and hammering out. The last time I was at the podiatrist he mentioned capsulitis in that toe. So, could it really be the autoimmune arthritis and not a neuroma? I don't know whether to let him cut me open or not.

Went to an orthopedic doctor who specializes in feet/ankle. He said I have tendonitis all over my foot/feet. Took an xray of the R foot ball and you can see that the toe has hammered, said he couldn't do surgery due to the inflammation in the feet = too much scar tissue would develope in my current state. I asked him if he ever saw something like this before. He said 'just a couple times and that I need to tell my rheumatologist to get my inflammation under control.'

Result number: 168

Message Number 261128

Re: New Post OP From TTS Surgery View Thread
Posted by Mary L on 10/07/09 at 15:28

Dottie,

Thanks for your response. Everything that my husband and I have read is that the recovery is pretty long. I'm going on 2 weeks post -op and I can honestly say I don't feel much better. I'm nauseous almost constantly and right now my life consists of pain pills and frustration. If I don't take the pills on a regular basis, I get sick and boy, does it come with a vengance! I'm not a pill taker, so it's diificult to keep taking them.
My hubbie has his own issues with several back injuries so it's difficult for him to do his own stuff, let along help me. He borrowed a wheelchair from his Dad and that's what I use when we go out, but my max is 2 hrs., then I need to get back to my chair...LOL!
I'm not one to sit around and I'm really becoming concerned about whether or not I will be able to work, as the crazy nerve pain hasn't improved....it's gotten worse. On top of THAT now my left leg is giving me problems. Oh the Joy!

Result number: 169

Message Number 261107

Re: Barefoot Running View Thread
Posted by Jav on 10/06/09 at 14:04

Thanks for the POSE method reference Dr. I found it (and the related 'Chi' running styles) rather baffling yet interesting. I never thought much about trying to adjust the body's alignment and foot strike positioning to such a degree (thinking that the body must naturally find the most efficient mode to move itself), but there is quite a bit of food for thought here, especially considering the number of injuries that runners sustain after years of hitting the pavement.

I would guess that younger runners might realize more benefits from starting out 'programming' all the muscles and tendons in a more 'proper' alignment, but I bet vets like myself would incur a whole raft of niggling ailments learning to re-train the musculature in such a radically different style. Then again, it might do wonders to older backs and knees to slowly adapt and introduce some of these methods in hopes of curing some classic running injuries (IO band, runners knee, PF etc).

That said, this running barefoot movement seems incredibly risky to me. Maybe if I wasn't a PF sufferer I'd be less wary, but as you point out, the minority of practitioners with perfect form will perhaps become raving advocates, while the majority of participants with even slight alignment issues likely would eventually fall foul of all sorts of 'issues'.

I'll monitor from the sidelines in my trusty, dusty Saucony Hurricanes for now :)

Result number: 170

Message Number 261090

Re: Dr DSW View Thread
Posted by AllenF on 10/05/09 at 21:31

Dr DSW,

Wow, you are quite the typist. I really do not have time to give you the dignified response I would like. When it comes to free wheeling places of anarchy like the Internet I guess I simply live by the policy of 'caveat emptor'. If people are going to completely change their doctor prescribed treatment routine, without consulting said doctor, solely based off of what some guy suggested to them on a forum then they have some serious issues.

I understand that not everyone uses common sense, but we should not limit ourselves because some information may be used in a bad way. Maybe scott should put something in huge bold letters that says something to the effect of 'Don't be stupid and change your DOCTOR PRESCRIBED treatment routine based off of what somebody tells you on the Internet' at the bottom of each message. Have a great day Dr. DSW and try not to get mad about what you read on the box in front of you. Anger is bad for the digestion don't you know.

Allen

Result number: 171

Message Number 261042

Re: which type of shoe best for pronation and PF? View Thread
Posted by Dr. Wedemeyer on 10/04/09 at 17:42

Brenda not every case of PF is due strictly to pronation issues, although it is a definite factor. If I feel that a patient truly needs custom orthoses and either they cannot afford them or their insurance does not cover the cost, I would not change their treatment plan to suit their budget.

I would and have however reduced the cost of these items on an individual case basis by having the patient verify their income and that to pay my regular fees would produce a 'financial hardship'. I feel that everyone deserves the same level of care regardless of their ability to pay, employment status or insurance benefits and make exceptions for those with limited incomes or who have fallen on hard times. I can only speak for my practice though, many doctors and providers will simply not do this. We keep an agreement and documentation of the reduction of fees/costs in their file as required by State law. I would ask your doctor if he or she maintains a similar policy.

As for the type of shoe that is truly needed in your case there is absolutely no way that we can help you with this online. Jeremy has given you excellent suggestions and I suggest that you follow them. A PowerStep in a well made and appropriate shoe may perform better for you than a poorly conceived orthosis in an inappropriate shoe for your foot and biomechanics.

