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hot v cold treatment

Posted by Jan C on 2/05/01 at 15:37 (038239)

Hi

I have been diagnosed with pf and have had the problem for 18 months now.

I have recently purchased a N'ice night splint - and wow NO pain with my first steps. However - it still comes back during the day.

My questions are:

What else can I do to avoid it recurring during the day?

should I just use ice for pain - or alternative hot and cold as some people have advised. (ie 10 minutes in hot water follwed by 10 minutes in cold - for 30 minutes in total)?

When resting - should I elevate the foot thus taking off the pressure from the pf - but which causes the foot to pronate, or should I rest it on the floor - or is this an appropriate time to use the N'ice night splint?

I have tried the stretches - but this causes more foot pain - should I keep going with it - or am I doing it wrong?

Your advise would be appreciated.

Re: hot v cold treatment

Dr. Zuckerman on 2/05/01 at 21:25 (038267)

All of what you are doing is good. Remember that foot pain means that the pf is being injured. Rest is the best treatment. You are also a very good patient for ESWT if you have pf insertional pain. That is pain at the insertion where the plantar fascia ataches to the heel bone on the bottom of the foot. . So read about ESWT if this doesn't start to respond. It does sound like you have done alot of things already and then you need more advance treatment like ESWT. What else have you done. Talk to me about you shoes . They could be a major factor in your continued foot pain.

Re: hot v cold treatment

Jan C on 2/05/01 at 23:30 (038280)

Hi - thanks for your prompt reply. I have had physio/strapping and ultra-sound. Several orthotics made for me - the latest have silicone filled heels to try and give more softness.

I have had two hydrocortisone injections and I have tried acupuncture.

I have tried various creams and several anti-inflammatory drugs.

As I said earlier - the ONLY thing to have made a difference is the N'ice night splint.

I have to use a lot of stairs at home - but recently only use them by leading with the good foot on the way up - and with the bad foot on the way down. That does seem to help.

I only wear Rockport shoes - boot style with laces. At home I wear a light lace up sand shoe. I ALWAYS use my orthotics!!! I always wear socks with extra thick soles.

I live in NZ so don't think ESWT treatment is available - but I will enquire.

ANY advise will be appreciated. I used to play golf - but I can't even walk to the shops now.

What about the hot versus cold traetments? Also - what is the best position to rest my foot?

Thanks again.

Re: hot v cold treatment

Julie on 2/06/01 at 03:10 (038285)

Jan, what stretches are you doing? If they are the generally-advised ones that you do against a wall, and the one that involves standing on a step with your heels hanging off it, I would lay off them. They are difficult to control, they may not be what you need anyway, and there are other types of exercise that are not weight-bearing that you might find more helpful. Whatever exercises you are doing, if they cause more pain, you ought to stop them.

The Personal Foot Trainer and the Acu-Flex (both with links to this website) have been found helpful by many.

The bottom line with PF is, if it hurts, stop.

Julie

Re: hot v cold treatment

Dr. Zuckerman on 2/07/01 at 11:10 (038354)

Hot vs Cold or a combination of both is the great debate. I like hot if at all possible except for an initial injury or overuse problem

The best position for your foot. Well let me think. I would keep it flexing back of forth before placing any weight on the foot when first walking. Elevation is perfect for excessive swelling. I like placing the foot in a big bucket of hot water as much as possible It ther is painful then cold then hot then cold . End on the cold.

Re: hot v cold treatment

Dr. Zuckerman on 2/05/01 at 21:25 (038267)

All of what you are doing is good. Remember that foot pain means that the pf is being injured. Rest is the best treatment. You are also a very good patient for ESWT if you have pf insertional pain. That is pain at the insertion where the plantar fascia ataches to the heel bone on the bottom of the foot. . So read about ESWT if this doesn't start to respond. It does sound like you have done alot of things already and then you need more advance treatment like ESWT. What else have you done. Talk to me about you shoes . They could be a major factor in your continued foot pain.

Re: hot v cold treatment

Jan C on 2/05/01 at 23:30 (038280)

Hi - thanks for your prompt reply. I have had physio/strapping and ultra-sound. Several orthotics made for me - the latest have silicone filled heels to try and give more softness.

I have had two hydrocortisone injections and I have tried acupuncture.

I have tried various creams and several anti-inflammatory drugs.

As I said earlier - the ONLY thing to have made a difference is the N'ice night splint.

I have to use a lot of stairs at home - but recently only use them by leading with the good foot on the way up - and with the bad foot on the way down. That does seem to help.

I only wear Rockport shoes - boot style with laces. At home I wear a light lace up sand shoe. I ALWAYS use my orthotics!!! I always wear socks with extra thick soles.

I live in NZ so don't think ESWT treatment is available - but I will enquire.

ANY advise will be appreciated. I used to play golf - but I can't even walk to the shops now.

What about the hot versus cold traetments? Also - what is the best position to rest my foot?

Thanks again.

Re: hot v cold treatment

Julie on 2/06/01 at 03:10 (038285)

Jan, what stretches are you doing? If they are the generally-advised ones that you do against a wall, and the one that involves standing on a step with your heels hanging off it, I would lay off them. They are difficult to control, they may not be what you need anyway, and there are other types of exercise that are not weight-bearing that you might find more helpful. Whatever exercises you are doing, if they cause more pain, you ought to stop them.

The Personal Foot Trainer and the Acu-Flex (both with links to this website) have been found helpful by many.

The bottom line with PF is, if it hurts, stop.

Julie

Re: hot v cold treatment

Dr. Zuckerman on 2/07/01 at 11:10 (038354)

Hot vs Cold or a combination of both is the great debate. I like hot if at all possible except for an initial injury or overuse problem

The best position for your foot. Well let me think. I would keep it flexing back of forth before placing any weight on the foot when first walking. Elevation is perfect for excessive swelling. I like placing the foot in a big bucket of hot water as much as possible It ther is painful then cold then hot then cold . End on the cold.