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pain relief

Posted by jacqueline m on 5/14/01 at hrmin (047757)

I am been diagnosed with TTS. As you know I am in terrible pain. I was given a shot in the ankle and told to return in two weeks. I am still in constant pain and am using ice packs daily and taking motrin 800mg and loritab 5mg. It does not get rid f the pain just makes me sleepy for a hr or so and then I am awake in pain again. What can I do or to tell the doctor to prescribe for me. Also is it bst to let a podiatriast treat tt or a neurologist? Please answer soon I am going to Disney World next month and need some relief. Please send reply to email thanks

Re: pain relief

Janette on 5/19/01 at 23:01 (048326)

I am curious about how you are planning to get around at Disney World? I am meant to be going to Orlando for a conference and just don't know how I can do any of the sites. There are a lot of places that rent electic scooters but I don't want to use them. Some days I do OK and others I don't.

The pain is another thing. I am dealing with it better than I did a year ago. Anti inflamatories help a bit but on bad days nothing helps. Good luck on your trip.

Re: Getting around

wendyn on 5/20/01 at 11:33 (048358)

If your pain is bad and you have to do a lot of walking - try using a cane. If it isn't enough - rent a wheelchair.

One Christmas I did my shopping in a wheelchair, it saved my feet, my sanity, and probably my marriage (hubby was shopping with me). I shopped for hours, I was still happy and capable of thought when I left.

I also used one to go to a museum, had a great day.

Canes are good, and always worth a try.

I don't use anything now - and I get around a lot better...but I'm glad I used them when I needed them.

Re: Getting around

Janette on 5/21/01 at 22:47 (048528)

Did I read that you never had surgery and do you have TTS in both ankles? I suppose that I was used to a life style of walking fast and getting to place very quickly. It's just hard to accept.

Re: Getting around

wendyn on 5/21/01 at 23:05 (048530)

Janette - I'm thinking your question was directed at me - I'm not sure~!

No - I've never had surgery - yes I get around much better.

I can relate to the 'getting around fast' idea - that seems to almost be a common thread among TTS sufferers. We all seem to be a bunch who were the type to blow by the slow pokes on the street.

My pain is NOTHING compared to what it used to be. I used to have trouble thinking while I sat, sleeping, eating - the pain made me nauseous. Now, it is very secondary to what I do. I can walk a fair ways now - and reasonably fast - although it's not the 'power walking' that I was used to, it's often hard now to see that there is anything wrong with me. I have come to terms with the fact that in my case - it means no more jogging, no more aerobics. I will take what I can get now, thank you very much. I can bike hard, I can walk some - and I have a decent life style. Two years ago I would have been devastated to have to give up so many activities - but from what I've been through (hell) - you will not hear me complain.

From 'very bad' till now has been 2 years. There is no quick fix unforunately.

Re: Getting around

Janette on 5/24/01 at 00:04 (048730)

Thanks Wendy. Yes I was asking you the question. Your answer gives me some hope. I didn't want to say it but yes, I was the one who overtook everyone. I have been doing that since I was a child.

When I found I could not walk last year I spent more time on the eliptical machine. Going backwards doesn't seem to put as much pressure on my feet. The most I have done in over a year at one time is probably about 12-15 mins and that is not pushing it at all. My feet are not sore but I do pay dearly for the next couple of hours or if really bad, days. I really miss working out and walking since I loved doing it.

I do need to give Yoga a try. Apparently some of the stretches I have done for years, people have told me that they are Yoga stretches. I tried using video tapes and got no-where, so I need to go to a class.

Massage seems to help as long as it's not on the TT area. PT hurt more than it helped. I have made a lot of other changes, including how I work, little or no driving and lifestyle.

Finding shoes that I can actually wear is the first part of the battle. I go through stages when I cannot have anything other than a sandal or nothing on my feet.

How did you find out what caused your TT? With all the doctors I went to, no one could tell me. I appreciate your comments and help. You seem very dedicated to this message board. I usually just read what is posted especially when I am in pain and very frustrated.