Result number: 172

Message Number 261039

complicated..... View Thread
Posted by Jewel on 10/04/09 at 14:10

Hello Doctors!

Gosh am I glad I found you. First let me say that I have some sort of autoimmune disease. I've been to many doctors and none of them agree. The latest being where 2 highly regarded rheumatologists took a look at my records and gave their determination and both completely contradicted each other. The possible diagnosises are RA, Undifferentiated Spondy, CPPD, Reiters/Reactive arthritis, Lupus and fibromyalgia. So, really who knows. I'm partial to the spondyloarthoapathies due to my foot problems.

I've gotten this foot pain on and off since 97. It has come and gone of it's own accord despite treatment. But now, I've had pain in feet constant for the last 5 years. Terrible, excrutiating pain that has now rendered me immobile. No, I wasn't overweight when it started, yes I am now. The one podiatrist I went to kept saying it was PF. I did the stretching, PT, night splints, injections, custom oththodics and none of it worked. He finally said he couldn't help me. Yes, I do have heel spurs - quite large ones. Floated between several other doctors, had EMG's = negative. Finally the one I have now has Dx'd a haglunds (doesn't hurt unless you press on it) and achillies insertion tendonitis. PT isn't really helping much.

The pain is in the back heel in a horse shoe shape - just along the edge of the foot. Yes it hurts when you squeeze the heel. In addition, there's a bone on the side of the foot by the tarsals on one side of the 'tuberosity' and according to the PT and Podiatrist it's where another tendon attaches and its super painful too. The achillies is sore in the ankle areas going up the ankle sides into the calf. The peroneous tendons (?) are very sore from the foot all the way up to the knee.

The ball of the R foot has issues. Podiatrist thought there was a neuroma between toes 2 & 3 as it was super painful too. He injected it there 3 times now (cortisone, over the past 1.5yrs) and it has helped. However, MRI showed no neuroma. Now toe 2 has very quickly deformed curving toward the big toe and hammering out. The last time I was at the podiatrist he mentioned capsulitis in that toe. So, could it really be the autoimmune arthritis and not a neuroma? I don't know whether to let him cut me open or not.

Went to an orthopedic doctor who specializes in feet/ankle. He said I have tendonitis all over my foot/feet. Took an xray of the R foot ball and you can see that the toe has hammered, said he couldn't do surgery due to the inflammation in the feet = too much scar tissue would develope in my current state. I asked him if he ever saw something like this before. He said 'just a couple times and that I need to tell my rheumatologist to get my inflammation under control.'

I don't know what to do. I've lost my ability to walk. The wheelchair/scooter people came on Friday..... I'm hoping you can help.

Thank you,
Jewel

Result number: 173

Message Number 261037

Re: Dr DSW View Thread
Posted by Dr. DSW on 10/04/09 at 11:11

Allen,

I think you may have missed my point. For every patient like you that 'gets it', there are dozens that don't.

I've been participating on this forum for many, many years and have witnessed patients that DO take what others say as 'gospel' and change treatment regimens based on other patient's experiences.

Not everyone thinks as logically as you do and assimilates all the information or takes bits and pieces of information and utilizes what may be beneficial. Unfortunately, many patients that visit this site are very vulnerable and often will change direction and follow any 'advice' if he/she believes it 'may' help.

NO WHERE in my post did I ever state that this website or any other similar website wasn't valuable regarding obtaining useful information as you have pointed out. Obviously, if I didn't believe this site was of significant value, I would not associate myself with the site.

I believe this site is extremely valuable regarding the fact that many patients have been educated regarding the true etiology (cause) of heel pain, tarsal tunnel pain, etc., the treatment options for plantar fasciitis, fasciosis, tarsal tunnel syndrome, etc. I also believe the site has been valuable discussing various medications, new technologies, scams, treatment options, surgical procedures, conservative alternatives, insurance issues, etc.,etc.

I personally have been a VERY STRONG advocate on this site for patients rights. I often get very angered when patients come on this site and state that his/her doctor didn't answer questions, rushed out of the room, didn't discuss treatment options, wouldn't return a phone call, etc. It's my feeling that it's not my responsibility or the responsibility of any of the medical professionals on this site to answer questions that should have been answered by your treating doctor. I shouldn't have to interpret the findings of your x-ray, MRI or CT scan. I shouldn't have to tell you the possible complications of your surgery tomorrow, I shouldn't have to tell you how long your doctor plans on keeping you in the cast HE applied.

That is the RESPONSIBILITY of the treating doctor. It's not that I don't want to answer the question, it's simply that I want patients to learn to demand answers that they deserve from their doctors.

You wouldn't purchase an expensive TV from a store and then call another appliance store to ask them how to use the TV would you? You'd expect and demand that the store where you purchased the TV give you all the information. You should expect no less from YOUR doctor!!!

