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Cortizone: would like medical studies to read & did any of you get better without ever having cortizone?

Posted by Beverly on 6/23/00 at 17:30 (022292)

Hi guys!

My patience is running thin. I know many of you have suffered far longer than my mere 3.5 months, but with family coming into town and realizing the most I can do is take them to a movie/dinner while they are off to go sightseeing, I am aware of just how limited I am.

I have read so many pro's and con's discussed here about cortizone.
But I realize since we are here, most of us are not 'cured' and that impacts findings. I would like to read some objective medical studies and abstracts concerning cortizone and especially it's success/failure rate and complications. The injection kind.( I am not will to take the pills now that I have read more about them.) Besides our own board, where would I look ... especially on the web? And are there particular studies on our board I should look at?

No matter how much it may hurt, if I thought I stood even a 50-50 chance of being healed, I'd do it. What I am afraid of is having it make me far worse. For instance, I have a friend who had a cortizone shot in his elbow for tendonitis, and he felt better... thought he was well, and ended up rupturing it. That is what I am afraid of... making myself worse. Nor, do I want to endure a painful shot for only a few weeks worth of relief. But if I thought it would fix me for a year or more, I'd do it. And yes, I would follow conservative rest afterwards. But does the cortizone itself set you up for a rupture even without increased activity?

Finally, of those of you who are getting better, did any of you forgo cortizone altogether... never even had that first shot? As much as I hear cortizone bad mouthed on our board, I wonder if it played a part in the healing process overall.

Those of you who follow my posts, know I have a MORTAL FEAR OF CORTIZONE. I saw it almost destroy my mother's health (MS patient), and it made her totally whacky. But I also recall she was on longterm use.
This seems unheard of now, but as a child in the 1960's, I can remember seeing Mother give herself a cortizone shot in her hip at least once a week and maybe even more often than that. So, my perspective may be warped.

Thanks,
Beverly



Re: Cortizone: would like medical studies to read & did any of you get better without ever having cortizone?

Melody on 6/23/00 at 17:36 (022295)

Beveryly,
My first cortisone shot hurt like crazy but after a few days my foot stopped hurting and I felt great for about 3 months. Had another one and it too hurt like crazy and just kept on hurting! I am in more pain since having the second one than I was before it.

I am very afraid of having any others!!!

I have no idea what is the best treatment. I am hoping that if I ignore it, it will all go away!!!

Mel


Re: Cortizone: would like medical studies to read & did any of you get better without ever having cortizone?

laurie R on 6/23/00 at 17:43 (022296)

Hi Beverly,
I don't think this is what you want to hear but I will tell you anyways,I didn't want cortisone either when this all started for me 1 year ago ,so one day I just had it with the pain and I said I should try because if I don't I will never know if this would be the thing that is going to help,so I had my first cortisone shot ,all it did was numb my foot for a few hours and than that was it all the pain was still their , my therapist told me some times it can take 3 shots before it helps I went back and had shot #2 same thing happened just a little bit of numbing and it wore off and all the pain was back .My Pod said thats it if 2 did not help # 3 is not going to help.I do get shots now once in a while but just to numb my nerve in my Tarsel Tunnel area,with no cortisone .I just got one yesterday my foot stayed numb for 8 hours. I forgot to tell you I got both my cortisone shots for TTS not PF I have both .The shots did not hurt at all but they were not put in my heel all have been in my ankle.

All I can say is it might help and maybe not I know some people swear by them and others say it does nothing.

My best to you. Laurie R



Re: Cortizone: would like medical studies to read & did any of you get better without ever having cortizone?

Bea K on 6/23/00 at 18:01 (022297)

Once again, Cortizone does not cure. If you are fortunate it will help the pain for awhile or maybe not and can do damage. It can also cause internal problems. The main thing to remember is that it will not cure and can do damage.

Re: Cortizone: would like medical studies to read & did any of you get better without ever having cortizone?

john h on 6/23/00 at 18:05 (022298)

beverly: you will get different opinions on this board concerning cortisone shots. i had one in each foot and did not find them painful. the painfree effect lasted about 3 weeks for me. i think because my feet were feeling so good after 4 years that i over extended and relapsed. cortisone shots are commonly used in hips, shoulders, wrist, elbows, etc to reduce inflamation and are very effective. some people get lasting results. i have communicated with people who have had over 20 shots in their foot (that is crazy). most doctors i have discussed this with say you can (generally) get 3 shots in a year without much chance of any adverse effects. find a doctor you trust and go with his advice.

