Home The Book Dr Articles Products Message Boards Journal Articles Search Our Surveys Surgery ESWT Dr Messages Find Good Drs video

the tough cases that nothing helps !!!- Fatigue Perturbation of the Os Calcis.

Posted by Dr. Zuckerman on 8/06/00 at 14:33 (024762)

there is an article from The Journal of Foot and Ankle Surgery dated 1994. The title is called Fatigue Perturbation of the Os Calcis.
The article talks about the stages of stress fracture of the heel bone. The author and Dr. Zuckerman feel that the problem is from the heel bone and that the plantar fasciitis is secondary. Due to the continual walking and standing on the heel there are micro-cracks in the heel pain. The only way to determine this is by bone scan and mri. The treatment is the use of bone stimulator and screw fixation of the heel to rest the heel bone traction . This article gives specific stages, case studies and results. Conclusion: Get a bone scan
and an mri on the tough cases that you have ruled out other levels causing the problem such as the back. I tried to scan this article but it is ten pages and difficult to scan. Any one wanting this article just give me your address and i will have copies made for mailing.

Re: the tough cases that nothing helps !!!- Fatigue Perturbation of the Os Calcis.

alan k on 8/06/00 at 14:43 (024763)

you can send me one, if it is not too much trouble, at 1298 Annandale Road, Red Hook NY 12571.


thanks Dr. Z!

I'm getting my back MRI result tommorrow, and if negative I want to push for a foot one next.


Re: the tough cases that nothing helps !!!- Fatigue Perturbation of the Os Calcis.

Dr. Zuckerman on 8/06/00 at 15:32 (024765)

I guess I need your last name. You can fax your complete name and address to my office at 1-856-848-5122 or e-mail at (email removed)

Re: the tough cases that nothing helps !!!- Fatigue Perturbation of the Os Calcis.

john h on 8/07/00 at 09:37 (024820)

dr z: if you have tiny stress fractures in your heel should you not be able to squeeze the heel from the sides and reproduce pain? should not the pain manifest itself as pain in the heel itself rather than the arch? if you had a cortisone shot into the area of the fascia where it attaches to the heel and you were pain free for 3 weeks would this not rule out stress fractures of the heel? i do not know the answers to these question i am asking?

Re: the tough cases that nothing helps !!!- Fatigue Perturbation of the Os Calcis.

Dr. Zuckerman on 8/07/00 at 17:25 (024849)

Usually pain is on lateral compression of the heel bone. Usually no relief at all from steriod injections. Usually pain all the time with increase pain with increase standing or walking. If the patient has had no relief at all and the pain is extreme then I would begin to look for stress fracture. This article is for the cases that the entire foot,ankle hurts and you can stand for any length of time at all. I hope I decide declare a search and destroy mission for stress fractures. That wasn't my intent. I kmow that there are people on this site that are in alot of pain with nothing working at all . These are the ones that should have a stress fracture search.

Re: the tough cases that nothing helps !!!- Fatigue Perturbation of the Os Calcis.

Nancy M on 8/07/00 at 21:33 (024866)

Dr. Z. I have a stress fracture in my cuboid bone. I don't believe this is the same place mentioned in the above messages. My Pod told me this is a soft bone and takes a long time to heal. The only way we found it was when I had a bone scan done. I've been in a hard cast, soft cast with cam/walking boot, and just my cam/walking boot since April 27th. On crutches for 4 weeks non-weight bearing and about 2 weeks weight bearing as I could tolerate. Going this Friday for another bone scan to make sure it's completely healed before we remove the boot.

Nancy M in AZ


Re: the tough cases that nothing helps !!!- Fatigue Perturbation of the Os Calcis.

Kathy on 8/08/00 at 06:54 (024878)

This is interesting since I did have a positive bone scan and when I asked my pod. what that ment he told me that my heel spurs had probably cracked or fractured. I still plan on ESWT and wonder if this will affect me going ahead with my plans, I must also mention this was 1 year ago that I had the scan.

Re: the tough cases that nothing helps !!!- Fatigue Perturbation of the Os Calcis.

alan k on 8/06/00 at 14:43 (024763)

you can send me one, if it is not too much trouble, at 1298 Annandale Road, Red Hook NY 12571.


thanks Dr. Z!

I'm getting my back MRI result tommorrow, and if negative I want to push for a foot one next.


Re: the tough cases that nothing helps !!!- Fatigue Perturbation of the Os Calcis.

Dr. Zuckerman on 8/06/00 at 15:32 (024765)

I guess I need your last name. You can fax your complete name and address to my office at 1-856-848-5122 or e-mail at (email removed)

Re: the tough cases that nothing helps !!!- Fatigue Perturbation of the Os Calcis.

john h on 8/07/00 at 09:37 (024820)

dr z: if you have tiny stress fractures in your heel should you not be able to squeeze the heel from the sides and reproduce pain? should not the pain manifest itself as pain in the heel itself rather than the arch? if you had a cortisone shot into the area of the fascia where it attaches to the heel and you were pain free for 3 weeks would this not rule out stress fractures of the heel? i do not know the answers to these question i am asking?

Re: the tough cases that nothing helps !!!- Fatigue Perturbation of the Os Calcis.

Dr. Zuckerman on 8/07/00 at 17:25 (024849)

Usually pain is on lateral compression of the heel bone. Usually no relief at all from steriod injections. Usually pain all the time with increase pain with increase standing or walking. If the patient has had no relief at all and the pain is extreme then I would begin to look for stress fracture. This article is for the cases that the entire foot,ankle hurts and you can stand for any length of time at all. I hope I decide declare a search and destroy mission for stress fractures. That wasn't my intent. I kmow that there are people on this site that are in alot of pain with nothing working at all . These are the ones that should have a stress fracture search.

Re: the tough cases that nothing helps !!!- Fatigue Perturbation of the Os Calcis.

Nancy M on 8/07/00 at 21:33 (024866)

Dr. Z. I have a stress fracture in my cuboid bone. I don't believe this is the same place mentioned in the above messages. My Pod told me this is a soft bone and takes a long time to heal. The only way we found it was when I had a bone scan done. I've been in a hard cast, soft cast with cam/walking boot, and just my cam/walking boot since April 27th. On crutches for 4 weeks non-weight bearing and about 2 weeks weight bearing as I could tolerate. Going this Friday for another bone scan to make sure it's completely healed before we remove the boot.

Nancy M in AZ


Re: the tough cases that nothing helps !!!- Fatigue Perturbation of the Os Calcis.

Kathy on 8/08/00 at 06:54 (024878)

This is interesting since I did have a positive bone scan and when I asked my pod. what that ment he told me that my heel spurs had probably cracked or fractured. I still plan on ESWT and wonder if this will affect me going ahead with my plans, I must also mention this was 1 year ago that I had the scan.