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What problems does heel spur surgery address.

Posted by Dr. Zuckerman on 8/15/00 at 22:35 (025529)

I would like to comment on the exact pain symptoms that heel spur surgery will address and what it does help. Heel spur syndrome is when you have pain and limping after sitting for any length of time and then start to walk. The pain and or limping usually will be reduced after walking it can last anywhere from five minutes to hours. If you have constant pain thru out the day then surgery may not be in your best interest. Most doctors who treat heel pain should and will agree that it is heel spur syndrome that you are addressing when you do any type of pf release be it EPF, open release, or mis procedure.

Re: What problems does heel spur surgery address.

suzi d on 8/15/00 at 23:03 (025534)

Dr. Z,
Thanks for the explanation, but I have a question as to where the pain is located during those first minutes or hours when you walk after rest. Is it in the arch or in the heel itself? The pain in the bottom of my arch has left and now it's only the outside of the heel and the area between the ankle and arch in the soft tissue that hurts like the dickens after rest. Hope that was explained correctly.
Thanks for all the helpful advice you've given to everyone.


Re: What problems does heel spur surgery address.

Dr. Zuckerman on 8/16/00 at 00:18 (025540)

The pain is in the heel bone, where the plantar fascia is attached.
This is called the medial tuberosity. If you look at the heel chart on this web site. it is in the area of the #7 site. When I examine the feet the pain on palpation is where the medial and or central band attaches to the inside of the heel bone. I am not sure where your are talking about with your description. Sorry!!

Re: What problems does heel spur surgery address.

john a on 8/16/00 at 10:03 (025553)

I have pain on palpation where the PF attaches to the heel, but no first step pain - the pain just increases the longer I walk or stand, necessitating sitting after at most 10 minutes. It is slightly more comfortable walking than just standing still. I can't even be *IN* shoes for very long before pain starts without my feet even touching the floor. In fact, even with shoes off, and sitting, with my feet just dangling, it gets uncomfortable. All this ultrasensitivity makes me think its caused by swelling, perhaps directly compressing the nerve. However, visually, the swelling seems to be minimal. Any comments? Similar situations?

Re: What problems does heel spur surgery address.

wendyn on 8/16/00 at 12:43 (025572)

John, that sounds like me when my TTS was worse. 10 min max standing, and I had to elevate my feet even when sitting because otherwise it felt like they would pop. Shoes always hurt.

Happy to say that I feel as though I am on the road to almost full recovery. I can pretty much do whatever I need to do now, but I would not try running or hiking. I am going to the zoo tomorrow!!! I am so excited I could burst. The zoo is a big deal (as you know) for anyone with foot problems.

Have you investigated the possibility of nerve entrapment (I'm sorry, I cannot remember your situation exactly).


Re: What problems does heel spur surgery address.

john a on 8/16/00 at 13:08 (025576)

Everytime I read you guys discussing TTS, it didn't seem to apply to me - no numbness, no redness, (although my feet do get hot, mostly after dinner), no Tinel's sign. I also had a nerve conduction test almost a year ago now, performed by a neurologist that uncovered nothing unusual, and even a year ago, my symptoms were pretty much the same as now.

Re: What problems does heel spur surgery address.

AmyM on 8/16/00 at 14:03 (025578)

Dear John
I have a similar type of pain to what you describe, I have no pain in the morning but it worsens all day, the pain in my heel is not localised though. Standing is worse, but I think thats because I think about it more. There isn't any swelling on the sole of my feet, but the AT, thats a different story!

AmyM


Re: What problems does heel spur surgery address.

john h on 8/16/00 at 18:52 (025597)

john a: i was reading an article today in the Wheeless Book of Orthopedics that about 50% of EMG test will give you a false negative which is about what value my surgeon put on the test. You may test negative for tts and still have it or the other way around.

Re: What problems does heel spur surgery address.

suzi d on 8/15/00 at 23:03 (025534)

Dr. Z,
Thanks for the explanation, but I have a question as to where the pain is located during those first minutes or hours when you walk after rest. Is it in the arch or in the heel itself? The pain in the bottom of my arch has left and now it's only the outside of the heel and the area between the ankle and arch in the soft tissue that hurts like the dickens after rest. Hope that was explained correctly.
Thanks for all the helpful advice you've given to everyone.


Re: What problems does heel spur surgery address.

Dr. Zuckerman on 8/16/00 at 00:18 (025540)

The pain is in the heel bone, where the plantar fascia is attached.
This is called the medial tuberosity. If you look at the heel chart on this web site. it is in the area of the #7 site. When I examine the feet the pain on palpation is where the medial and or central band attaches to the inside of the heel bone. I am not sure where your are talking about with your description. Sorry!!

Re: What problems does heel spur surgery address.

john a on 8/16/00 at 10:03 (025553)

I have pain on palpation where the PF attaches to the heel, but no first step pain - the pain just increases the longer I walk or stand, necessitating sitting after at most 10 minutes. It is slightly more comfortable walking than just standing still. I can't even be *IN* shoes for very long before pain starts without my feet even touching the floor. In fact, even with shoes off, and sitting, with my feet just dangling, it gets uncomfortable. All this ultrasensitivity makes me think its caused by swelling, perhaps directly compressing the nerve. However, visually, the swelling seems to be minimal. Any comments? Similar situations?

Re: What problems does heel spur surgery address.

wendyn on 8/16/00 at 12:43 (025572)

John, that sounds like me when my TTS was worse. 10 min max standing, and I had to elevate my feet even when sitting because otherwise it felt like they would pop. Shoes always hurt.

Happy to say that I feel as though I am on the road to almost full recovery. I can pretty much do whatever I need to do now, but I would not try running or hiking. I am going to the zoo tomorrow!!! I am so excited I could burst. The zoo is a big deal (as you know) for anyone with foot problems.

Have you investigated the possibility of nerve entrapment (I'm sorry, I cannot remember your situation exactly).


Re: What problems does heel spur surgery address.

john a on 8/16/00 at 13:08 (025576)

Everytime I read you guys discussing TTS, it didn't seem to apply to me - no numbness, no redness, (although my feet do get hot, mostly after dinner), no Tinel's sign. I also had a nerve conduction test almost a year ago now, performed by a neurologist that uncovered nothing unusual, and even a year ago, my symptoms were pretty much the same as now.

Re: What problems does heel spur surgery address.

AmyM on 8/16/00 at 14:03 (025578)

Dear John
I have a similar type of pain to what you describe, I have no pain in the morning but it worsens all day, the pain in my heel is not localised though. Standing is worse, but I think thats because I think about it more. There isn't any swelling on the sole of my feet, but the AT, thats a different story!

AmyM


Re: What problems does heel spur surgery address.

john h on 8/16/00 at 18:52 (025597)

john a: i was reading an article today in the Wheeless Book of Orthopedics that about 50% of EMG test will give you a false negative which is about what value my surgeon put on the test. You may test negative for tts and still have it or the other way around.