The web site is also an excellent 'support' site for those to discuss issues and understand that other patients also have similar concerns and symptoms.

However, I still caution anyone from attempting to 'compare' your symptoms and situation to another person. What may sound similar may in fact be completely different.

Result number: 174

Message Number 261018

Re: Posterior Tibial Tendon Dysfuntion Therapy View Thread
Posted by Dr. Ed on 10/03/09 at 00:54

Steve:

A major consideration is that stage of the PTTD. Other issues such as subtalar joint and ankle arthrosis? An MRI will often help answer such questions.

There are a number of brace/AFO designs to consider. A new design is working very well on advanced PTTD patients, the 'Turbo.'

See: http://www.advancedorthopedicdesigns.com/TURBO.html

Dr. Ed

Result number: 175

Message Number 261015

Re: Solutions to PF View Thread
Posted by Dr. Wedemeyer on 10/02/09 at 18:59

'Not stretching is the cause of most PF issues'

I disagree. Improper biomechanics and footwear is the cause of MOST PF (along with gastroc/soleus/Achilles tightness, sudden increase in activity, rapid weight gain etc). While a high number of PF patients exhibit equinus at the ankle and a tight GSAT complex, many do not and therefore stretching will not address their particular issue.

Result number: 176

Message Number 260984

Re: Solutions to PF View Thread
Posted by John from MN on 10/01/09 at 09:55

I tried rest, did not work either. Don't forget there is tissue damage. Rest does not fix this type of damage. You must breakup the scar tissue manually, then let it heal. Very important you must stretch your calf muscles, quads and hamstring 3 times a day. Not stretching is the cause of most PF issues.

Result number: 177

Message Number 260977

China and Canadia --Oil View Thread
Posted by john h on 9/30/09 at 22:09

It is no urban legend that China is on the move to gain some leverage on oil in Canada who happens to be our largest importer of oil. They have purchased a stake in an Alberta Oil Company for drilling in the oil sands. Does this bother you at all?

Published: Sept. 2, 2009 at 3:57 PM
Order reprints
CALGARY, Alberta, Sept. 2 (UPI) -- PetroChina's $1.9 billion venture into Alberta's oil sands calls attention to the value of Canada's oil sands but is raising alarm bells about energy security.

Under the deal announced by Athabasca Oil Sands Corp. on Monday, PetroChina will acquire a 60 percent stake in its MacKay River and Dover oil sands projects. It is China's largest venture in Canadian oil sands to date.

Both projects are situated on some 5 billion barrels of yet-to-be-developed bitumen, part of Athabasca's nearly 10 billion barrels of bitumen reserves. Calgary-based Athabasca will continue to operate both projects, which will cost between $15 billion and $20 billion to develop.

Commercial oil could flow by 2014, with an initial production of 35,000 barrels per day and subsequent phases reaching a total 150,000 barrels per day.

The PetroChina-Athabasca deal, expected to close Oct. 31, will bolster Alberta's investment arena, hit by about $100 billion in canceled mining and oil sands projects since last year. Canadian oil sands represent the second-largest oil reserves in the world.

'Given the sheer size of the Canadian oil sands, it's an area that cannot be ignored by China,' said analyst Lanny Pendill with Edward Jones in St. Louis, the Calgary Herald reports.

But Carolyn Bartholomew, chairwoman of the U.S.-China Economic and Security Review Commission, warns of a growing Chinese presence in America's 'back yard,' the Globe and Mail reports.

She said that state-owned PetroChina is a proxy of Beijing's Communist government and rejects the notion that it operates as any other commercial oil company.

'I think that an acquisition like this should raise national security questions both for the government of Canada and for the government of the United States,' Bartholomew said, calling for a thorough review by Ottawa that would include sensitive national security issues.

However, former U.S. Ambassador to Canada Gordon Giffin said he doesn't expect the Obama administration to oppose PetroChina's investment in the oil sands.

Ottawa has recently added a national security test to its Investment Canada Act, which reviews foreign takeovers above $600 million.

Prime Minister Stephen Harper Tuesday acknowledged that PetroChina's investment in the assets controlled by Athabasca is more controversial than a private sector, foreign investment in Canada would be.

'I will just say that there are laws in place to review foreign investment transactions when they meet a certain threshold and our government has strengthened those reviews by including a clause that allows officials to examine issues of national security,' he said, the Globe and Mail reports.

Athabasca Chairman Bill Gallacher said he was confident that Ottawa would give a green light to the acquisition.

'Whatever customary reviews are required, we're going to follow that path and make sure we have all the fulsome disclosure required to make this project move forward,' he said.

© 2009 United Press International, Inc. All Rights Reserved.