Re: Cortizone: would like medical studies to read & did any of you get better without ever having cortizone?

Lori E. on 6/23/00 at 19:13 (022301)

I agree with the other postings. Cortizone shots are NOT something that you want to have alot of. Overuse of cortizone can cause damage. The temporary relief you get can cause you to over do it and make things worse. Plus lots of cortizone can weaken the tissues it is injected into. I suppose some pods may use it as a weeding device to see if it will be a quick fix. I did have one set of shots and they numbed my feet, and then hobbled me for the rest of the week. The shots were administered correctly, on the side of the heels after they were numbed first, but I got no relief from them. The only reason my pod suggested it, and I agreed to it, was I was in tears from so much pain. My pod didn't think with the result I got that I should have any more shots. We moved on to PT and then acupuncture. I found the acupuncture much more effective than a cortizone shots for pain relief in the long run, plus I find the acupuncture doesn't hurt. Just some pinching sometimes, and now I get relief from a treatment for a good week or so.

Re: Cortizone: would like medical studies to read & did any of you get better without ever having cortizone?

Dr. Zuckerman on 6/23/00 at 19:39 (022302)

local steriod injections are used for reduction of excessive edema. Either they work or don't. I have had patients that get an injection that lasts for years. It is my opinion that if it is a bursitis (fluid sac) at the pf insertion it can work. You must have additional
treatment such as taping ,heel cups or orthosis in conjunction with the steriod injection. This is very important!!! Don't just get the shot and not deal with the mechanics of the problem if there is a mechanical problem to begin with. The correct evaluation before the shot is important. Anyway the bursa sac injected for heel pain seens to be the key for sucess. Look at the study on this site that talks about pf rupture with an average of just two shots.

Re: Cortizone: would like medical studies to read & did any of you get better without ever having cortizone?

Pauline on 6/23/00 at 19:49 (022303)

I have had one shot in each foot. They took the inflammation down somewhat but not long lasting. I belive the Orthopedic Surgeon gives more cortisone per treatment than the Pod because when I had this back in 1993 one shot in the bottom of my foot really helped it alot.

Additionally at physical therapy they are using iontophoresis and
dexamethasone. I am experiencing good pain control and inflammation
relief at this time but I am staying off my feet as much as possible.
I do not work so this is pretty easy for me to do.

I am hoping the combination of staying off my feet while getting the
treatments will eliminate the PF, however most others posting here
indicate that this too does not last. We'll see. Just getting pain relief and having the inflammation down is wonderful. I am now able
to do a little stretching and I watch that very carefully so as not
to over do.

This trial and error is difficult because just when you get your hopes up things take a turn for the worse. I really hate haveing PF especially when I see others walking down the street and I'm watching from my sofa.

It would be wonderful if one of us could come up with a simple solution to this disease. I think calling it 'heel pain' is the
worst thing because it does not begin to tell the whole story.


Re: Cortizone: would like medical studies to read & did any of you get better without ever having cortizone?

Nancy S. on 6/23/00 at 20:56 (022307)

Beverly, I don't know where Robin is, but as you know she is doing really well now due mostly to Birks, rest, low-carb diet, and bromelain. I don't think she ever had a cortisone shot. Robin, forgive me for trying to speak for you and please correct me if I'm wrong. --Nancy

Re: I did

Robin B. on 6/24/00 at 04:55 (022316)

Nancy is right -- I got better (at least quite a bit better) and not only didn't get a cortisone injection -- WOULDN'T get a cortizone injection. The question to me would be -- why would anyone consider it without having taken most of the non-invasive steps?

Bea is also right. Cortisone does not 'cure' anything. It does not 'heal' you. Cortisone reduces inflammation -- it is an anti-inflammatory -- just like Relafen or Vioxx. There are steroid anti-inflammatories and non-steroid anti-inflammatories, and cortisone is a steroid drug. What it does is reduce inflammation, period. Sometimes its effect lasts a long time. Often -- and especially with feet -- it doesn't.

