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Long suffering BRIT

Posted by UK Mark on 6/09/00 at 05:43 (021560)

I have had back pain for about 17 years and foot pain for 7 years. After studying pain management teqniques I just about cope although the chronic pain has given me depression which can somtimes stop me doing anything.

The problem I have is never being given a real diagnosis. To experience this much pain and not know the cause makes it hard to know what the best treatment is.

I have had x-rays on my back and blood tests which are OK.
My doctor says I have PF and suggests injections which I have refused because of their linited effectiveness. I don't feel I have been investigated enough for the foot problem and the doctor won't refer me for any scans.

I have had massage and tried ibuprofen cream without much effect. Stretching and swimming help a little to prevent tightning-up, the swimming feels great at the time as the weight is off my feet

I really feel I must do all I can to ease the pain but dont know how to get a proper diagnosis.
Can anyone suggest anything. Also are there any other Brits on the message board or British sites like this one.


Re: Long suffering BRIT

alan k on 6/09/00 at 07:52 (021562)

You should still get an emg test for radiculopathy since you have that foot/back thing going-- an x-ray will not tell you much about this.

Nevertheless you may have pf instead, or both a back problem and pf. Definitely keep swimming, to keep off the depression which is a major obstacle to healing.

Read Scott's book and the message board, to get ideas for new therapies you can try. I suggest strengthening, stretching, and massage along with heating (before activity, stretching, and in the morning) and icing after strains.

Perhaps you would benefit from nightsplints and custom orthotics. There is a lot you can do. Shots may be ineffective, but the main reason not to do them (in my opinion) is the danger of rupturing the pf, and also fat pad atrophy (which I believe is irreversible).


good luck!

alan k


Re: Long suffering BRIT

wendyn on 6/09/00 at 08:35 (021563)

Greetings Mark.

I'm not sure how your health care system works over there, but I do know that we've had folks from Britain post here before.

I also have lower back pain and foot pain. The problem is, sometimes it's hard to tell which causes the other. You may have sore feet from something happening in your back, or your back may hurt because you walk funny (this is my situation).

Back in September I had to have a lower back/hips/pelvis bone scan done to rule out ankylosing spondiltyis (I could be a bit off on the spelling). It's a form of arthritis that stiffens the spine and causes PF like symptoms. I'm surprised that your doctor isn't willing to do tests to rule things like this out.

Have you been seeing the same doctor all along? What type of doctor is he? Seven years is a long time to go without a definate diagnosis. You've had blood tests - but do you know for what?

My suggestion would be to ask (or demand) a referral to a well respected orthepedic foot and ankle surgeon. Make sure you detail your history and bring a copy of your test results. Most (especially after 7 years) will do things like x-rays, bonescans, MRI, nerve conduction testing and various blood tests. There are all kinds of systemic problems that can cause PF like symptoms. You may also want to get another opinion from a podiatrist. Be forewarned, they are much more likely to push the cortisone shot/surgery route. You'll have to decide what's best for you.

You may be wise to stay away from the shots, especially unless or untill that it's proven that your problem really is PF and only PF.


Re: Long suffering BRIT

john h on 6/09/00 at 09:56 (021570)

sounds like you are traveling the same road i have been on-very bumpy. I had low back surgery 18 years age (laminectomy) which stopped the pain in my leg but left me with pain in my low back and buttocks. I have never found a NASID that would help this problem. Before my feet went south on me i controlled my back pain with running,basketball, and vigorous exercise (sounds crazy but it worked). Once i developed PF and could no longer do those things my back got much worse. Some things that may help your back are a TEN's Unit, Mentholatum Pain Patches (Can Purchase from Drugstore.Com), and back exercises. I have had Epidurals, Facet Injections, MRI's, and will have a Discogram in the near future. My problem is deterioriating disc in the L-5/S-1 and L/4-L5 area which is most common to all as we age. One is really better off if they blow out a disc because you then can clearly identify the problem. One of my Doctor buddies had a fusion of the 3 lower levels about 6 months ago with a post with screws to stabilize the spine and he is pain free after l7 years ( he is only about 38) and he swims, walks and is very active. If you have not had an MRI,epidurals,facet injections, or discogram they are important diagnostic tools. All my doctors agree my feet problems are not releated to my back problem. You should try to see a Spine Specialist with a Fellowship in Spine Surgery. I can understand the depression over your problems. Just do not give up and try and get to a qualified doctor.

