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Surgery

Posted by SharonG on 3/29/01 at 14:57 (042945)

Hi all!!
What a great board!! I have been going to the podiatrist since July of 2000, and have had shots 2times in each foot since then, and I still have pain! He said that I could have PT, or wear the brace, or have the surgery (endoscopic) or have the open heal surgery. Do you think that I should try the PT or brace, since i have not tried that? I work in food service in a school, and Im on my feet 7hrs at work, and more when I get home. I think this is a great board ( I just surfed on it!!)
Thanks again!!
Sharon

Re: Surgery

Julie on 3/29/01 at 17:02 (042958)

Hello Sharon

Could you tell us a little more, please? Have you been diagnosed as having plantar fasciitis or some other condition?

Yes, this is a great board and I'm glad you've found it. You can get a great deal of information from the heel pain book (links to it are on the home page). There are many conservative treatments to use before considering surgery: taping, icing, stretching, PT which you've been offered and above all, rest. You do need to commit yourself to being active in your own treatment, though.

If you do have PF, you may be a candidate for ESWT, which is non-invasive and does not have the complications that surgery may have: it should certainly be investigated before you consider surgery. Read up about it in the ESWT section.

Standing on your feet at work all day may have contributed to your foot problems, so perhaps there is something you can do about that. Without knowing more about what you actually do at work, it would be hard to advise you. So do give us a better idea of your circumstances.

All the best

Julie

Re: Surgery

SharonG on 3/29/01 at 18:17 (042979)

Hi
Yes i have been diagnosed with having PF. At work I run a cash register, make coffee,get food ready for breakfast and lunch. There is no way to sit while running the cash register, I have looked into that. I stand at the register maybe 15 mins at one time and then get to walk away for a bit, and then go back for 5 mins or less or more. I hurt getting going in the am, and then it lets up for about hour or so, then they hurt all day! By the end of the day, my legs hurt too.
I just looked to see what DR's do the ESWT, and the closest one is about 6 hours away. I will ask the Dr about ESWT when I see him again.
Thanks
Sharon

Re: Surgery

Susan U on 3/29/01 at 19:07 (042985)

That's the problem with the ESWT. There are so few drs. doing the procedure and I doubt if your insurance will cover it. You are in the early stages of your treatment. I have been suffering since 1992! I am scheduled for surgery on 4/11. Do whatever you can BEFORE surgery, but keep in mind it is an option. Good luck.

Re: Surgery there is still alot of things to try first

matt on 3/29/01 at 20:44 (042992)

Yes you should try some of the things talked about here on this board and in the PF Book first, the brace or boot is worth a try as well as PT. There are alot of suggestions before surgery. Good Luck.

Re: Surgery

Julie on 3/30/01 at 01:44 (043010)

Thanks, Sharon.

Taping may help you. In Part 2 of the heel pain book you'll find a detailed section on it, with illustrations. Tape has been a life-saver for me when I have to stand, as I do when I'm teaching, for any length of time. Tape actually rests the fascia (which is what it needs) by substituting its tension for the tension the fascia has lost due to tearing. It therefore supports the arch, so you may find it offers some relief. Try the simplest method first - two strips of tape connecting the ball of the foot and the heel. I've found this works as well as more complex, tape-intensive techniques, but if it doesn't help, then try the others.

You can also buy an elastic ankle support - the Futuro one is excellent - in sports stores and pharmacies. It supports the arch as well as the ankle. I use it as well as the tape, and find the two together give really good support.

It won't be the whole solution, though. Most importantly, the fascia needs rest in order to heal. Is there any way you can be shifted to alternative duties for a few months while you work your way towards recovery? It's very unlikely that the fascia will heal while you're doing this job. Standing and walking on hard surfaces for long periods is a known cause of PF, as many people on the board can testify.

Make sure you are wearing good, supportive shoes.Lots of us swear by Birkenstocks, which have good arch support, but they don't suit everyone. Has your pod evaluated you properly, and done an analysis of your gait? If you have a biomechanical problem, you may need orthotics.