Beverly, you start your message by saying that your patience is wearing thin -- and the very next line is that you have had PF for 3.5 months. I think, therein, lies some of your frustration. For most of us on this board, PF is a very long-term condition. For me, I personally believe it is lifelong. I believe I have forced it into a combination of healing/remission with my silly Birks and rest mania, bromelain and diet, but that relapse is just around the corner if I don't moderate my life. I CAN say that within the last six months, I have been able to go shopping for hours on end. I can go to craft fairs and antique shows and be on my feet for 5 or 6 hours and be okay. But I would love to paint my condo by myself -- and I'm not yet willing to risk that 8-10 hours on my feet, stretching and pulling and flexing. Paint ain't worth the pain. Nothing is worth the pain.

I was still just searching the Internet for clues at 3.5 months. I had had PF for nearly a year by the time the impact of the Birks kicked in, and Birks were the first major turnaround for me. As I recall, you have only had your Birks for a week or two -- and now you're considering cortisone??? It sounds as if you're looking for a quick fix -- and PF isn't a quick-fix condition. No matter WHAT you try -- taping, PT, stretching, resting, icing, diet, bromelain, shoes -- nothing is going to turn this thing around for you in two days, or even two weeks. An effective remedy will probably take months of experimentation to arrive at. I have met several people in the last year who have had those 'minor' case of PF -- where they went to the doctor, got some NSAIDS, took them, and four months later they were fine. But even those lightweight cases take months and months -- not weeks and weeks.

I have posted to this board to the point where people must see my name and just know what I'm going to write. Time and again I say that many PF sufferers do not allow enough time for remedies to kick in. I took glucosamine sulfate for seven months before I decided to abandon it. Seven months -- not weeks. It took about that long or longer for me to see the impact of low-carb foods.

It's been two years for me. I still have PF. I control it pretty well -- but my life has been changed 100% by it. I used to walk 4-5 miles a day and I don't do that anymore. I'm pretty sure I never will again. I won't take the risk. Yes, I have gained weight as a result of PF and yes, I need to lose it. Weight used to be excessively important to me and walking was a way to moderate it -- but for me, personally, being in 24-hours a day, excrutiating pain taught me how to put things in priority.

It's normal to want to return to your 'previous' life. Everyone does. I do too, and the truth is, I won't. I have accepted other, fairly enjoyable forms of exercise, a different way of eating, funky looking shoes and carrying bromelain around with me wherever I go. I'm so doggone happy to not be in 24-hour pain anymore that absolutely nothing is worth the risk of getting that pain back. Not weight, not exercise, not craft fairs, not painting the condo. Everyday that I can live a fairly normal life, do what I want, shop, vacuum, walk, run errands, visit friends -- and not be in pain -- is a blessing I won't risk for the sake of recapturing my previous life. My 'new' life has made me much more aware of what is important in life, and much more conscious of the debilitating impact that chronic pain carries for me.

So, finally, here's my advice. Bite the bullet. Give yourself an artificial deadline -- say 8 more months -- decide exactly what combinations of remedies you are going to try and apply, and in what order. Then do so. Give anything and everything a fair shot at working, at least a month or two. Keep a journal and write down everything -- and how you seem to respond to it.

By the way, I did have a cortisone injection once in my wrist for a condition that is very similar to carpal tunnel syndrome. The effect lasted six months. Then the pain came back. Eventually I had surgery. I have also cured myself of severe carpal tunnel in both wrists with only non-invasive therapies and a little mega-vitamin experimentation. (I have posted it several times to the board so it's available via search)It took me a long time and it required incredible rest for my hands. That's why I was determined to attack PF in a similar way.



Re: Cortizone: would like medical studies to read & did any of you get better without ever having cortizone?

BJC on 6/24/00 at 09:51 (022319)

What a problem! I had cortisone shots (2) in my right foot, and was taped at the same time. I felt good while the tape was on, but no better afterward. By the time I had surgery a year later, my other foot was almost as bad as the first, so I asked to try a shot in that foot. It worked wonders, and lasted 4 months! Probably the rest post op helped as well. I had more shots in May, both feet, in May, and have been great since. I can be on my feet all day and night (wearing custom orthotics in Reeboks), and there is no limit to my activities. I take no anti-inflammatories, icing does not help, but heat and massage are soothing. But I do have more freedom of movement than in the last 2 years.

Re: I did

Steve P on 6/24/00 at 10:58 (022320)

Robin --- Great post! Thanks for helping us keep things in perspective. We much appreciate it.

Re: THANK YOU FOR SUCH DETAILED POSTS & BIRK QUESTION

Beverly on 6/24/00 at 11:47 (022322)

To everyone who responded,

Thank you for such detailed posts. I appreciate the time you took. (Robin, you are wonderful in your attention to detail!)