Re: Getting around

Julie on 5/24/01 at 03:24 (048740)

Hi Janette

You are right that you cannot learn yoga from a video. May I make a comment about yoga classes? (I teach yoga.) Do try to find a class: I think you would find yoga a help (in more ways than just the physical). But you will need to explore around a bit to find the right kind of class for you. Some styles will be too strong (i.e. Iyengar and the very popular Ashtanga or 'Power' yoga) and many classes are too large for the teacher to give the individual attention you (and everyone) needs and is entitled to. You need to find a teacher who teaches his or her students, not just a range of postures he or she has been taught. Someone who is willing to get to know her students as an individual, and help them with their problems.

Avoid doing too many standing poses while you are in pain. When you are have to stand (in the class, I mean, and at all times) wear good arch-supportive shoes like trainers or Birkenstocks. (General rule: NEVER GO BAREFOOT)

Good luck in finding a good class and teacher for you,

Julie

Re: Getting around

wendyn on 5/24/01 at 23:59 (048833)

Hi Janette - please heed any advice Julie gives on yoga (she is the yoga queen here and very helpful)!

Finding shoes is very frustrating. I can wear Birks, but after about 5 months they seem to lose their support and I end up buying new ones. I don't know why I have this problem. I can also wear running shoes with my new orthotics - and I have new custom made Birks as well. I am still on the hunt for a casual shoe that I can wear orthotics in, and I have never found a winter boot that I like.

TTS is usually diagnosed by ruling out other things. This is what happened in my case. I was having unexplained pain that was primarily located in my arch/inner ankle area (although there was a lot of foot pain generally). It didn't settle down on it's own, blood work for diabetes, rheumatoid arthritis, lupus, and thyroid were all normal. I also had a normal xray and bone scan (relatively normal bone scan...PF and some other changes but no fractures).

TTS (from what I've learned) is just a collection of symptoms...basically if you have burning/tingling/pain in the general area of the Tarsal Tunnel - then you could theoretically have TTS. But, it can happen for all kinds of reasons. In my case, the doctors believe that it's because my feet are flattening out and stretching and irritating the nerve (I've also had a fairly normal MRI). Some people could have almost the same symptoms, and be suferring from diabetes as a cause. In my case, I have very visible structural problems in both my feet - so once I got to the right doctor, a cause really wasn't a big mystery.

I would try laying off the eliptical machine for a bit. In fact, to be honest - I would try laying off EVERYTHING for a bit. When my feet were bad - even biking was too much. Replace the activity with something else like yoga or swimming (without using your feet). In yoga, as Julie said - no barefeet, wear Birks. And, no standing on one foot until you are much better.

You also might want to weight train, just don't do any squats or lower leg type work. Sit while you lift free weights. If your activity goes down a lot- adjust your diet accordingly to avoid a big weight gain (and even more problems with your feet).

Can you give us a history of what's happened to you and your feet - might help give some insight into what could be going on.

Re: Getting around

Janette on 5/27/01 at 14:19 (049055)

I started having problems with my right foot back in 1998. No one could find the problem and to date, still have not found a reason for the pain. By April 2000, I could hardly walk. I had spent 10 days in New Orleans on my feet and the convention center is nearly a mile long. I walked from one end to the other a few times a day, getting where I needed to be. Coming home, I nearly went to the Emergency Room. My foot problems got worse and worse and worse.
Walking (apart from work and around the house) was out of the question.

In April, I went to a specialist who has had three other and I have seen another two Otho's since then. A bone scan (not density), X-rays & MRI have not shown anything. Pressing or tapping over the nerve would start shooting pains & tingling but this would not happen for about 20 - 30, minutes and usually I had left the doctor's office. I had a cortisone injection, was in a soft cast for 3 weeks, and then had an ankle block, (which lasted for 26 hours) which they wanted to do again. They had suspected TT at this time but they were not possible. In addition, this was only on my right foot. Anyway, they finally sent me for physical therapy and at this point, I didn't know if it was helping or hurting. I tried swimming but found this painful.