Result number: 178

Message Number 260941

Re: Roman Polanskii View Thread
Posted by Dr. Z on 9/30/09 at 05:34

I believe he left because the Judge ignored the plea arrangement that was made. I believe jail time was avoided and the judge gave him jail time.
I need to understand exactly what the legal issues were and are today to make any judgements I am still trying to understand how the lockerbee killer was released home due to his illness.
PS) I really think his movie talent is way over rated.

Result number: 179

Message Number 260930

Re: We are turning left -they are turning right. View Thread
Posted by marie:) on 9/29/09 at 18:39

Hi Max and John,

What you may not understand fully is that conservatives in Europe are different from conservatives in our country. Merkel supports UNIVERSAL HEALTH CARE and FREE COLLEGE Educations for all!

In fact all European conservatives support UNIVERSAL HEALTH CARE!!!

Give me European conservatives any day of the week! They=Moderate!!!! They don't have hang ups on social issues either. ;)

Result number: 180

Message Number 260919

Re: Iran View Thread
Posted by Rick R on 9/29/09 at 09:32

Marie,

If one were to believe that there are free and fair elections in Iran then our issues with the government become issues with the people. I do not see that as the case so it makes things more complicated. Sanctions will hurt the common folk and may galvanize them against us. I don't see a gas shortage impacting their involvement in Iraq nor do I see it impacting their nuclear missile program and desire to turn Israel into vapors.

I also see Russia continuing to support Iran. Russia does not want stability in the Middle East. The Russian economy is in a bad way and needs oil prices to rise. Instability in oil producing regions will boost the Russian economy. Like it or not for the near term the world runs on oil. Our reluctance to exploit our own resources is sucicidal.

Rick

Result number: 181

Message Number 260904

Re: Go, go Obama!!!!! Obama wins stricter stance on nuclear weapons at UN!!!! View Thread
Posted by marie:) on 9/28/09 at 17:59

Ok Rick I'm not saying ANY government can be fully trusted on secret security issues.........including us. Howsever, Russia is on board and that fact is what's incredible and should be a sign to you what's up. This announcement came before we, the people, knew about Iran's secret new uranium plant. I'm pretty sure Russia and China were briefed prior to this meeting. And since it began with the Bush administraition I have to give him credit were credit is due. Nice job Bush.

Result number: 182

Message Number 260893

Re: Dr. DSW: Do any of your TTS patients have a history of bulimia/anorexia? View Thread
Posted by Dr. DSW on 9/28/09 at 14:16

Dottie,

It seems as if you have a very astute podiatrist. I also utilize Metanx for any patients that have nerve issues/nerve related problems, not just diabetic neuropathy patients.

Although Metanx has been proven to be effective for the reasons you've already described, Metanx also contains the B vitamins that I believe are very helpful in many nerve related problems.

Many of my non diabetic patients have related significant benefits since taking Metanx. They did not receive the same benefits when taking OTC B vitamins (the Metanx literature or website will explain the reason). There are really very few if any significant side effects to Metanx since they are water soluble vitamins and are very safe, so there's really no 'downside' to trying this medication.

Result number: 183

Message Number 260892

Health care View Thread
Posted by john h on 9/28/09 at 13:30

The U.S. received a grade of 'D' along with England on health care. Canada ranked 10Th and received a grade of 'B'. The grades were based not just on health care but other side issues of health care. Americans themselves thought there health care was excellent. Perception is very important in any issue. They largely agree that our health care system is broke but cannot agree on how to fix it. The large amount of money to fix it and where this money will come from is the largest item in the on going debate. As it stands now the Speaker of the House is unlikely to let the public see their final plan prior to a vote. It is unlikely the Senators and House members will see the final plan when they vote and most will not have read it. I find it strange that they can call it- bi-partisan if only Olympia Snow votes for it. One vote makes it bi-partisan? To any thinking person this sound ludicrous since this represents 1/6Th of the total American Economy. Some members suggest that 3 days is enough time for the public to read the final bill and have recommended posting it but will have to fight House and Senate Leadership to do this. We should have something for Obama to sign by the new year unless the whole thing falls apart. From my point of view I will be a loser as the Democrats plan to finance 500 billion dollars from 'so called' Medicare savings in waste and fraud. If that much exist why have they not saved it before now? They will end up cutting the pay to Doctors and hospitals and we will have fewer who will accept Medicare just at a point when we need more Doctors in family practice. One clear savings would be tort reform which is an absolute no brain-er but even that is not likely to happen as these lawyers are some of the largest donors that exist.

Which ever way Olympia Snow votes I will be OK with it as I think this lady is level headed and looks after the people first and the politics second.

Result number: 184

Message Number 260812

Re: Att:Dr. Wedemeyer or other Doc/pro View Thread
Posted by Roger on 9/24/09 at 10:37

Interesting thread.

I'd say I to am in the fasciosis stage. Have been fighting this for 4-5 years.