From your posts and from rereading all the journal articles on our board, I will wait longer before I even consider cortizone. At this point, the potential rewards don't justify the cost. And Robin, you are right, I need to try each tactic for longer. I like the idea of a journal. I've used it in the past for other things (like tracking food allergies), and I found it very helpful.

I have high hopes for the Birks. I feel like these Arizona's are starting to get broken in, and although they are not a perfect fit (wish they had 1/2) sizes, they feel better than any other shoe I've worn. I need to wait to get more $$, but I'm curious about the Milano's, because the backstrap would hold my foot more securely. I'm also curious about Birk's 'outdoor' sandals that have Velcro straps called 'Sonoma' and 'Ottawa'. I know the Tatani line has a higher arch. I have a somewhat high arch, but not real high.

My only real experience with cortizone has been in the eyedrop form. I have a history of an inflammatory eye condition called 'Iritis.' (Cortizone is the only thing that cures it.) My eye doctor gives me the cortizone eyedrops instead of pills or a shot, because the eyedrops go right to the eye but are less potent to the body than a shot or pills. Too bad, you can't just put something topical like that on the foot!

One thing I am noticing is that sometimes when I get a light friction massage, it makes my foot feel better... especially the heel. But other times, even though the massage itself feels wonderful, within a few hours, my arch starts to hurt, and stays that way for days. I had that happen after a massage yesterday. I sometimes wonder if it's not helping my heel at all, just making my arch hurt so much that it seems like my heel is better, because it hurts less than the arch!

Also, although I can't see any inflammation with my naked eyes, the athletic shoes I bought when I first got this, now feel so tight (even without orthodic), I would not want to wear them. So, that tells me I have inflammation even though I can't see it. My feet are so narrow by nature, I think this inflammation has simply taken me from a size narrow to a size regular width.

I must seem incredibly impatient to those of you who have had this for several years. I'm trying to get more patient. I've had some other miserable conditions, but medical treatment always either fixed them or helped them with time, and I could see progress so much sooner.

Robin, if I could just get to where you are, I would be thrilled. I was never an athlete; so I have no need to run. I do look forward to being able to just do normal things again like take a walk or browse through the grocery store without terrible pain... go to a museum, ect...

Thanks a bunch,
Beverly


Re: Newly Diagnosed

Sandy G on 6/25/00 at 15:34 (022385)

I have just been diagnosed with Plantar Fasciitis. Have had the problem for about 1 month. When I went to my physician I was only inpain for the first 10 steps and then I'd be okay as long as I was moving. After seeing the doctor, I am in constant pain if I even rest my foot on the floor. So far, only my left heel is effective. He started me on using a tennis ball for 10 minutes - twice a day. now it really hurts. Didn't think this was a big deal, but after reading some of the messages, I'm starting to get very discouraged. Has anyone ever had any success with rolling the tennis ball under the ball of your foot. I am also doing stretching exercises.

Re: Newly Diagnosed

JudyS on 6/25/00 at 16:58 (022389)

Sandy, believe it or not - you're in luck. Why? Because you have caught this EARLY so you have a huge chance of overcoming it but ONLY if you follow your Dr. advice to the letter. The most important thing the Doc will tell you is don't overdue. If you exercise regularly on your feet (running, walking, etc.) you should stop immediately. But, because it's so early for you, stopping that exercise may be relatively temporary. You'll find, if you read this board regularly, that many of us exercised through the pain (being macho athletes and all.....) and did nothing but make it worse - to the point of chronicness. Some people here had no choice, though. Some are teachers, nurses, etc. and are forced to be on their feet all day. If you're not forced to, then don't. Conservative treatment, especially this early, would include stretching, icing, massage, ibuprofen, good shoes and so on. Most of that is outlined here in Scott's PF book. The big deal though is NOT to overdue ANY of that. If you can ice, massage and slightly stretch about three times a day, and take an anti-inflammatory (prescribed by your Doc), then your chances are so much better. Try to lightly massage and stretch before you get out of bed, and never go barefoot - not even when you first get up. Remember, the key here is moderation. If you think an extreme calf stretch is the thing to do, you'll find out differently when it only hurts more the next day. Minimal, non-weightbearing stretches include things like sitting on the floor with a towel slung around your toes, then gently pulling your foot towards your body with the towel. Also, just holding your foot and gently pulling back on your toes will help provide a gentle stretch to the fascia. Last, read this board every day! As in all else, too many of us have learned the hard way and if we can help you avoid that then hurray! Be patient and you'll be happy in the long run - this is not cured overnight.

