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TO DR. Z......DESPARATE.....WHAT DO I DO NOW?

Posted by JUDY S on 8/25/00 at 11:11 (026186)

I'M A 47 YO W/ HEEL PAIN X 3YRS SINCE BEING GIVEN A PAIR OR RIGID ORTHOTICS TO PREVENT PROGRESSION OF (B) BUNIONS AND INJURING MY HEELS AFTER WALKING 2 MI. W/ THEM. WAS GIVEN SEMI-RIGID ORTHOTICS FOR CONTNUED HEEL PAIN (INTENSE ACHING WITH STANDING IN ONE SPOT) THAT REINJURED MY HEELS AS THE POST WAS IN THE MIDDLE OF THE HEEL WHERE THE HEEL PAIN WAS. WAS PUT INTO CAST BOOTS X 2 MO. (TILL 6/2000)WHICH ATROPHIED MY CALVES AND TIGHTENED UP MS/TENDONS IN MY FEET. I AM TRYING TO RESTRETCH/STRENGHTEN MY FEET AND I AM WALKING VERY LITTLE. CURRENTLY WEARING LEATHER SEMI-RIGID ORTHOTICS WITH ARCH SUPPORT AND SOFT SPOT UNDER MIDDLE OF HEEL IN P.W. MINOR EXTRA DEPTH SHOES WHICH DOES NOT SEEM TO BE WORKING (?SHOES TOO ROOMY/ORTHOTICS NEED ADJUSTING/CHANGING)...MRI SHOWED SWELLING/BRUISING, NCS SHOWED TTS HOWEVER I HAVE A NEG. TINEL'S SIGN, XRAYS/BONE SCANS NEGATIVE. I HAVE NEVER HAD SHARP PAIN UPON WTBEARING FIRST THING IN AM ETC. CURRENT SYMPTOMS...SWELLING ACROSS FRONT OF HEEL INCREASES W/ WEIGHTBEARING; SHOCK SENSATION W/ WEIGHTBEARING ON (R) HEEL, RAW/TINGLY FEELING ON BOTTOM OF FEET THAT INCREASES WITH INCREASED WTBEARING/STRETCHING, TEARING FEELING IF I TRY TO WALK AT A NORMAL PACE W/ NORMAL GAIT PATTERN, ARCH OF ORTHOTIC UNCOMFORTABLE W/ STANDING > FEW MINUTES.........ANY SUGGESTIONS WHAT TO DO NOW???

Re: TO DR. Z......DESPARATE.....WHAT DO I DO NOW?

suzi on 8/25/00 at 12:13 (026192)

Dr. Z it scares me that the hard orthodics made judy worse, could it be that they weren't made properly? I am having a hard pair of ucbl's made next week and if they make my feet worse, i'm in bigggggggg trouble. any suggestions?? It's awful she ended up worse off!

Re: TO DR. Z......DESPARATE.....WHAT DO I DO NOW?

Dr. Zuckerman on 8/25/00 at 15:12 (026196)

Don't worry . It is very rare but possible. Just break in the orthosis slowly and if it increases the pain. Then stop wearing and start over very slowly (increase time one hour each day.) . If after the second time you can't wear them , give up

Re: TO DR. Z......DESPARATE.....WHAT DO I DO NOW?

Dr. Zuckerman on 8/25/00 at 15:18 (026198)

I would go see a board certified pain specialist to see if an epidural would help stop this pain cycle.

Re: TO DR. Z......DESPARATE.....WHAT DO I DO NOW?

cindyp on 8/25/00 at 18:59 (026219)

What my question then is how do you know when to throw them out. I have had mine maybe three months and have seen no difference. Still in pain. GO to see the pain management people on Wednesday. Have a sense of dread about that but that is probably the 'wonderful' experiences I have had thus far.

Re: TO DR. Z......DESPARATE.....WHAT DO I DO NOW?

Dr. Zuckerman on 8/25/00 at 19:35 (026223)

I am sorry if I repeat the question before the answer. WE are talking about orthosis. (foot inserts.) After three months if they aren't helping then either an adjustment, if they aren't causing additional problems (pain) then you could be getting help but help only comparative to what what of pain would you be in without wearing the foot orthosis.