I do not have morning heel pain as such. My pain and discomfort come interestingly if I am off my feet a lot, sitting, I have discomfort, pain in the bottom of the foot/fascia area, as well as stress in the calf. If I am on my feet too much, and particularly certain pairs of shoes, I have discomfort.

I partculary find that I am comfortable/out of pain more, if I do regular stretches and moderate exercise of legs (exercise cycle or walking). My issues seem particularly tied to tight calf muscles. Keeping the legs warm help immensely too. If I let my legs get cool during the night, my calf muscle will be very tight, my foot will be pulling down in the morning. A night splint for 15 min before I get up helps with that, and then stretching.

If I let myself get over exercised, or don't do stretches, then the discomfort starts spreading beyond discomfort in the bottom of the foot and starts hurting in the heel.

During my fasciatis stage, ART, ICE, stretching, taping and night splint were the primary things that helped me. Now mostly stretching, and occasional use of the splint keep me going.

Result number: 185

Message Number 260782

Re: Haglund's Deformity View Thread
Posted by cartera on 9/22/09 at 18:46

I too suffered from Haglund's deformity for over a year and a half, and I want to let you know there is a non-surgical method that works! Like you, I was terrified at the idea of surgery, especially after reading some of these posts. My foot doctor x-rayed me and gave me anti-inflamatories and steroid patches - no change. He said the next step would be surgery and I did NOT want to go there. I am a very active person who likes to play soccer, run, and do martial arts, and the pain was almost unbearable even when just walking. So I went and saw my chiropractor who is very into homeopathic remedies and is very anti-'modern' medicine. Let me just say that EVERY problem I have had, from shoulder pain, knee pain, constipation, breathing issues, and headaches have ALL been cured through chiropractic treatment. I know some people think it's not a real cure, but all I care about is results and it has worked every time for me.

Anyway, the first thing he did was show me how an overly-tight tendon in my hip was causing my right leg to rotate out, which caused severe over-pronation in my right foot. This was essentially the cause of the deformity, as well as severe knee pain when I ran. TWO stretches in his office and my foot turned the right direction! I continued the stretches each day and the knee pain vanished within a few days! The foot pain continued, but a few months later I got orthotics and proper shoes (Rockport World Tour Elite) and now, two months later, the pain is all but gone, the bump on the back of my heel is less than half of what it was at its worst, and I am running like I was before without pain.

When I learned that the 'growth' on my heel was basically a callus on my bone that formed from everything being out of alignment, logic told me that if I get everything back in place the 'callus' would go away. PLEASE consider this treatment method before you have surgery.

It works!

Result number: 186

Message Number 260726

Had f/up w/podiatrist - neuropathy, TTS, post surgical pain View Thread
Posted by 362 on 9/21/09 at 04:21

I see my surgeon regularly for a $25 chat (my insurance co-pay) and, as usual, he was kind & compassionate but had that look on his face that I know so well. I have no reason to believe that this man (nor the doctor who performed my first surgery) has done anything but the best he could under the circumstances. But truth is a cold 'muther' and my truth is very clear: there is nothing more that medical science can offer me at this point in time.

So we talked about acceptance. There comes a time for some of us when we have to just deal with the fact that we are in pain now and will probably be in pain for the rest of our lives. We have to wrap our brains around not only today's pain but the distinct possibility that tomorrow's pain will be even more terrible. That being said, what shall we do? I am in that rather dark place that has me emotionally paralyzed. My kind doctor told me that it was doctor's orders that I never give up my fight. It is hard. The pain is bad even with the pain pills and Neurontin. Tonight I have been dealing with feet that feel like they are sitting near a roaring fire. Then comes the crushing pain that can only be described as something akin to having my feet being smashed in the jaws of an invisible vise. As the Neurontin pulled back some of those feelings, I sit here and experience the odd sensation of my bones throbbing and the strange feeling of something alive crawling inside my feet.

Once I get the worst of it to a dull roar, I try to sleep. Not so fast! Then the feet begin to want to curl which causes terrible 'charley horse' like involuntary spasms. I often must jump up from whatever I am doing (I've had this happen from a sound sleep as well) and stand on my toes to keep the cramp under control. Yes, I have Flexeril. Does it help? Just enough, I think.

VB, I completely understand your frustration and anger. My fella tries to understand but he really can't. On my bad days, I just stay home & give some excuse not to go see him. I get tired of having to say 'I'm in too much pain tonight' because I am sure he is tired of hearing it. I get mad that he seems to 'forget' that I have these medical issues that have my life in a stranglehold. I don't 'look sick' enough.

What we are dealing with is cruel and unfair. We walk a tightrope with our meds...taking enough to be somewhat effective but not so much that we cannot function as human beings. We walk a tightrope with our friends & family as we try to remain civil and 'normal' when our minds are screaming from the pain. We walk a tightrope on the job trying to not screw up even though the agony we experience will not allow us more than minimal concentration on the tasks at hand. You are truly blessed to have such a large support system!