By July 2000, what ever was happening in my right foot was starting in my left foot. In August 2000, I had by first EMG, including needle examination, which was considered 'abnormal'. The testing left me in more pain than I had experienced up to now. The pain lasted for a good two weeks. Since they now had a diagnose of TTS the POD was taking a conservative approach. Ankle braces, orthotics etc to start. The ankle braces were a joke. I wore the right one for less than a day, on and off. The left one I could not keep on for more than 10 minutes. I kept trying thinking that feeling pain might help me. Anyway I realized that this was stupid and stopped in less than 1 1/2 days. Ten to 14 days of intense pain started again. I did not go back to the POD but started looking around for a new ORTHO, who told me that the nerve should not be compressed. I was learning!

Since then I have tried a few more ORTHO and they all say that surgery will make me worse. One of then could not find the findings of the EMG or TTS and sent me back in January 2001 for another EMG. The findings were very similar and I will never go back for another EMG. I had some pain after the test but it was nothing compared to my test last August. The only one who wanted to do surgery was the POD and I have never been back.

I did find someone through this site that had been operated on by a doctor in Phoenix. I emailed the person and got the doctor's information. He apparently has done a successful TT surgeries but I have gone to the office to ask questions but not for an appointment. With what I see on the results of TT surgery, I really don't want surgery.

I have probably put you to sleep by now. I have done more PT but stopped as they kept compressing the nerve and I ended up in agony. I have had acupuncture, massage and unsuccessfully tried orthotics. It is hard to put them in a sandal and I rarely can wear closed-in shoes, eg tennis shoes. In addition, the ORTHO's I saw said I did not have any structural problems with my feet, so they probably won't help me. Just after I started using them, I broke a bone in the top of my foot, so I wasn't impressed.

One reason for exercising besides feeling so much better is weight control. Yes, I love food. I have put on quite a bit of weight since January 2000 since I have cut down drastically to nearly nothing of my previous workouts. The 2nd reason I need to exercise is that I have osteoporosis. I hate weight training but do some. My doctor still thinks walking etc will bring me more benefits. Since I cannot walk, I use the eliptical machine. I can usually walk well in my ECCO sandals but feel if I could find one that doesn't touch the nerve, I would be able to do more. The faster I walk the more pain I experience.

I am still trying to swim but find this painful and even for the next day. Hope I didn't bore you to death. Any feedback you can give me would be great. Thanks.

Re: pain relief

Janette on 5/19/01 at 23:01 (048326)

I am curious about how you are planning to get around at Disney World? I am meant to be going to Orlando for a conference and just don't know how I can do any of the sites. There are a lot of places that rent electic scooters but I don't want to use them. Some days I do OK and others I don't.

The pain is another thing. I am dealing with it better than I did a year ago. Anti inflamatories help a bit but on bad days nothing helps. Good luck on your trip.

Re: Getting around

wendyn on 5/20/01 at 11:33 (048358)

If your pain is bad and you have to do a lot of walking - try using a cane. If it isn't enough - rent a wheelchair.

One Christmas I did my shopping in a wheelchair, it saved my feet, my sanity, and probably my marriage (hubby was shopping with me). I shopped for hours, I was still happy and capable of thought when I left.

I also used one to go to a museum, had a great day.

Canes are good, and always worth a try.

I don't use anything now - and I get around a lot better...but I'm glad I used them when I needed them.

Re: Getting around

Janette on 5/21/01 at 22:47 (048528)

Did I read that you never had surgery and do you have TTS in both ankles? I suppose that I was used to a life style of walking fast and getting to place very quickly. It's just hard to accept.

Re: Getting around

wendyn on 5/21/01 at 23:05 (048530)

Janette - I'm thinking your question was directed at me - I'm not sure~!

No - I've never had surgery - yes I get around much better.

I can relate to the 'getting around fast' idea - that seems to almost be a common thread among TTS sufferers. We all seem to be a bunch who were the type to blow by the slow pokes on the street.