Oh - and and make sure you never ever go barefoot. Slip your feet into shoes with arch support (not floppy slippers) as soon as your feet drop over the side of the bed.

Keep reading the message boards. You'll learn a lot from other people's questions and answers. Most of us who've been around for awhile rank this website high up in the list of 'things that help'.

All the best, Julie

Re: Surgery

rickb on 3/30/01 at 06:41 (043016)

dont have any surgery until you have tried every option you will not be any worse after pt or wearing a cast/boot for a while. you can be a lot worse after surgery. go to a different doctor before surgery also see what they say. is this a workers comp case. that is somthing to look into also.
all work has to do is agravate your condition to be covered by comp.

Re: Surgery

SharonG on 3/31/01 at hrmin (043127)

Hi again!
Just wanted to say thankyou all for the info. You have been better than my Dr. I am going to try the PT and brace for nite time. Surgery will be the last resort. I do have the inserts for shoes, but boy are they a pain in the butt!! I can never find shoes that they fit into. The other day he gave me Medrol 4 mg dosepak to take for 6 days. And oooh my gosh do my feet feel better. I will keep in touch and let you know what is going on. I wish all of you the best!!
Sharon

Re: Surgery

Dr. Marlene Reid on 4/03/01 at hrmin (043397)

Hi Sharon,

I see a lot of PF in my practice and 80% get better with conservative treatment if a comprehensive treatment plan is taken. I give injections, one or two weeks apart (no further apart because they lose their effectiveness) and usually ultrasound started after the 2nd or 3rd injection for 3x a week x 3 weeks. I have patients wear a heel cup (the firm kind) and stretch. No going barefooted. Shoes must have a good heel counter. I have not had patients with success with the splint. If one injection does not help, it may not have hit the spot. I always try a second. If both are not helpful, I stop. I expect 50% improvment with the first injection. Only after the pain resides, do I use orthotics.
I will probably not do much surgery for PF again, now that there is ESW. Patients are doing really well from this. Even my heavier patients who I advise may not do well. I use the Ossatron which is FDA approved for PF and is based on a single treatment. Many insurance companies are approving it, but it takes some work. Hold off on surgery - success rate is only 70-75%. It can cause a lot of other problems. OssaTron success rate is higher and has not been found to cause any other problems!

Good luck.

Re: Surgery

Julie on 3/29/01 at 17:02 (042958)

Hello Sharon

Could you tell us a little more, please? Have you been diagnosed as having plantar fasciitis or some other condition?

Yes, this is a great board and I'm glad you've found it. You can get a great deal of information from the heel pain book (links to it are on the home page). There are many conservative treatments to use before considering surgery: taping, icing, stretching, PT which you've been offered and above all, rest. You do need to commit yourself to being active in your own treatment, though.

If you do have PF, you may be a candidate for ESWT, which is non-invasive and does not have the complications that surgery may have: it should certainly be investigated before you consider surgery. Read up about it in the ESWT section.

Standing on your feet at work all day may have contributed to your foot problems, so perhaps there is something you can do about that. Without knowing more about what you actually do at work, it would be hard to advise you. So do give us a better idea of your circumstances.

All the best

Julie

Re: Surgery

SharonG on 3/29/01 at 18:17 (042979)

Hi
Yes i have been diagnosed with having PF. At work I run a cash register, make coffee,get food ready for breakfast and lunch. There is no way to sit while running the cash register, I have looked into that. I stand at the register maybe 15 mins at one time and then get to walk away for a bit, and then go back for 5 mins or less or more. I hurt getting going in the am, and then it lets up for about hour or so, then they hurt all day! By the end of the day, my legs hurt too.
I just looked to see what DR's do the ESWT, and the closest one is about 6 hours away. I will ask the Dr about ESWT when I see him again.
Thanks
Sharon

Re: Surgery

Susan U on 3/29/01 at 19:07 (042985)

That's the problem with the ESWT. There are so few drs. doing the procedure and I doubt if your insurance will cover it. You are in the early stages of your treatment. I have been suffering since 1992! I am scheduled for surgery on 4/11. Do whatever you can BEFORE surgery, but keep in mind it is an option. Good luck.

