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Have tried everything past 2 1/2 years)....pain keeps coming back....quallity of life?

Posted by Ms.Fitz on 4/28/00 at 16:32 (019572)

After 4 podiatrists and 1 Ortho. surgeon, cortisone shots, custom orthotics, Physical therapy, ultrasound, Medrol pack, stretching, rest, ice, MRI, bone scan, NSAIDS, Rheumatologist, blood work and so on, the pain comes back and it's in both heels now. I'm a full time nurse, work on concrete floors, and finally took a medical leave about six weeks ago. Surgery seems to be my last option (EPF). Any feedback? suggestions? Time has become my enemy and I'm afraid I'll have to kiss my job good-bye (worked for 2 1/2 years with pain in left heel and 7 months with pain also in right heel). Besides the intolerable pain, it affected my concentration immensely.

Re: Have tried everything past 2 1/2 years)....pain keeps coming back....quallity of life?

john h on 4/28/00 at 18:03 (019579)

being a nurse and on your feet all the time you have a tough road to go to get the needed rest. a number of poditrist are giving up endoscopic surgery for minimal invasive surgery-from my reading i would not personally have surgery on my fascia thu a scope. read all you can on this board. aside from surgery there are many things to try including the orbasone,ossatron in canada,night splints,etc.

Re: Have tried everything past 2 1/2 years)....pain keeps coming back....quallity of life?

FWS on 4/29/00 at 02:43 (019594)

Like you I spend a lot of time on my feet - I'm a teacher. I have tried about everything except acupuncture in the last 16 months. Tne only thing that has seemed to work for me, albeit only for a short time, is a night splint, with a wedge under the ball of my foot, just behind my toes. It leaves me without pain well into the morning.

The following excerpt from remarks by Dr. Conti, an orthopedist at the University of Pittsburg, which I found on this message board, caught my attention because it sounds similar to my experience with the night splint:

'Conti: With somebody who calls me at two months and says they're absolutely no better and their symptoms remain unchanged, we have several options. One is to put a cortisone shot into the insertion of the plantar fascia. I rarely do that, because it's not addressing any of the pathology. There are several good case reports of acute plantar fascia rupture following an injection when the foot is not protected. So what I'll often do is recommend the patient go into a short-leg walking cast. The idea is that the walking cast is going to keep the Achilles tendon and the plantar fascia stretched 24 hours a day. We put the cast on a little differently than a standard cast. We put the ankle at neutral, but we put a foam pad beneath the toes and extend the toes so that when a patient has the cast on, their plantar fascia is stretched 24 hours a day. And we allow them to ambulate on the cast for one month. At the end of the month, I'll take the cast off and reexamine them. Rarely do I put them in additional casting, but sometimes I will, if it still seems inflamed. Most of the time it's settled down enough so that they can do the weight loss, activity modification, stretching, night splinting, and appropriate shoe wear. And we haven't reported on this yet, but we have found that the short-leg casts are a marvel as an adjunct to treatment in patients who seem to be very resistant to the traditional methods.'

I got casted this morning, and while its too early to predict the results, my heel feels pretty good. When the cast comes off, I am going t have some PT and start using custom orthotics, which are being made now.

I am adamantly opposed to surgery and after 16 months of PF, this seems like something that is worth a try. At worst it means a month of a slight inconvenience.

Best of luck.


Re: Have tried everything past 2 1/2 years)....pain keeps coming back....quallity of life?

caryne on 4/29/00 at 08:10 (019598)

Boy, I couldn't wait that long...I lasted 16 months before I had my surgery. They did surgery on March 30th. I'm still pretty sore and walk very slowly but I don't use the crutches anymore and hoperfully will continue to heal up and get back to normal by mid-summer. Will know more after next Dr. visit in May. Sometimes you just have to have the surgery and get it over with.

Re: Have tried everything past 2 1/2 years)....pain keeps coming back....quallity of life?

Laurie R on 4/29/00 at 10:33 (019602)

Hello FWS,
I am so happy you are trying a hard cast I just have such a good feeling it is going to help you.Keep us posted on how you are doing .I guess we both are in a cast for the same amount of time.Also you must have a wonderful doctor too.........