Re: Suggestions

Steve P on 6/09/00 at 10:04 (021573)

Mark --- I agree with the above comments by Alan & Wendyn. You need to 'start over' & get a new, comprehensive re-evaluation by the best orthopedic practice you can find. Try a large, well-respected hospital with a major Orthopedic Department that includes Sports Medicine or Sports Rehab .....i.e., a place where athletes come as well as the general public.
Here are 2 questions for your doctors:
1) Would custom orthotics help? Since you have both back & foot problems, your doctor will have to assess the impact on both. But orthotics have helped many people who have suffered a long time.
2) Do you have a leg length difference? Ask to be measured! Even a slight leg length difference can cause back/leg/foot problems & is usually correctable with prescription shoes.
Good luck!

Re: Long suffering BRIT

YvonneC on 6/09/00 at 12:43 (021580)

Mark, I was/am a PF sufferer for approximately 5 1/2 years. Last December I had surgery on my back (herniated disk). Anyway, here's what has helped me:

Surgery on my back, rest, low-carb diet (I think this really helped the most) Mike's PFT and Spring Step shoes/sandals.

You will find that what works for one person may not work for everyone, but I really do believe that you are your own doctor with this problem. I have spent a fortune on doctor's, surgery (PR partial release), this medication that medication. But when I took an aggressive approach to my problem things got better. Now I know it will take time, it took me over 1 1/2 yr, but it will be worth it. It is very very rare that I would have any pain in the mornings now, the only time would be if I wear my dress shoes (yes I can wear them again) to long. I hope this helps, good luck, and stick with this board even if you don't post, you can get some really great advice.


Re: Long suffering BRIT

Melody on 6/09/00 at 16:00 (021583)

Mark,
CHANGE YOUR GP!!

you cannot carry on seeing someone who is so unhelpful! I have a chronic pain problem but my GP is brilliant. She has been such a help to me.

Thr trouble with chronic pain is that it is often difficult to pin point exactly where it is coming from. Have you been referred to a pain clinic yet? If not you definitely should. The guy I see in Oxford is wonderful. I have just finished a pain management course which gives suggestions on how to cope with living in pain.

I don;t know about tests for the PF but if you are in that much pain you should be seeing a consultant of some description. Your GP should not be being so obstructive. I know you can refer yourself to see someone privately if that is a financial option for you. Cost me 80 when I saw someone about my hand- probably would cost the same for a foot!!*S*

I've got the names of some pain relief/management books if you are interested. Let me know


Yours

Caroline - Oxford UK


Re: Long suffering BRIT

Truffle on 6/09/00 at 17:13 (021588)

Hi Mark, The treatment path in UK seems more limited than in the States, however, there are routes that can be followed. Like you, my GP isn't very clued up re. PF, and didn't tell me of all the things that can make a difference in the short term. These include support, icing, NO bare feet, etc. (See PF book for help). He did refer me to the orthopeadic (?) consultant at the local hospital, although the waiting list was 24 months, during which time my PF gor worse & worse. If he won't refer you, I'd suggest seeing another GP at the surgery or changing to another GP - you can just walk into a new one and register with them, and usually see them the same day. Due to the long waiting list, I eventually saw my consultant privately for an assessment, after which he transferred me to his NHS appointments for the following week. It cost me about 200 for appt. & x-ray of each foot, but at the time I could hardly walk, so was worth it. I'm not too impressed with my consultant; he's v. keen to operate without trying all 'conservative' treatments first, but no-one else in the hospital is able to deal with PF. Perserverance seems to be the key - along with as much info as you can find out yourself. Good luck, T.

Re: Long suffering BRIT

Jeff Iverson on 6/09/00 at 19:27 (021590)

I suffered with pf from the time I was sixteen untill I was Twenty. I saw doctor after doctor. Tryed a cast for three weeks; two cortozone shots; foot braces; exercises; I was on crutches. Nothing worked untill I saw a specialist who diagnosed me. I was given specially formed insoles with accents. I also did one simple streach with a towle around the front of my foot. I became healed right away. I have had almost no problems for four years now. If I walk for any length of time without the insoles it immediatly comes back. It is a good idea to have two pair. It will save you money in the long run. I PROMISE!!! The insoles won't last as long if your always swithing them between shoes. I have one pair for my rollerblades and ski boots and another pair for my runners and boots. Anyone with questions can email me jeff@cablelan.net

Re: Long suffering BRIT

Bob G. on 6/10/00 at 00:48 (021602)

Hello Truffle,

I wish you the best of good luck. Please research and study this board as it may provide you with answers and sooner results than the 'system' may provide.