Well, my feet are back on fire (the Neurontin helped for about an hour) and I need to try to get a little sleep. Yeah, right!

Result number: 187

Message Number 260705

Re: Solutions to PF View Thread
Posted by Dr. Wedemeyer on 9/19/09 at 19:05

Alex it is basically transverse friction massage of the affected tissues. It is not advised to perform this as a layperson because some intimate knowledge of anatomy is crucial to doing it properly. If you have any physical medicine benefits available to you, I would suggest you seek out a good manual therapist.

Alex have you tried taping btw? You've been posting for a while now and it doesn't seem like you are getting any solid progress. I remember our discussion from this thread and unless I missed it I did not see taping listed as a treatment:

http://heel.server327.com/bbs/bbt.cgi?n=253361

Result number: 188

Message Number 260690

ankle pain View Thread
Posted by erma v on 9/18/09 at 19:58

my mri report joint effusion edema of the soft tissues, fluid within the peroneal and medial tendon sheaths consistent with tenosynovitis. signal abnormality of the tarsal bones, which may represent chronic changs. marrow edema cannot be excluded. clinical correlayion is recommended.what does all of this mean will my ankle and foot get better. the pain started last november I went to the dr in may of this year and he has been given me injection. may up until aug 1st of this year. i refuse to take any more injections do to my ankle and foot Ican't walk 3blocks.Ihave sugar and afraid. Please could you tell me something. thank you.

Result number: 189

Message Number 260681

Re: Joe Wilson? View Thread
Posted by john h on 9/18/09 at 11:49

I would not yell out you lie to POTUS under any circumstance Marie either in or out of the military. Even if it was Bill Clinton swearing he never had sex with that woman. He has lied many times but that is not the issue. Good manners is the issue. I do not think 1 person in 100,000 would approve of his yelling out.

Is it more offensive to do this to the President than if it were say the Leader of the House or Senate.? Not really as once again it is a matter of decorum,

Yesterday the President of Iran was once again spreading the word during holiday celebrations that there was no Holocaust. Does this guy really believe that or is he just using it? If he believes it then he is crazy and must be feared. If he is using it for political purposes then the people who believe him have some real issues.

If a person tells another person he is lying and he believes what he says is he a liar? Is there a husband who has never at one time lied to his wife? Are there big lies and little lies or is a lie just a lie? If you look at the dictionary a lie is a lie regardless of the consequences.

I do not really see anyone out there defending Wilson so people for the most part think he was wrong. I doubt any election is going to hang on this. The worst thing to come of this is that some people like Maureen Dowd is trying to make it a racial issue and sadly there are many who will believe her. You and I disagree all the time but neither of us has called the other a liar. We may say you are wrong but have not resorted to the liar name calling.

Result number: 190

Message Number 260675

Re: Need Help Fast have big plans suffering from Plantar Fascitis View Thread
Posted by Dr. Wedemeyer on 9/17/09 at 21:52

Kay you really should seek a second opinion and a good neurologist. We can speculate but since only a physician who can examine you in real time can effectively diagnose you and offer you the appropriate treatment. I feel that your problems may be a complex of issues and that your low back and other symptoms need to be assessed further and imaging/electrodiagnostic studies are warranted.

Result number: 191

Message Number 260662

Re: Need Help Fast have big plans suffering from Plantar Fascitis View Thread
Posted by Kay A on 9/17/09 at 17:32

Yes I have always had lower back issues since I was little. We purchase a sleep number bed and that has help me alot with my back troubles. So I have been really good up until this April when I started doing my spring gardening and I jumped out of the back of the pickup from off loading dirt. STUPID...I am not a kid anymore. That is when this all started this whole mess. I started going to the Chiropractor for adjustment and accupunture which really works great on me but didn't help with my back and foot pain. Accupunture in the bottom of the foot is not a real treat let me tell you. But I wanted to do anything to relieve the pain. Then I decided to see my podiatrist found out that I had done a really stupid thing and put my orthodics in the wrong shoe. Have a good laugh still not sure when I did it and how long it was that way, I don't think very long though. Amazingly enough my back troubles went away but not my foot pain. That is when the podaitrist put me in the walking boot and then fitted me for new orthodics since mine were 10 years old. Also notice that my arch on my left foot (problem foot) has dropped, so more reason for new orthodics. Yes, you are correct that I do have relief when I am not weight bearing now. It use to ache alot at night she put me on Naproxen right away which didn't help much but got me to sleep for a little while, and wearing the splint boot at night. Then it was in the end of August when she put me on the neurotin and I am still taking the Naproxen. So when you say mechanical in nature that this is something I have to give it time or surgerically fixable? I appreciate your time with this it is good to talk and to be able to vent and problem solve with another person that understands it what we are going through. Thank you.