Re: Cortizone: would like medical studies to read & did any of you get better without ever having cortizone?

Barb T. on 6/27/00 at 14:38 (022501)

I have had to cortizone shots....neither helped actually Pf seemed more painful after. I know that some people get relief from them (unfortunately doesnt seem like many). I also have not heard of many who have had permament damage. But, as far as the pain, they do not have to be painful. Ask your Doc, Pod, etc to inject a novocaine substance along with the cortizone. Some doctors do and some don't. Believe, I am the biggest baby when it comes to pain. And the shot I received was a mere pinch and the doctor explained to me about the novocaine he injects with it. Good luck on whatever decision you make.

Re: Cortizone: would like medical studies to read & did any of you get better without ever having cortizone?

Melody on 6/23/00 at 17:36 (022295)

Beveryly,
My first cortisone shot hurt like crazy but after a few days my foot stopped hurting and I felt great for about 3 months. Had another one and it too hurt like crazy and just kept on hurting! I am in more pain since having the second one than I was before it.

I am very afraid of having any others!!!

I have no idea what is the best treatment. I am hoping that if I ignore it, it will all go away!!!

Mel


Re: Cortizone: would like medical studies to read & did any of you get better without ever having cortizone?

laurie R on 6/23/00 at 17:43 (022296)

Hi Beverly,
I don't think this is what you want to hear but I will tell you anyways,I didn't want cortisone either when this all started for me 1 year ago ,so one day I just had it with the pain and I said I should try because if I don't I will never know if this would be the thing that is going to help,so I had my first cortisone shot ,all it did was numb my foot for a few hours and than that was it all the pain was still their , my therapist told me some times it can take 3 shots before it helps I went back and had shot #2 same thing happened just a little bit of numbing and it wore off and all the pain was back .My Pod said thats it if 2 did not help # 3 is not going to help.I do get shots now once in a while but just to numb my nerve in my Tarsel Tunnel area,with no cortisone .I just got one yesterday my foot stayed numb for 8 hours. I forgot to tell you I got both my cortisone shots for TTS not PF I have both .The shots did not hurt at all but they were not put in my heel all have been in my ankle.

All I can say is it might help and maybe not I know some people swear by them and others say it does nothing.

My best to you. Laurie R



Re: Cortizone: would like medical studies to read & did any of you get better without ever having cortizone?

Bea K on 6/23/00 at 18:01 (022297)

Once again, Cortizone does not cure. If you are fortunate it will help the pain for awhile or maybe not and can do damage. It can also cause internal problems. The main thing to remember is that it will not cure and can do damage.

Re: Cortizone: would like medical studies to read & did any of you get better without ever having cortizone?

john h on 6/23/00 at 18:05 (022298)

beverly: you will get different opinions on this board concerning cortisone shots. i had one in each foot and did not find them painful. the painfree effect lasted about 3 weeks for me. i think because my feet were feeling so good after 4 years that i over extended and relapsed. cortisone shots are commonly used in hips, shoulders, wrist, elbows, etc to reduce inflamation and are very effective. some people get lasting results. i have communicated with people who have had over 20 shots in their foot (that is crazy). most doctors i have discussed this with say you can (generally) get 3 shots in a year without much chance of any adverse effects. find a doctor you trust and go with his advice.

Re: Cortizone: would like medical studies to read & did any of you get better without ever having cortizone?

Lori E. on 6/23/00 at 19:13 (022301)

I agree with the other postings. Cortizone shots are NOT something that you want to have alot of. Overuse of cortizone can cause damage. The temporary relief you get can cause you to over do it and make things worse. Plus lots of cortizone can weaken the tissues it is injected into. I suppose some pods may use it as a weeding device to see if it will be a quick fix. I did have one set of shots and they numbed my feet, and then hobbled me for the rest of the week. The shots were administered correctly, on the side of the heels after they were numbed first, but I got no relief from them. The only reason my pod suggested it, and I agreed to it, was I was in tears from so much pain. My pod didn't think with the result I got that I should have any more shots. We moved on to PT and then acupuncture. I found the acupuncture much more effective than a cortizone shots for pain relief in the long run, plus I find the acupuncture doesn't hurt. Just some pinching sometimes, and now I get relief from a treatment for a good week or so.