My pain is NOTHING compared to what it used to be. I used to have trouble thinking while I sat, sleeping, eating - the pain made me nauseous. Now, it is very secondary to what I do. I can walk a fair ways now - and reasonably fast - although it's not the 'power walking' that I was used to, it's often hard now to see that there is anything wrong with me. I have come to terms with the fact that in my case - it means no more jogging, no more aerobics. I will take what I can get now, thank you very much. I can bike hard, I can walk some - and I have a decent life style. Two years ago I would have been devastated to have to give up so many activities - but from what I've been through (hell) - you will not hear me complain.

From 'very bad' till now has been 2 years. There is no quick fix unforunately.

Re: Getting around

Janette on 5/24/01 at 00:04 (048730)

Thanks Wendy. Yes I was asking you the question. Your answer gives me some hope. I didn't want to say it but yes, I was the one who overtook everyone. I have been doing that since I was a child.

When I found I could not walk last year I spent more time on the eliptical machine. Going backwards doesn't seem to put as much pressure on my feet. The most I have done in over a year at one time is probably about 12-15 mins and that is not pushing it at all. My feet are not sore but I do pay dearly for the next couple of hours or if really bad, days. I really miss working out and walking since I loved doing it.

I do need to give Yoga a try. Apparently some of the stretches I have done for years, people have told me that they are Yoga stretches. I tried using video tapes and got no-where, so I need to go to a class.

Massage seems to help as long as it's not on the TT area. PT hurt more than it helped. I have made a lot of other changes, including how I work, little or no driving and lifestyle.

Finding shoes that I can actually wear is the first part of the battle. I go through stages when I cannot have anything other than a sandal or nothing on my feet.

How did you find out what caused your TT? With all the doctors I went to, no one could tell me. I appreciate your comments and help. You seem very dedicated to this message board. I usually just read what is posted especially when I am in pain and very frustrated.

Re: Getting around

Julie on 5/24/01 at 03:24 (048740)

Hi Janette

You are right that you cannot learn yoga from a video. May I make a comment about yoga classes? (I teach yoga.) Do try to find a class: I think you would find yoga a help (in more ways than just the physical). But you will need to explore around a bit to find the right kind of class for you. Some styles will be too strong (i.e. Iyengar and the very popular Ashtanga or 'Power' yoga) and many classes are too large for the teacher to give the individual attention you (and everyone) needs and is entitled to. You need to find a teacher who teaches his or her students, not just a range of postures he or she has been taught. Someone who is willing to get to know her students as an individual, and help them with their problems.

Avoid doing too many standing poses while you are in pain. When you are have to stand (in the class, I mean, and at all times) wear good arch-supportive shoes like trainers or Birkenstocks. (General rule: NEVER GO BAREFOOT)

Good luck in finding a good class and teacher for you,

Julie

Re: Getting around

wendyn on 5/24/01 at 23:59 (048833)

Hi Janette - please heed any advice Julie gives on yoga (she is the yoga queen here and very helpful)!

Finding shoes is very frustrating. I can wear Birks, but after about 5 months they seem to lose their support and I end up buying new ones. I don't know why I have this problem. I can also wear running shoes with my new orthotics - and I have new custom made Birks as well. I am still on the hunt for a casual shoe that I can wear orthotics in, and I have never found a winter boot that I like.

TTS is usually diagnosed by ruling out other things. This is what happened in my case. I was having unexplained pain that was primarily located in my arch/inner ankle area (although there was a lot of foot pain generally). It didn't settle down on it's own, blood work for diabetes, rheumatoid arthritis, lupus, and thyroid were all normal. I also had a normal xray and bone scan (relatively normal bone scan...PF and some other changes but no fractures).

TTS (from what I've learned) is just a collection of symptoms...basically if you have burning/tingling/pain in the general area of the Tarsal Tunnel - then you could theoretically have TTS. But, it can happen for all kinds of reasons. In my case, the doctors believe that it's because my feet are flattening out and stretching and irritating the nerve (I've also had a fairly normal MRI). Some people could have almost the same symptoms, and be suferring from diabetes as a cause. In my case, I have very visible structural problems in both my feet - so once I got to the right doctor, a cause really wasn't a big mystery.