Result number: 192

Message Number 260638

Re: Need Help Fast have big plans suffering from Plantar Fascitis View Thread
Posted by Dr. Wedemeyer on 9/16/09 at 22:38

Kay that's alright, I realize that many people who find this site are in chronic pain and frustrated. I imagine that it's difficult to focus and that after recounting your history multiple times that small details can get lost along the way. They are important though.

From what you describe I have to ask if you have any low back issues or have in the past, previous treatment for low back pain and has this been ruled out as a cause or concomitant?

What you describe is nerve entrapment. Being placed on Neurotin is not always a panacea for neuropathic pain, like everything it has a benefit and it also abject failures to mediate your pain. It is also not diagnostic.

Your description sounds a lot like lumbar radiculopathy AND Tarsal Tunnel Syndrome occurring concomitantly (double crush syndrome) but it could also be TTS and heel pain syndrome such as chronic PF, fat pad displacement or lateral plantar nerve entrapment at the heel (Terri) . Either way the etiology of your complaint sounds mechanical in nature since you do experience relief when you are not weight-bearing.

Result number: 193

Message Number 260625

Re: Republican Bad boys at it again................. View Thread
Posted by marie:) on 9/16/09 at 15:39

Again I only wish you the best Tammy. I understand you have some issues. That's evident. I'm glad you don't have foot pain. Who was making fun of your foot pain? Not I. Wishing you well. No desire to get involved with your quest of personal attacks. Stay well.

:)

Result number: 194

Message Number 260609

Re: cryosurgery View Thread
Posted by Dr. DSW on 9/16/09 at 06:29

Norm,

I may be wrong, but IF I remember correctly, you're a physician. I was involved with many of those infamous debates many years ago regarding some of the cryosurgery issues.

You correctly stated the main point that I was 'arguing' during that time when one of the doctors was exploring/utilizing cryosurgery for tarsal tunnel symptoms. And that was the claim that it was 'selectively' destroying (effecting)sensory fibers, while not injuring motor fibers.

I kept asking for an explanation, but never received what I considered an adequate answer. As you apparently know, the tibial nerve is a mixed nerve, meaning it is both sensory and motor, and I never understood how cryosurgery could selectively eliminate sensory fibers without injuring or POTENTIALLY injuring motor fibers.

Therefore, I felt that utilizing cryosurgery on a mixed nerve had the potential to be a disaster if the motor fibers were injured.

HOWEVER, after some research and an eventual explanation some time later by Dr. Carazos (sp) and his colleagues in Arizona and Florida, I began to understand that they really are NOT applying the 'freeze' to the actual tibial nerve, but are more accurately targeting the more terminal branches of the tibial nerve which are strictly sensory branches.

In my opinion, the success or failure of the procedure will therefore be dependent on the level of the nerve entrapment/involvement. If the involvement is proximal in the tarsal tunnel and involves the actual tibial nerve, my opinion is that cryosurgery has the potential danger of injuring motor and sensory fibers. If the involvement is distal and only involves the sensory nerves, I believe that the procedure is no more risky than other alternatives.

If my memory is correct, I also thought you were being treated for RSD/CRPS??? Prior to any procedure, I would attempt to determine whether the pain is from the potential nerve entrapment, RSD/CRPS (if you have this disorder) or both, and discuss all treatment options with your 'team' of doctors.

Result number: 195

Message Number 260595

Re: The Gang of Six View Thread
Posted by marie:) on 9/15/09 at 17:28

Well I have to repsectfully disagree with you on the public option. Polls still have it ahead.....although slightly. I'm thinking it will be present in some form but maybe not in the Senate Bill. If no Republicans sign on to Health Care in the Senate then I predict Dems will view as an obstructionist move towards ALL health care reform and the entire thing could change.

I do agree that we need to take a second look at nuclear power. It's not what it was 30 years ago. It's much more advanced and somewhat safer.

Not sure what I think about these trade issues. Still watching.

Result number: 196

Message Number 260546

Immobilization for Sesamoiditis and Morton's Neuroma View Thread
Posted by Robbie on 9/13/09 at 18:13

My doctor put me in a cam boot for sesamoiditis and morton’s neuroma and said no weight bearing for 6 weeks. I am removing the boot several times a day to ice and am taking 5 days of anti-inflammatories to hopefully jump start the healing process. I’ve had these problems for about 4 months now.

I suffer from other foot problems (arch pain for 5 years) and wanted to treat this aggressively. Before the boot we tried rest, ice, physical therapy (ultrasound and iontopheresis), custom orthotics – all this right at the beginning as I didn’t want another chronic foot pain. None of these helped and the pain continued to get worse.