Re: Surgery there is still alot of things to try first

matt on 3/29/01 at 20:44 (042992)

Yes you should try some of the things talked about here on this board and in the PF Book first, the brace or boot is worth a try as well as PT. There are alot of suggestions before surgery. Good Luck.

Re: Surgery

Julie on 3/30/01 at 01:44 (043010)

Thanks, Sharon.

Taping may help you. In Part 2 of the heel pain book you'll find a detailed section on it, with illustrations. Tape has been a life-saver for me when I have to stand, as I do when I'm teaching, for any length of time. Tape actually rests the fascia (which is what it needs) by substituting its tension for the tension the fascia has lost due to tearing. It therefore supports the arch, so you may find it offers some relief. Try the simplest method first - two strips of tape connecting the ball of the foot and the heel. I've found this works as well as more complex, tape-intensive techniques, but if it doesn't help, then try the others.

You can also buy an elastic ankle support - the Futuro one is excellent - in sports stores and pharmacies. It supports the arch as well as the ankle. I use it as well as the tape, and find the two together give really good support.

It won't be the whole solution, though. Most importantly, the fascia needs rest in order to heal. Is there any way you can be shifted to alternative duties for a few months while you work your way towards recovery? It's very unlikely that the fascia will heal while you're doing this job. Standing and walking on hard surfaces for long periods is a known cause of PF, as many people on the board can testify.

Make sure you are wearing good, supportive shoes.Lots of us swear by Birkenstocks, which have good arch support, but they don't suit everyone. Has your pod evaluated you properly, and done an analysis of your gait? If you have a biomechanical problem, you may need orthotics.

Oh - and and make sure you never ever go barefoot. Slip your feet into shoes with arch support (not floppy slippers) as soon as your feet drop over the side of the bed.

Keep reading the message boards. You'll learn a lot from other people's questions and answers. Most of us who've been around for awhile rank this website high up in the list of 'things that help'.

All the best, Julie

Re: Surgery

rickb on 3/30/01 at 06:41 (043016)

dont have any surgery until you have tried every option you will not be any worse after pt or wearing a cast/boot for a while. you can be a lot worse after surgery. go to a different doctor before surgery also see what they say. is this a workers comp case. that is somthing to look into also.
all work has to do is agravate your condition to be covered by comp.

Re: Surgery

SharonG on 3/31/01 at hrmin (043127)

Hi again!
Just wanted to say thankyou all for the info. You have been better than my Dr. I am going to try the PT and brace for nite time. Surgery will be the last resort. I do have the inserts for shoes, but boy are they a pain in the butt!! I can never find shoes that they fit into. The other day he gave me Medrol 4 mg dosepak to take for 6 days. And oooh my gosh do my feet feel better. I will keep in touch and let you know what is going on. I wish all of you the best!!
Sharon

Re: Surgery

Dr. Marlene Reid on 4/03/01 at hrmin (043397)

Hi Sharon,

I see a lot of PF in my practice and 80% get better with conservative treatment if a comprehensive treatment plan is taken. I give injections, one or two weeks apart (no further apart because they lose their effectiveness) and usually ultrasound started after the 2nd or 3rd injection for 3x a week x 3 weeks. I have patients wear a heel cup (the firm kind) and stretch. No going barefooted. Shoes must have a good heel counter. I have not had patients with success with the splint. If one injection does not help, it may not have hit the spot. I always try a second. If both are not helpful, I stop. I expect 50% improvment with the first injection. Only after the pain resides, do I use orthotics.
I will probably not do much surgery for PF again, now that there is ESW. Patients are doing really well from this. Even my heavier patients who I advise may not do well. I use the Ossatron which is FDA approved for PF and is based on a single treatment. Many insurance companies are approving it, but it takes some work. Hold off on surgery - success rate is only 70-75%. It can cause a lot of other problems. OssaTron success rate is higher and has not been found to cause any other problems!

Good luck.