Your cast sister Laurie R


Re: surgery

ChrisO on 4/29/00 at 11:01 (019603)

Hi Caryn - what kind of surgery did you have? Both feet? What was/is your foot type and type of PF pain? Thanks

Re: Have tried everything past 2 1/2 years)....pain keeps coming back....quallity of life?

Pamela Austin on 5/03/00 at 11:30 (019815)

I just read FWS and agree. I hac PF for over 2 years and I believe that the night splint with PT has enabled me to carry on with a normal life now. I've been pain free for 2 months now. Hope this helps. Good luck.

Re: Have tried everything past 2 1/2 years)....pain keeps coming back....quallity of life?

john h on 4/28/00 at 18:03 (019579)

being a nurse and on your feet all the time you have a tough road to go to get the needed rest. a number of poditrist are giving up endoscopic surgery for minimal invasive surgery-from my reading i would not personally have surgery on my fascia thu a scope. read all you can on this board. aside from surgery there are many things to try including the orbasone,ossatron in canada,night splints,etc.

Re: Have tried everything past 2 1/2 years)....pain keeps coming back....quallity of life?

FWS on 4/29/00 at 02:43 (019594)

Like you I spend a lot of time on my feet - I'm a teacher. I have tried about everything except acupuncture in the last 16 months. Tne only thing that has seemed to work for me, albeit only for a short time, is a night splint, with a wedge under the ball of my foot, just behind my toes. It leaves me without pain well into the morning.

The following excerpt from remarks by Dr. Conti, an orthopedist at the University of Pittsburg, which I found on this message board, caught my attention because it sounds similar to my experience with the night splint:

'Conti: With somebody who calls me at two months and says they're absolutely no better and their symptoms remain unchanged, we have several options. One is to put a cortisone shot into the insertion of the plantar fascia. I rarely do that, because it's not addressing any of the pathology. There are several good case reports of acute plantar fascia rupture following an injection when the foot is not protected. So what I'll often do is recommend the patient go into a short-leg walking cast. The idea is that the walking cast is going to keep the Achilles tendon and the plantar fascia stretched 24 hours a day. We put the cast on a little differently than a standard cast. We put the ankle at neutral, but we put a foam pad beneath the toes and extend the toes so that when a patient has the cast on, their plantar fascia is stretched 24 hours a day. And we allow them to ambulate on the cast for one month. At the end of the month, I'll take the cast off and reexamine them. Rarely do I put them in additional casting, but sometimes I will, if it still seems inflamed. Most of the time it's settled down enough so that they can do the weight loss, activity modification, stretching, night splinting, and appropriate shoe wear. And we haven't reported on this yet, but we have found that the short-leg casts are a marvel as an adjunct to treatment in patients who seem to be very resistant to the traditional methods.'

I got casted this morning, and while its too early to predict the results, my heel feels pretty good. When the cast comes off, I am going t have some PT and start using custom orthotics, which are being made now.

I am adamantly opposed to surgery and after 16 months of PF, this seems like something that is worth a try. At worst it means a month of a slight inconvenience.

Best of luck.


Re: Have tried everything past 2 1/2 years)....pain keeps coming back....quallity of life?

caryne on 4/29/00 at 08:10 (019598)

Boy, I couldn't wait that long...I lasted 16 months before I had my surgery. They did surgery on March 30th. I'm still pretty sore and walk very slowly but I don't use the crutches anymore and hoperfully will continue to heal up and get back to normal by mid-summer. Will know more after next Dr. visit in May. Sometimes you just have to have the surgery and get it over with.

Re: Have tried everything past 2 1/2 years)....pain keeps coming back....quallity of life?

Laurie R on 4/29/00 at 10:33 (019602)

Hello FWS,
I am so happy you are trying a hard cast I just have such a good feeling it is going to help you.Keep us posted on how you are doing .I guess we both are in a cast for the same amount of time.Also you must have a wonderful doctor too.........

Your cast sister Laurie R


Re: surgery

ChrisO on 4/29/00 at 11:01 (019603)

Hi Caryn - what kind of surgery did you have? Both feet? What was/is your foot type and type of PF pain? Thanks

Re: Have tried everything past 2 1/2 years)....pain keeps coming back....quallity of life?

Pamela Austin on 5/03/00 at 11:30 (019815)

I just read FWS and agree. I hac PF for over 2 years and I believe that the night splint with PT has enabled me to carry on with a normal life now. I've been pain free for 2 months now. Hope this helps. Good luck.