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Posted by Michael McDonald on 9/23/00 at 10:08 (028937)

If anybody is out there who can give me some advice I would greatly appreciate it. I came down with this heel pain on the first day of my honeymoon in Disneyland over a year ago and have been living with this pain ever since. I have tried physical therapy, a stretching tool and every other option except surgery. After a visit to my doctor yesterday he says my heel spur has gotten bigger and he says that we should now try surgery since all options have been tried. Tomorrow I am going for a second opinion and am really nervous. All of the results I see are not very encouraging and I wonder what will happen if surgery does not work. My job entails being on my feet all day so naturally I am concerned about that and recovery time from surgery. Another dilemna I have is now that I decided to go ahead with surgery my foot seems to be better and I don't understand that because the last time I went to the doctor he did not do anything different than all the other times when he gave me a needle to release the fluid from the bursa sac. I know I am rambling alot but I need somebody to talk to who has gone through a similar situation, help!Mike

Re: surgery

Dr. Biehler on 9/23/00 at 10:39 (028938)

A bursa sack developes to protect the heel from too much pounding. When the repetative pressure is taken off the heel the bursa sack reabsorbs. This is different from surgery for plantar fasciitis. First be sure what you are trying to treat.

Re: surgery

Dr. Biehler on 9/23/00 at 17:39 (028969)

It is very rare that the spur by itself causes pain. If your doctor says your spur is growing ( I have never seen one grow) there might be another process going on there. An x-ray showing the type of bone growth and its consistency should tell alot

Re: surgery

john h on 9/23/00 at 18:38 (028975)

michael: i would sure try ESWT before surgery!!!!!! i have had both. i talked to a guy thursday at Dr Z's office. He had bi-laterial PF. another doctor had done surgery on one foot. and dr Z had done ESWT on the other foot. the foot that Dr Z did the ESWT on had been pain free since early august and he works on his feet all day. The foot that some doctor had done a release on apparentlly was not bothering him with PF but had some major arthritis on top of the foot. i was supprised to see how much the bottom of the foot had collapsed as a result of the PF release. my release looks nothing like his as the bottom of my feet both look the same. no collapse as the surgeon release very little of the fascia. like i said, i would work the night shift and overtime to pay for the ESWT to give it a shot before surgery.

Re: surgery

lenore r on 9/26/00 at 17:56 (029207)

couldnt help but respond to this heel spur growth. if it doesnt grow how does it get there?? i just had surgery 2 weeks ago and as they were rolling me out of the operating room i looked up to see the x-rays and was i surprised at the size my heel spur had become. i remember the last x-ray i saw the spur was very small and hard to see but i had no problem seeing this one. even asked doctor to see the x-rays on my first visit post-op to be sure i wasnt just seeing things!! just to add a note the foot is doing great and im up and walking with no pain , spent 3 years trying to cure this should have done the surgery a long time ago. stiches out after 10 days and am now in a cam walker.

Re: surgery

Dr. Biehler on 9/26/00 at 18:47 (029209)

After surgery osteoclasts are stimulated starting new bone growth. When some one has a heel spur syndrome the spur is usually very slow in growing as a responce to chronic trama. If the size of a spur is increasing at a rate that is easy to detect there are other abnormalities and causes of bone growth that need to be ruled out.

Re: surgery

michael on 9/26/00 at 19:31 (029213)

Thanks for the vote of confidence Ienore, the foot I think that I have to decided to have surgery on seems a little better but my other foot seems like it might be starting the same thing.

Re: surgery

michael on 9/26/00 at 19:39 (029214)

Thanks alot for your advice. I am going for my second opinion tomorrow. Ever since in my mind I have decided to have surgery my left foot has felt alot better. I wonder if it isn't pschosomatic. My other foot feels like it is starting to develop the same thing, I wonder if it is because I have been favoring for almost a year my bad foot. We will see what he says and I will post it.

Re: surgery

lenore r on 9/26/00 at 19:56 (029217)

if im remembering right the last x-rays were about 10 months to a year ago. my dr. sent me for all kinds of tests to rule out other problems, cat scan ,mri , tri phase bone scan, sent to neurologist and rhumetoligst. cat scan showed the spurs , bone scan came back hot, neuro tests were neg and rhumetologist didnt come up with anything . also had all blood work done everything normal!! thats when after 3 years i went for the surgery, so we will see how it turns out. might you have done something different??