Re: Cortizone: would like medical studies to read & did any of you get better without ever having cortizone?

Dr. Zuckerman on 6/23/00 at 19:39 (022302)

local steriod injections are used for reduction of excessive edema. Either they work or don't. I have had patients that get an injection that lasts for years. It is my opinion that if it is a bursitis (fluid sac) at the pf insertion it can work. You must have additional
treatment such as taping ,heel cups or orthosis in conjunction with the steriod injection. This is very important!!! Don't just get the shot and not deal with the mechanics of the problem if there is a mechanical problem to begin with. The correct evaluation before the shot is important. Anyway the bursa sac injected for heel pain seens to be the key for sucess. Look at the study on this site that talks about pf rupture with an average of just two shots.

Re: Cortizone: would like medical studies to read & did any of you get better without ever having cortizone?

Pauline on 6/23/00 at 19:49 (022303)

I have had one shot in each foot. They took the inflammation down somewhat but not long lasting. I belive the Orthopedic Surgeon gives more cortisone per treatment than the Pod because when I had this back in 1993 one shot in the bottom of my foot really helped it alot.

Additionally at physical therapy they are using iontophoresis and
dexamethasone. I am experiencing good pain control and inflammation
relief at this time but I am staying off my feet as much as possible.
I do not work so this is pretty easy for me to do.

I am hoping the combination of staying off my feet while getting the
treatments will eliminate the PF, however most others posting here
indicate that this too does not last. We'll see. Just getting pain relief and having the inflammation down is wonderful. I am now able
to do a little stretching and I watch that very carefully so as not
to over do.

This trial and error is difficult because just when you get your hopes up things take a turn for the worse. I really hate haveing PF especially when I see others walking down the street and I'm watching from my sofa.

It would be wonderful if one of us could come up with a simple solution to this disease. I think calling it 'heel pain' is the
worst thing because it does not begin to tell the whole story.


Re: Cortizone: would like medical studies to read & did any of you get better without ever having cortizone?

Nancy S. on 6/23/00 at 20:56 (022307)

Beverly, I don't know where Robin is, but as you know she is doing really well now due mostly to Birks, rest, low-carb diet, and bromelain. I don't think she ever had a cortisone shot. Robin, forgive me for trying to speak for you and please correct me if I'm wrong. --Nancy

Re: I did

Robin B. on 6/24/00 at 04:55 (022316)

Nancy is right -- I got better (at least quite a bit better) and not only didn't get a cortisone injection -- WOULDN'T get a cortizone injection. The question to me would be -- why would anyone consider it without having taken most of the non-invasive steps?

Bea is also right. Cortisone does not 'cure' anything. It does not 'heal' you. Cortisone reduces inflammation -- it is an anti-inflammatory -- just like Relafen or Vioxx. There are steroid anti-inflammatories and non-steroid anti-inflammatories, and cortisone is a steroid drug. What it does is reduce inflammation, period. Sometimes its effect lasts a long time. Often -- and especially with feet -- it doesn't.

Beverly, you start your message by saying that your patience is wearing thin -- and the very next line is that you have had PF for 3.5 months. I think, therein, lies some of your frustration. For most of us on this board, PF is a very long-term condition. For me, I personally believe it is lifelong. I believe I have forced it into a combination of healing/remission with my silly Birks and rest mania, bromelain and diet, but that relapse is just around the corner if I don't moderate my life. I CAN say that within the last six months, I have been able to go shopping for hours on end. I can go to craft fairs and antique shows and be on my feet for 5 or 6 hours and be okay. But I would love to paint my condo by myself -- and I'm not yet willing to risk that 8-10 hours on my feet, stretching and pulling and flexing. Paint ain't worth the pain. Nothing is worth the pain.

I was still just searching the Internet for clues at 3.5 months. I had had PF for nearly a year by the time the impact of the Birks kicked in, and Birks were the first major turnaround for me. As I recall, you have only had your Birks for a week or two -- and now you're considering cortisone??? It sounds as if you're looking for a quick fix -- and PF isn't a quick-fix condition. No matter WHAT you try -- taping, PT, stretching, resting, icing, diet, bromelain, shoes -- nothing is going to turn this thing around for you in two days, or even two weeks. An effective remedy will probably take months of experimentation to arrive at. I have met several people in the last year who have had those 'minor' case of PF -- where they went to the doctor, got some NSAIDS, took them, and four months later they were fine. But even those lightweight cases take months and months -- not weeks and weeks.