I would try laying off the eliptical machine for a bit. In fact, to be honest - I would try laying off EVERYTHING for a bit. When my feet were bad - even biking was too much. Replace the activity with something else like yoga or swimming (without using your feet). In yoga, as Julie said - no barefeet, wear Birks. And, no standing on one foot until you are much better.

You also might want to weight train, just don't do any squats or lower leg type work. Sit while you lift free weights. If your activity goes down a lot- adjust your diet accordingly to avoid a big weight gain (and even more problems with your feet).

Can you give us a history of what's happened to you and your feet - might help give some insight into what could be going on.

Re: Getting around

Janette on 5/27/01 at 14:19 (049055)

I started having problems with my right foot back in 1998. No one could find the problem and to date, still have not found a reason for the pain. By April 2000, I could hardly walk. I had spent 10 days in New Orleans on my feet and the convention center is nearly a mile long. I walked from one end to the other a few times a day, getting where I needed to be. Coming home, I nearly went to the Emergency Room. My foot problems got worse and worse and worse.
Walking (apart from work and around the house) was out of the question.

In April, I went to a specialist who has had three other and I have seen another two Otho's since then. A bone scan (not density), X-rays & MRI have not shown anything. Pressing or tapping over the nerve would start shooting pains & tingling but this would not happen for about 20 - 30, minutes and usually I had left the doctor's office. I had a cortisone injection, was in a soft cast for 3 weeks, and then had an ankle block, (which lasted for 26 hours) which they wanted to do again. They had suspected TT at this time but they were not possible. In addition, this was only on my right foot. Anyway, they finally sent me for physical therapy and at this point, I didn't know if it was helping or hurting. I tried swimming but found this painful.

By July 2000, what ever was happening in my right foot was starting in my left foot. In August 2000, I had by first EMG, including needle examination, which was considered 'abnormal'. The testing left me in more pain than I had experienced up to now. The pain lasted for a good two weeks. Since they now had a diagnose of TTS the POD was taking a conservative approach. Ankle braces, orthotics etc to start. The ankle braces were a joke. I wore the right one for less than a day, on and off. The left one I could not keep on for more than 10 minutes. I kept trying thinking that feeling pain might help me. Anyway I realized that this was stupid and stopped in less than 1 1/2 days. Ten to 14 days of intense pain started again. I did not go back to the POD but started looking around for a new ORTHO, who told me that the nerve should not be compressed. I was learning!

Since then I have tried a few more ORTHO and they all say that surgery will make me worse. One of then could not find the findings of the EMG or TTS and sent me back in January 2001 for another EMG. The findings were very similar and I will never go back for another EMG. I had some pain after the test but it was nothing compared to my test last August. The only one who wanted to do surgery was the POD and I have never been back.

I did find someone through this site that had been operated on by a doctor in Phoenix. I emailed the person and got the doctor's information. He apparently has done a successful TT surgeries but I have gone to the office to ask questions but not for an appointment. With what I see on the results of TT surgery, I really don't want surgery.

I have probably put you to sleep by now. I have done more PT but stopped as they kept compressing the nerve and I ended up in agony. I have had acupuncture, massage and unsuccessfully tried orthotics. It is hard to put them in a sandal and I rarely can wear closed-in shoes, eg tennis shoes. In addition, the ORTHO's I saw said I did not have any structural problems with my feet, so they probably won't help me. Just after I started using them, I broke a bone in the top of my foot, so I wasn't impressed.

One reason for exercising besides feeling so much better is weight control. Yes, I love food. I have put on quite a bit of weight since January 2000 since I have cut down drastically to nearly nothing of my previous workouts. The 2nd reason I need to exercise is that I have osteoporosis. I hate weight training but do some. My doctor still thinks walking etc will bring me more benefits. Since I cannot walk, I use the eliptical machine. I can usually walk well in my ECCO sandals but feel if I could find one that doesn't touch the nerve, I would be able to do more. The faster I walk the more pain I experience.

I am still trying to swim but find this painful and even for the next day. Hope I didn't bore you to death. Any feedback you can give me would be great. Thanks.