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How soon should TTS sugery be suggested / done

Posted by elisabeth on 4/01/01 at 12:58 (043242)

I have TTS - diagnosed about one week ago although been suffering from heel pain since mid-Jan. I would not class my pain as unlivable with although as an athlete it affects my sport & I don't walk much as that makes it worse.

Surgery has been suggested as 2 months of physio have not worked, but I feel that is a little too early - especially reading some of the reports on these sights about the pain after surgery and other methods might help, but have not been suggested.

how bad should my tts be before I have surgery, or am I just delaying the recovery period. Secondly, is it possible that the earler you have surgery the better the recovery time?

I obviously want to play sport again asap, but as I still have the ability to walk (allbeit gently) I wonder if surgery is the right option for me now.

Any suggestions?

Re: How soon should TTS sugery be suggested / done

wendyn on 4/01/01 at 14:28 (043260)

elisabeth - there are different opinions on this. Most surgeons won't touch a foot surgically until at least 6 to 12 months of conservative treatment - and then only following nerve conduction tests, as well as blood work to rule out any other systemic causes.

TTS most often does not cause pain in the heel - is TTS your only diagnosis or do you have something else as well?

Can you provide a history?

Re: How soon should TTS sugery be suggested / done

elisabeth on 4/02/01 at 03:39 (043297)

I have pf as well - diagnosed by MRI scan, but has not improved with usual treatments from physio (who I was seeing twice a week) hance the decision to have nerve conductor tests to see what else was preventing the pf getting better (I prolapsed a disc 5 years ago).

What I worry about is as I am seeing a sports physian, his aim is to get me on my feet asap & has already said if the tests show nerve compression at the heel then he would recommend surgery, but my thoughts are that this is too soon, especailly as I don't think my feet are that bad - if it is a back problem I would obviously think again.

Re: How soon should TTS sugery be suggested / done

Julie on 4/02/01 at 04:55 (043298)

Hi Elizabeth

Let me encourage you to follow your intuition. You've had PF only for two and a half months, and your TTS was diagnosed only a week ago. It's much too soon to even think about surgery. You certainly haven't exhausted all the conservative methods, and that should be done first. As Wendy said, most doctors wouldn't do surgery before at least 6 months. And TTS surgery, from what I've read on these boards, is not always successful and prone to complications.

Possibly your sports physician, knowing that you are an athlete, is thinking that YOU are desperate to get back to sport as soon as possible and wants to help you. But my reading of what you say in your posts is that you are more sensible than that, and are prepared to be patient and work towards a good outcome.

If it is an intervertebral disc problem causing nerve compression, that too can probably be treated conservatively. I would certainly get a second opinion before going down the drastic surgery route.

If you haven't yet read the heel pain book, please do, for information on all your treatment options.

All the best

Julie

Re: How soon should TTS sugery be suggested / done

Julie on 4/02/01 at 04:58 (043299)

Elisabeth, sorry, I misspelled your name. (You must get sick of people doing that!)

Re: How soon should TTS sugery be suggested / done

Dr. Marlene Reid on 4/02/01 at hrmin (043389)

Elisabeth,
Did they try any conservative tx for the TTS other then PT? What about cortisone injections for the TTS. Usually, the TTS improves when the PF improves, has your PF improved at all?

Re: How soon should TTS sugery be suggested / done

john h on 4/05/01 at 10:27 (043706)

elizabeth: i agree with wendy. as she says most surgeons will not consider surgery until at least 6 months of conservative treatment. i have had TTS surgery and PF surgery. i really think that PF pain to be very different from TTS pain. TTS is most difficult to diagnosis. even a positive nerve condution test (as my doctor said) is no gold standard. The possiblity to do damage during a TTS surgery (in my opinion) sometimes outweighs other outcomes. Do not be rushed into TTS surgery and get a 2nd and a 3rd opinion.

Re: How soon should TTS sugery be suggested / done

wendyn on 4/01/01 at 14:28 (043260)

elisabeth - there are different opinions on this. Most surgeons won't touch a foot surgically until at least 6 to 12 months of conservative treatment - and then only following nerve conduction tests, as well as blood work to rule out any other systemic causes.

TTS most often does not cause pain in the heel - is TTS your only diagnosis or do you have something else as well?

Can you provide a history?

Re: How soon should TTS sugery be suggested / done

elisabeth on 4/02/01 at 03:39 (043297)

I have pf as well - diagnosed by MRI scan, but has not improved with usual treatments from physio (who I was seeing twice a week) hance the decision to have nerve conductor tests to see what else was preventing the pf getting better (I prolapsed a disc 5 years ago).

What I worry about is as I am seeing a sports physian, his aim is to get me on my feet asap & has already said if the tests show nerve compression at the heel then he would recommend surgery, but my thoughts are that this is too soon, especailly as I don't think my feet are that bad - if it is a back problem I would obviously think again.

Re: How soon should TTS sugery be suggested / done

Julie on 4/02/01 at 04:55 (043298)

Hi Elizabeth

Let me encourage you to follow your intuition. You've had PF only for two and a half months, and your TTS was diagnosed only a week ago. It's much too soon to even think about surgery. You certainly haven't exhausted all the conservative methods, and that should be done first. As Wendy said, most doctors wouldn't do surgery before at least 6 months. And TTS surgery, from what I've read on these boards, is not always successful and prone to complications.

Possibly your sports physician, knowing that you are an athlete, is thinking that YOU are desperate to get back to sport as soon as possible and wants to help you. But my reading of what you say in your posts is that you are more sensible than that, and are prepared to be patient and work towards a good outcome.

If it is an intervertebral disc problem causing nerve compression, that too can probably be treated conservatively. I would certainly get a second opinion before going down the drastic surgery route.

If you haven't yet read the heel pain book, please do, for information on all your treatment options.

All the best

Julie

Re: How soon should TTS sugery be suggested / done

Julie on 4/02/01 at 04:58 (043299)

Elisabeth, sorry, I misspelled your name. (You must get sick of people doing that!)

Re: How soon should TTS sugery be suggested / done

Dr. Marlene Reid on 4/02/01 at hrmin (043389)

Elisabeth,
Did they try any conservative tx for the TTS other then PT? What about cortisone injections for the TTS. Usually, the TTS improves when the PF improves, has your PF improved at all?

Re: How soon should TTS sugery be suggested / done

john h on 4/05/01 at 10:27 (043706)

elizabeth: i agree with wendy. as she says most surgeons will not consider surgery until at least 6 months of conservative treatment. i have had TTS surgery and PF surgery. i really think that PF pain to be very different from TTS pain. TTS is most difficult to diagnosis. even a positive nerve condution test (as my doctor said) is no gold standard. The possiblity to do damage during a TTS surgery (in my opinion) sometimes outweighs other outcomes. Do not be rushed into TTS surgery and get a 2nd and a 3rd opinion.