I have posted to this board to the point where people must see my name and just know what I'm going to write. Time and again I say that many PF sufferers do not allow enough time for remedies to kick in. I took glucosamine sulfate for seven months before I decided to abandon it. Seven months -- not weeks. It took about that long or longer for me to see the impact of low-carb foods.

It's been two years for me. I still have PF. I control it pretty well -- but my life has been changed 100% by it. I used to walk 4-5 miles a day and I don't do that anymore. I'm pretty sure I never will again. I won't take the risk. Yes, I have gained weight as a result of PF and yes, I need to lose it. Weight used to be excessively important to me and walking was a way to moderate it -- but for me, personally, being in 24-hours a day, excrutiating pain taught me how to put things in priority.

It's normal to want to return to your 'previous' life. Everyone does. I do too, and the truth is, I won't. I have accepted other, fairly enjoyable forms of exercise, a different way of eating, funky looking shoes and carrying bromelain around with me wherever I go. I'm so doggone happy to not be in 24-hour pain anymore that absolutely nothing is worth the risk of getting that pain back. Not weight, not exercise, not craft fairs, not painting the condo. Everyday that I can live a fairly normal life, do what I want, shop, vacuum, walk, run errands, visit friends -- and not be in pain -- is a blessing I won't risk for the sake of recapturing my previous life. My 'new' life has made me much more aware of what is important in life, and much more conscious of the debilitating impact that chronic pain carries for me.

So, finally, here's my advice. Bite the bullet. Give yourself an artificial deadline -- say 8 more months -- decide exactly what combinations of remedies you are going to try and apply, and in what order. Then do so. Give anything and everything a fair shot at working, at least a month or two. Keep a journal and write down everything -- and how you seem to respond to it.

By the way, I did have a cortisone injection once in my wrist for a condition that is very similar to carpal tunnel syndrome. The effect lasted six months. Then the pain came back. Eventually I had surgery. I have also cured myself of severe carpal tunnel in both wrists with only non-invasive therapies and a little mega-vitamin experimentation. (I have posted it several times to the board so it's available via search)It took me a long time and it required incredible rest for my hands. That's why I was determined to attack PF in a similar way.



Re: Cortizone: would like medical studies to read & did any of you get better without ever having cortizone?

BJC on 6/24/00 at 09:51 (022319)

What a problem! I had cortisone shots (2) in my right foot, and was taped at the same time. I felt good while the tape was on, but no better afterward. By the time I had surgery a year later, my other foot was almost as bad as the first, so I asked to try a shot in that foot. It worked wonders, and lasted 4 months! Probably the rest post op helped as well. I had more shots in May, both feet, in May, and have been great since. I can be on my feet all day and night (wearing custom orthotics in Reeboks), and there is no limit to my activities. I take no anti-inflammatories, icing does not help, but heat and massage are soothing. But I do have more freedom of movement than in the last 2 years.

Re: I did

Steve P on 6/24/00 at 10:58 (022320)

Robin --- Great post! Thanks for helping us keep things in perspective. We much appreciate it.

Re: THANK YOU FOR SUCH DETAILED POSTS & BIRK QUESTION

Beverly on 6/24/00 at 11:47 (022322)

To everyone who responded,

Thank you for such detailed posts. I appreciate the time you took. (Robin, you are wonderful in your attention to detail!)

From your posts and from rereading all the journal articles on our board, I will wait longer before I even consider cortizone. At this point, the potential rewards don't justify the cost. And Robin, you are right, I need to try each tactic for longer. I like the idea of a journal. I've used it in the past for other things (like tracking food allergies), and I found it very helpful.

I have high hopes for the Birks. I feel like these Arizona's are starting to get broken in, and although they are not a perfect fit (wish they had 1/2) sizes, they feel better than any other shoe I've worn. I need to wait to get more $$, but I'm curious about the Milano's, because the backstrap would hold my foot more securely. I'm also curious about Birk's 'outdoor' sandals that have Velcro straps called 'Sonoma' and 'Ottawa'. I know the Tatani line has a higher arch. I have a somewhat high arch, but not real high.