Re: surgery

lenore r on 9/26/00 at 20:01 (029219)

mike if feet are feeling better you might want to hold off on surgery, as i have been told over they years and by all of the 4 foot drs ive seen that sometimes this monster corrects itself and goes away. what else besides pt and streches have you tried??

Re: surgery

Michael on 9/29/00 at 08:12 (029396)

I just went for my 2nd opinion and he injected with me with cortisone for the first time, he was suprised my doctor had not tried that before. It has been 3 days and my foot has felt a little better but I do not know if it is the injection or the tape job he did, will know more Monday when I take the tape off and have a full day of work. He really didn't recommend the full cut type of surgery which has a long recovery but said it might be better to try a small incision and take a partial endo procedure which is less recovery time. I guess I have some decisions to make.

Re: surgery

Lesu on 9/29/00 at 21:12 (029485)

I have had my PF with a heel spur for at least 14 months. My first Dr. just said I had heel spurs and put me on Celebrex. Said he did not like to do cortisone shots because they hurt so much... I changed Drs for that and other reasons. New doc gave me an injection (in Dec.99) and it did hurt, but it was worth it, 'cause it DID help. For about 3 months. Two more injections with no results. Referred to Orthopedic Surgeon (June,00). Sent to PT. Night splint, stretches and custom orthotics. Pain remained. (July,00) Ortho. schedules PF release surg. for late Sept. Went to a Podiatrist for 2nd opinion (July ,00). Another injection and taping, which helped about 50 % with pain. Went back to PT to build up orthotics a little more. After those did not work satisfactorily, reconciled myself to surgery. Had it 9/21/00. I will return for my follow-up visit and to remove stitches 10/2/00. No cast, just bulky bandage and a fracture shoe. Podiatrist suggested that I wear the night splint post-op since Ortho. said he did not use a cast. I have been alternating using the fracture shoe and night splint while awake. I'm still pretty sore, but only needed 1 Vicodin today. Like others, my other foot is now beginning with the same symptoms.

Re: surgery

dianej on 10/19/00 at 05:38 (030821)

hi mike. good luck with youre recovery, i can sympathize with you, you need to be sure ask for a M R I to be done first before contenplating surgery, a orthopedic (foot) surgeon would be my only choice. i have had spur removed times 2 ops 12 months apart, with good result for a short few years, but not all cases the same, im about to have major surgery on same foot much pain in same area, have tried orthopedics, i have had 3 opinions from foot surgeons, make sure you ask all relevant questions, you sound young with good years ahead, i have been now approx 8-9 years now with these probs

Re: surgery

chrisJ on 10/19/00 at 15:04 (030849)

I had my surgery done by a podiatrist on 10/6. I am having very little pain and I am walking two weeks after surgery. All I have are a few bandages and a protective shoe. I get the stiches out on Friday.

Re: surgery

Dr. Biehler on 9/23/00 at 10:39 (028938)

A bursa sack developes to protect the heel from too much pounding. When the repetative pressure is taken off the heel the bursa sack reabsorbs. This is different from surgery for plantar fasciitis. First be sure what you are trying to treat.

Re: surgery

Dr. Biehler on 9/23/00 at 17:39 (028969)

It is very rare that the spur by itself causes pain. If your doctor says your spur is growing ( I have never seen one grow) there might be another process going on there. An x-ray showing the type of bone growth and its consistency should tell alot

Re: surgery

john h on 9/23/00 at 18:38 (028975)

michael: i would sure try ESWT before surgery!!!!!! i have had both. i talked to a guy thursday at Dr Z's office. He had bi-laterial PF. another doctor had done surgery on one foot. and dr Z had done ESWT on the other foot. the foot that Dr Z did the ESWT on had been pain free since early august and he works on his feet all day. The foot that some doctor had done a release on apparentlly was not bothering him with PF but had some major arthritis on top of the foot. i was supprised to see how much the bottom of the foot had collapsed as a result of the PF release. my release looks nothing like his as the bottom of my feet both look the same. no collapse as the surgeon release very little of the fascia. like i said, i would work the night shift and overtime to pay for the ESWT to give it a shot before surgery.

Re: surgery

lenore r on 9/26/00 at 17:56 (029207)

couldnt help but respond to this heel spur growth. if it doesnt grow how does it get there?? i just had surgery 2 weeks ago and as they were rolling me out of the operating room i looked up to see the x-rays and was i surprised at the size my heel spur had become. i remember the last x-ray i saw the spur was very small and hard to see but i had no problem seeing this one. even asked doctor to see the x-rays on my first visit post-op to be sure i wasnt just seeing things!! just to add a note the foot is doing great and im up and walking with no pain , spent 3 years trying to cure this should have done the surgery a long time ago. stiches out after 10 days and am now in a cam walker.