Best Wishes, Bob G.


Re: Long suffering BRIT

alan k on 6/09/00 at 07:52 (021562)

You should still get an emg test for radiculopathy since you have that foot/back thing going-- an x-ray will not tell you much about this.

Nevertheless you may have pf instead, or both a back problem and pf. Definitely keep swimming, to keep off the depression which is a major obstacle to healing.

Read Scott's book and the message board, to get ideas for new therapies you can try. I suggest strengthening, stretching, and massage along with heating (before activity, stretching, and in the morning) and icing after strains.

Perhaps you would benefit from nightsplints and custom orthotics. There is a lot you can do. Shots may be ineffective, but the main reason not to do them (in my opinion) is the danger of rupturing the pf, and also fat pad atrophy (which I believe is irreversible).


good luck!

alan k


Re: Long suffering BRIT

wendyn on 6/09/00 at 08:35 (021563)

Greetings Mark.

I'm not sure how your health care system works over there, but I do know that we've had folks from Britain post here before.

I also have lower back pain and foot pain. The problem is, sometimes it's hard to tell which causes the other. You may have sore feet from something happening in your back, or your back may hurt because you walk funny (this is my situation).

Back in September I had to have a lower back/hips/pelvis bone scan done to rule out ankylosing spondiltyis (I could be a bit off on the spelling). It's a form of arthritis that stiffens the spine and causes PF like symptoms. I'm surprised that your doctor isn't willing to do tests to rule things like this out.

Have you been seeing the same doctor all along? What type of doctor is he? Seven years is a long time to go without a definate diagnosis. You've had blood tests - but do you know for what?

My suggestion would be to ask (or demand) a referral to a well respected orthepedic foot and ankle surgeon. Make sure you detail your history and bring a copy of your test results. Most (especially after 7 years) will do things like x-rays, bonescans, MRI, nerve conduction testing and various blood tests. There are all kinds of systemic problems that can cause PF like symptoms. You may also want to get another opinion from a podiatrist. Be forewarned, they are much more likely to push the cortisone shot/surgery route. You'll have to decide what's best for you.

You may be wise to stay away from the shots, especially unless or untill that it's proven that your problem really is PF and only PF.


Re: Long suffering BRIT

john h on 6/09/00 at 09:56 (021570)

sounds like you are traveling the same road i have been on-very bumpy. I had low back surgery 18 years age (laminectomy) which stopped the pain in my leg but left me with pain in my low back and buttocks. I have never found a NASID that would help this problem. Before my feet went south on me i controlled my back pain with running,basketball, and vigorous exercise (sounds crazy but it worked). Once i developed PF and could no longer do those things my back got much worse. Some things that may help your back are a TEN's Unit, Mentholatum Pain Patches (Can Purchase from Drugstore.Com), and back exercises. I have had Epidurals, Facet Injections, MRI's, and will have a Discogram in the near future. My problem is deterioriating disc in the L-5/S-1 and L/4-L5 area which is most common to all as we age. One is really better off if they blow out a disc because you then can clearly identify the problem. One of my Doctor buddies had a fusion of the 3 lower levels about 6 months ago with a post with screws to stabilize the spine and he is pain free after l7 years ( he is only about 38) and he swims, walks and is very active. If you have not had an MRI,epidurals,facet injections, or discogram they are important diagnostic tools. All my doctors agree my feet problems are not releated to my back problem. You should try to see a Spine Specialist with a Fellowship in Spine Surgery. I can understand the depression over your problems. Just do not give up and try and get to a qualified doctor.