Re: Leather orthotics

Dr. Biehler on 8/25/00 at 20:58 (026237)

Leather orthotics can be functional but by design they are suppost to be accomodative. This means they are suppost to feel good. The fact that they are made out of leather means they should be very easy to adjust so when you are just standing, they feel good. Not having the pain with the firt step in the morning tends to bring your diagnosis away from the plantar fasciitis and more over to the bursitis or bone bruse. The leather orthotics should have a deep heel cup that wraps you heel and hold the fat pad under the heel bone where it can do some good. Dr Biehler

Re: TO DR. Z......DESPARATE.....WHAT DO I DO NOW?

cindyp on 8/26/00 at 08:51 (026260)

Can honestly say not much of a difference. No better No worse.

Re: TO DR. Z......DESPARATE.....WHAT DO I DO NOW?

Dr. Zuckerman on 8/26/00 at 14:11 (026279)

Go back to the doctor or whoever made them. Dr. Biehler's advice on leather orthosis is a great idea. If they still hurt . You need additional evaluation and different treatment plan. They may be too hard for you. Sometimes starting with a leather orthosis and then going to a semi-rigid could do the trick.. I like to use tape before any orthosis is made to determine what kind of benefit the patient can get from biomechanical correction,.

Re: TO DR. Z......DESPARATE.....WHAT DO I DO NOW?

cindyp on 8/26/00 at 18:06 (026285)

Well that's the thing as of now they plan to not treat me. Not much of nothing but on to the pain clinic on Wednesday. No taping, no physical therapy, no operation to remove neuroma. Nothing.

Re: TO DR. Z......DESPARATE.....WHAT DO I DO NOW?

suzi on 8/25/00 at 12:13 (026192)

Dr. Z it scares me that the hard orthodics made judy worse, could it be that they weren't made properly? I am having a hard pair of ucbl's made next week and if they make my feet worse, i'm in bigggggggg trouble. any suggestions?? It's awful she ended up worse off!

Re: TO DR. Z......DESPARATE.....WHAT DO I DO NOW?

Dr. Zuckerman on 8/25/00 at 15:12 (026196)

Don't worry . It is very rare but possible. Just break in the orthosis slowly and if it increases the pain. Then stop wearing and start over very slowly (increase time one hour each day.) . If after the second time you can't wear them , give up

Re: TO DR. Z......DESPARATE.....WHAT DO I DO NOW?

Dr. Zuckerman on 8/25/00 at 15:18 (026198)

I would go see a board certified pain specialist to see if an epidural would help stop this pain cycle.

Re: TO DR. Z......DESPARATE.....WHAT DO I DO NOW?

cindyp on 8/25/00 at 18:59 (026219)

What my question then is how do you know when to throw them out. I have had mine maybe three months and have seen no difference. Still in pain. GO to see the pain management people on Wednesday. Have a sense of dread about that but that is probably the 'wonderful' experiences I have had thus far.

Re: TO DR. Z......DESPARATE.....WHAT DO I DO NOW?

Dr. Zuckerman on 8/25/00 at 19:35 (026223)

I am sorry if I repeat the question before the answer. WE are talking about orthosis. (foot inserts.) After three months if they aren't helping then either an adjustment, if they aren't causing additional problems (pain) then you could be getting help but help only comparative to what what of pain would you be in without wearing the foot orthosis.

Re: Leather orthotics

Dr. Biehler on 8/25/00 at 20:58 (026237)

Leather orthotics can be functional but by design they are suppost to be accomodative. This means they are suppost to feel good. The fact that they are made out of leather means they should be very easy to adjust so when you are just standing, they feel good. Not having the pain with the firt step in the morning tends to bring your diagnosis away from the plantar fasciitis and more over to the bursitis or bone bruse. The leather orthotics should have a deep heel cup that wraps you heel and hold the fat pad under the heel bone where it can do some good. Dr Biehler

Re: TO DR. Z......DESPARATE.....WHAT DO I DO NOW?

cindyp on 8/26/00 at 08:51 (026260)

Can honestly say not much of a difference. No better No worse.

Re: TO DR. Z......DESPARATE.....WHAT DO I DO NOW?

Dr. Zuckerman on 8/26/00 at 14:11 (026279)

Go back to the doctor or whoever made them. Dr. Biehler's advice on leather orthosis is a great idea. If they still hurt . You need additional evaluation and different treatment plan. They may be too hard for you. Sometimes starting with a leather orthosis and then going to a semi-rigid could do the trick.. I like to use tape before any orthosis is made to determine what kind of benefit the patient can get from biomechanical correction,.

Re: TO DR. Z......DESPARATE.....WHAT DO I DO NOW?

cindyp on 8/26/00 at 18:06 (026285)

Well that's the thing as of now they plan to not treat me. Not much of nothing but on to the pain clinic on Wednesday. No taping, no physical therapy, no operation to remove neuroma. Nothing.