Question, is 6 weeks long enough in this boot and a treatment for sesamoiditis and morton's neuroma? Should I be doing something else besides resting and icing? Does this treatment have success for these issues? I should add a MRI was done to confirm a fracture did not exist. I do realize when I come out of the boot I will need to continue with shoe modifications to avoid this problem again (problem is not from injury). I did ask these questions of my doctor, but would like the opinions of the doctor's here too.

Thanks for your input.

Result number: 197

Message Number 260503

Re: Why so quiet Republicans? View Thread
Posted by marie:) on 9/11/09 at 14:20

Well I can't argue with that point. I'm fairly moderate on many issues but definitely lean health`care reform. It's long overdue and I believe most Americans know it. I will be anxious to read the final bill.....once I get done with War and Peace. ;)

Result number: 198

Message Number 260501

Re: Stretch for 10 seconds, release, repeat 10 times or just stretch for 2 minutes straight? View Thread
Posted by Julie on 9/11/09 at 11:38


There is a difference. It depends on what stretch you're doing, why you're doing it, and what you hope to achieve by doing it. The stretch-and-release technique gives the tissues you are stretching a chance to release and relax in between stretches, and the stretch will be more effective.

Strictly speaking, what the plantar fascia stretch does is to gently restore all the tissues, including the Achilles tendon and the calf muscles, to normal length after they have tightened and shortened during the night. Holding it for 2-3 minutes might damage the injured tissues and would be counterproductive.

This is an oversimplification, but the gist of it is that the plantar fascia stretch is a gentle, passive stretch that is not meant to be held. It is a good exercise for PF.
.

Result number: 199

Message Number 260487

Why so quiet Republicans? View Thread
Posted by marie:) on 9/10/09 at 20:14

The president gives a joint congressional speech on health care reform and ya'll got nothing to say? ;)

I like this site called PolitiFact. You can fact check the speech there.
http://www.politifact.com/truth-o-meter/

....................................

Nurses are on the front line of health care. Nothing against doctors but we all know they are the ones who are there with us when we are the most ill and often with us during our last breath. I have great respect for their judgement on the issues and they don't have anything to gain or lose in the debate.

http://www.nursingworld.org/FunctionalMenuCategories/MediaResources/PressReleases/2009-PR/ANA-Supports-Obama-Health-Care-Reform.aspx
“As nurses, every day we see first-hand the heart-breaking consequences of our nation’s flawed system,” Patton said. “We see patients in danger when they can’t access or afford the care they need. We hold a patient’s hand when they learn that their health insurance coverage has been denied or cancelled. And we see the day-to-day human cost of this system -- in the eyes of our patients and their families.”

..............................

Are Republicans concerned about the fact they allowed nuts to frame their ideas on Healthcare? I think some will come around. They don't want to be associated with the crazies during an election year.

http://www.chicagotribune.com/news/nationworld/sns-dc-health-congress-final,0,5073210.story
Most Republican leaders Thursday continued to lambaste Obama's healthcare plan. 'It sounded very much like the Chicago politics that I know he's familiar with,' said Arizona Sen. Jon Kyl, the No. 2 Republican in the Senate. 'It appeared as if he was trying to ram something through.'

Privately, however, some Republicans worried that the party's unremitting opposition to the Democratic plans could boomerang in next year's congressional elections, especially if a far-reaching plan is finally approved.

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What are our thoughts on assisting doctors to prevent defensive medicine as a result of frivolous lawsuits? Good? Bad? Thoughts?

http://whitehouse.blogs.foxnews.com/2009/09/10/hhs-plans-to-announce-tort-reform-in-one-month/
An administration official told Fox Sebelius hopes to announce within a month the location and scope of demonstration projects to curb frivolous lawsuits and, possibly, reduce the use of so-called defensive medicine to avoid them.

No decisions have been made, but the administration is looking at two approaches: one is to have doctors admit and disclose a medical mistake soon after it occurred and having patients submit a potential malpractice claim to a mediator instead of filing a lawsuit; the other is have an independent panel of experts review the merit of a patient's claim and validate it through an affidavit before a lawsuit can be filed.

Result number: 200

Message Number 260479

Re: PF as an Autoimmune Disease/ Arthritis View Thread
Posted by Cee Gee on 9/10/09 at 12:50

I can't believe what i've just read. IT'S ME! I have been diagnosed with muscle spasms, neck pain, tendonitis, Raynaud's Syndrome, not to mention other stuff. I have had severe PF...cortisone..orthotics..night splint..physical therapy and even surgery. have it in both feet. it went away for sometime now and is back along with multiple other pains. right now im on celebrex 200 mg 2x a day and God help me if i miss one dose. I have spinal issues..and they 'THINK....fibromyalgia'. sometimes i feel like a chronic complainer. No, not sometimes...most of the time.

Result number: 201

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