Re: surgery

Dr. Biehler on 9/26/00 at 18:47 (029209)

After surgery osteoclasts are stimulated starting new bone growth. When some one has a heel spur syndrome the spur is usually very slow in growing as a responce to chronic trama. If the size of a spur is increasing at a rate that is easy to detect there are other abnormalities and causes of bone growth that need to be ruled out.

Re: surgery

michael on 9/26/00 at 19:31 (029213)

Thanks for the vote of confidence Ienore, the foot I think that I have to decided to have surgery on seems a little better but my other foot seems like it might be starting the same thing.

Re: surgery

michael on 9/26/00 at 19:39 (029214)

Thanks alot for your advice. I am going for my second opinion tomorrow. Ever since in my mind I have decided to have surgery my left foot has felt alot better. I wonder if it isn't pschosomatic. My other foot feels like it is starting to develop the same thing, I wonder if it is because I have been favoring for almost a year my bad foot. We will see what he says and I will post it.

Re: surgery

lenore r on 9/26/00 at 19:56 (029217)

if im remembering right the last x-rays were about 10 months to a year ago. my dr. sent me for all kinds of tests to rule out other problems, cat scan ,mri , tri phase bone scan, sent to neurologist and rhumetoligst. cat scan showed the spurs , bone scan came back hot, neuro tests were neg and rhumetologist didnt come up with anything . also had all blood work done everything normal!! thats when after 3 years i went for the surgery, so we will see how it turns out. might you have done something different??

Re: surgery

lenore r on 9/26/00 at 20:01 (029219)

mike if feet are feeling better you might want to hold off on surgery, as i have been told over they years and by all of the 4 foot drs ive seen that sometimes this monster corrects itself and goes away. what else besides pt and streches have you tried??

Re: surgery

Michael on 9/29/00 at 08:12 (029396)

I just went for my 2nd opinion and he injected with me with cortisone for the first time, he was suprised my doctor had not tried that before. It has been 3 days and my foot has felt a little better but I do not know if it is the injection or the tape job he did, will know more Monday when I take the tape off and have a full day of work. He really didn't recommend the full cut type of surgery which has a long recovery but said it might be better to try a small incision and take a partial endo procedure which is less recovery time. I guess I have some decisions to make.

Re: surgery

Lesu on 9/29/00 at 21:12 (029485)

I have had my PF with a heel spur for at least 14 months. My first Dr. just said I had heel spurs and put me on Celebrex. Said he did not like to do cortisone shots because they hurt so much... I changed Drs for that and other reasons. New doc gave me an injection (in Dec.99) and it did hurt, but it was worth it, 'cause it DID help. For about 3 months. Two more injections with no results. Referred to Orthopedic Surgeon (June,00). Sent to PT. Night splint, stretches and custom orthotics. Pain remained. (July,00) Ortho. schedules PF release surg. for late Sept. Went to a Podiatrist for 2nd opinion (July ,00). Another injection and taping, which helped about 50 % with pain. Went back to PT to build up orthotics a little more. After those did not work satisfactorily, reconciled myself to surgery. Had it 9/21/00. I will return for my follow-up visit and to remove stitches 10/2/00. No cast, just bulky bandage and a fracture shoe. Podiatrist suggested that I wear the night splint post-op since Ortho. said he did not use a cast. I have been alternating using the fracture shoe and night splint while awake. I'm still pretty sore, but only needed 1 Vicodin today. Like others, my other foot is now beginning with the same symptoms.

Re: surgery

dianej on 10/19/00 at 05:38 (030821)

hi mike. good luck with youre recovery, i can sympathize with you, you need to be sure ask for a M R I to be done first before contenplating surgery, a orthopedic (foot) surgeon would be my only choice. i have had spur removed times 2 ops 12 months apart, with good result for a short few years, but not all cases the same, im about to have major surgery on same foot much pain in same area, have tried orthopedics, i have had 3 opinions from foot surgeons, make sure you ask all relevant questions, you sound young with good years ahead, i have been now approx 8-9 years now with these probs

Re: surgery

chrisJ on 10/19/00 at 15:04 (030849)

I had my surgery done by a podiatrist on 10/6. I am having very little pain and I am walking two weeks after surgery. All I have are a few bandages and a protective shoe. I get the stiches out on Friday.