My only real experience with cortizone has been in the eyedrop form. I have a history of an inflammatory eye condition called 'Iritis.' (Cortizone is the only thing that cures it.) My eye doctor gives me the cortizone eyedrops instead of pills or a shot, because the eyedrops go right to the eye but are less potent to the body than a shot or pills. Too bad, you can't just put something topical like that on the foot!

One thing I am noticing is that sometimes when I get a light friction massage, it makes my foot feel better... especially the heel. But other times, even though the massage itself feels wonderful, within a few hours, my arch starts to hurt, and stays that way for days. I had that happen after a massage yesterday. I sometimes wonder if it's not helping my heel at all, just making my arch hurt so much that it seems like my heel is better, because it hurts less than the arch!

Also, although I can't see any inflammation with my naked eyes, the athletic shoes I bought when I first got this, now feel so tight (even without orthodic), I would not want to wear them. So, that tells me I have inflammation even though I can't see it. My feet are so narrow by nature, I think this inflammation has simply taken me from a size narrow to a size regular width.

I must seem incredibly impatient to those of you who have had this for several years. I'm trying to get more patient. I've had some other miserable conditions, but medical treatment always either fixed them or helped them with time, and I could see progress so much sooner.

Robin, if I could just get to where you are, I would be thrilled. I was never an athlete; so I have no need to run. I do look forward to being able to just do normal things again like take a walk or browse through the grocery store without terrible pain... go to a museum, ect...

Thanks a bunch,
Beverly


Re: Newly Diagnosed

Sandy G on 6/25/00 at 15:34 (022385)

I have just been diagnosed with Plantar Fasciitis. Have had the problem for about 1 month. When I went to my physician I was only inpain for the first 10 steps and then I'd be okay as long as I was moving. After seeing the doctor, I am in constant pain if I even rest my foot on the floor. So far, only my left heel is effective. He started me on using a tennis ball for 10 minutes - twice a day. now it really hurts. Didn't think this was a big deal, but after reading some of the messages, I'm starting to get very discouraged. Has anyone ever had any success with rolling the tennis ball under the ball of your foot. I am also doing stretching exercises.

Re: Newly Diagnosed

JudyS on 6/25/00 at 16:58 (022389)

Sandy, believe it or not - you're in luck. Why? Because you have caught this EARLY so you have a huge chance of overcoming it but ONLY if you follow your Dr. advice to the letter. The most important thing the Doc will tell you is don't overdue. If you exercise regularly on your feet (running, walking, etc.) you should stop immediately. But, because it's so early for you, stopping that exercise may be relatively temporary. You'll find, if you read this board regularly, that many of us exercised through the pain (being macho athletes and all.....) and did nothing but make it worse - to the point of chronicness. Some people here had no choice, though. Some are teachers, nurses, etc. and are forced to be on their feet all day. If you're not forced to, then don't. Conservative treatment, especially this early, would include stretching, icing, massage, ibuprofen, good shoes and so on. Most of that is outlined here in Scott's PF book. The big deal though is NOT to overdue ANY of that. If you can ice, massage and slightly stretch about three times a day, and take an anti-inflammatory (prescribed by your Doc), then your chances are so much better. Try to lightly massage and stretch before you get out of bed, and never go barefoot - not even when you first get up. Remember, the key here is moderation. If you think an extreme calf stretch is the thing to do, you'll find out differently when it only hurts more the next day. Minimal, non-weightbearing stretches include things like sitting on the floor with a towel slung around your toes, then gently pulling your foot towards your body with the towel. Also, just holding your foot and gently pulling back on your toes will help provide a gentle stretch to the fascia. Last, read this board every day! As in all else, too many of us have learned the hard way and if we can help you avoid that then hurray! Be patient and you'll be happy in the long run - this is not cured overnight.

Re: Cortizone: would like medical studies to read & did any of you get better without ever having cortizone?

Barb T. on 6/27/00 at 14:38 (022501)

I have had to cortizone shots....neither helped actually Pf seemed more painful after. I know that some people get relief from them (unfortunately doesnt seem like many). I also have not heard of many who have had permament damage. But, as far as the pain, they do not have to be painful. Ask your Doc, Pod, etc to inject a novocaine substance along with the cortizone. Some doctors do and some don't. Believe, I am the biggest baby when it comes to pain. And the shot I received was a mere pinch and the doctor explained to me about the novocaine he injects with it. Good luck on whatever decision you make.