Re: Suggestions

Steve P on 6/09/00 at 10:04 (021573)

Mark --- I agree with the above comments by Alan & Wendyn. You need to 'start over' & get a new, comprehensive re-evaluation by the best orthopedic practice you can find. Try a large, well-respected hospital with a major Orthopedic Department that includes Sports Medicine or Sports Rehab .....i.e., a place where athletes come as well as the general public.
Here are 2 questions for your doctors:
1) Would custom orthotics help? Since you have both back & foot problems, your doctor will have to assess the impact on both. But orthotics have helped many people who have suffered a long time.
2) Do you have a leg length difference? Ask to be measured! Even a slight leg length difference can cause back/leg/foot problems & is usually correctable with prescription shoes.
Good luck!

Re: Long suffering BRIT

YvonneC on 6/09/00 at 12:43 (021580)

Mark, I was/am a PF sufferer for approximately 5 1/2 years. Last December I had surgery on my back (herniated disk). Anyway, here's what has helped me:

Surgery on my back, rest, low-carb diet (I think this really helped the most) Mike's PFT and Spring Step shoes/sandals.

You will find that what works for one person may not work for everyone, but I really do believe that you are your own doctor with this problem. I have spent a fortune on doctor's, surgery (PR partial release), this medication that medication. But when I took an aggressive approach to my problem things got better. Now I know it will take time, it took me over 1 1/2 yr, but it will be worth it. It is very very rare that I would have any pain in the mornings now, the only time would be if I wear my dress shoes (yes I can wear them again) to long. I hope this helps, good luck, and stick with this board even if you don't post, you can get some really great advice.


Re: Long suffering BRIT

Melody on 6/09/00 at 16:00 (021583)

Mark,
CHANGE YOUR GP!!

you cannot carry on seeing someone who is so unhelpful! I have a chronic pain problem but my GP is brilliant. She has been such a help to me.

Thr trouble with chronic pain is that it is often difficult to pin point exactly where it is coming from. Have you been referred to a pain clinic yet? If not you definitely should. The guy I see in Oxford is wonderful. I have just finished a pain management course which gives suggestions on how to cope with living in pain.

I don;t know about tests for the PF but if you are in that much pain you should be seeing a consultant of some description. Your GP should not be being so obstructive. I know you can refer yourself to see someone privately if that is a financial option for you. Cost me 80 when I saw someone about my hand- probably would cost the same for a foot!!*S*

I've got the names of some pain relief/management books if you are interested. Let me know


Yours

Caroline - Oxford UK


Re: Long suffering BRIT

Truffle on 6/09/00 at 17:13 (021588)

Hi Mark, The treatment path in UK seems more limited than in the States, however, there are routes that can be followed. Like you, my GP isn't very clued up re. PF, and didn't tell me of all the things that can make a difference in the short term. These include support, icing, NO bare feet, etc. (See PF book for help). He did refer me to the orthopeadic (?) consultant at the local hospital, although the waiting list was 24 months, during which time my PF gor worse & worse. If he won't refer you, I'd suggest seeing another GP at the surgery or changing to another GP - you can just walk into a new one and register with them, and usually see them the same day. Due to the long waiting list, I eventually saw my consultant privately for an assessment, after which he transferred me to his NHS appointments for the following week. It cost me about 200 for appt. & x-ray of each foot, but at the time I could hardly walk, so was worth it. I'm not too impressed with my consultant; he's v. keen to operate without trying all 'conservative' treatments first, but no-one else in the hospital is able to deal with PF. Perserverance seems to be the key - along with as much info as you can find out yourself. Good luck, T.

Re: Long suffering BRIT

Jeff Iverson on 6/09/00 at 19:27 (021590)

I suffered with pf from the time I was sixteen untill I was Twenty. I saw doctor after doctor. Tryed a cast for three weeks; two cortozone shots; foot braces; exercises; I was on crutches. Nothing worked untill I saw a specialist who diagnosed me. I was given specially formed insoles with accents. I also did one simple streach with a towle around the front of my foot. I became healed right away. I have had almost no problems for four years now. If I walk for any length of time without the insoles it immediatly comes back. It is a good idea to have two pair. It will save you money in the long run. I PROMISE!!! The insoles won't last as long if your always swithing them between shoes. I have one pair for my rollerblades and ski boots and another pair for my runners and boots. Anyone with questions can email me jeff@cablelan.net

Re: Long suffering BRIT

Bob G. on 6/10/00 at 00:48 (021602)

Hello Truffle,

I wish you the best of good luck. Please research and study this board as it may provide you with answers and sooner results than the 'system' may provide.

Best Wishes, Bob G.