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PF AND BACK PROBLEMS

Posted by Kim W. on 5/28/01 at hrmin (049132)

I have had PF for seven months now. I have found the Dyno steps that where advised on tis board to be very effective in helping me be more active and taking soem herbal suppliments to greatly reduce the symptoms without side affects as well but IT WILL NOT HEAL! I am starting to wonder if the lower back stiffness I experience along with this condittion is acontributor. I have scoliosis and was wondering if my condittion has worsened to the point of causing this condittion or if I havea sciactic nerve. Chiropractic, nerologic care and acupunctur are the only methods I have not tried so far. Do you think any one of these could be an answer?

Re: PF AND BACK PROBLEMS

Julie on 5/28/01 at 16:29 (049136)

I am not a doctor, Kim, but if you have scoliosis it is certainly possible that there is impingement on a nerve that could be contributing to your PF. (It could be the sciatic nerve: everyone has one and it can be irritated by a bulging disc.) I should think it would be worthwhile to consult a chiropractor for an evaluation of your back, and treatment if any is required.

You say you have tried almost everything, but have you been seen by a podiatrist and had your gait evaluated for a possible biomechanical fault which might be corrected by orthotics? Or been given other advice about treatment? Do you always wear shoes with good arch support, and never go barefoot? Have you tried taping to relieve the pain and rest the fascia? Icing to reduce inflammation? These are just a few of the things that have helped others.

Read the heel pain book (on line on this site) for information and ideas about these and other conservative treatments.

Above all have you stayed off your feet as much as possible in order to give the fascia time to heal?

Re: PF AND BACK PROBLEMS

Cynthia D on 5/28/01 at 17:52 (049149)

Hi Kim, sorry to hear about your problems. I was just going to start a thread to see if anyone else has scoliosis and/or other back problems that may have contributed to pf/heel spurs. I had sciatica while pregnant, and that is so SHARP at times, it's hard to breathe. PF, for me anyway, is so constant, chronic.

I'm seeing an orthopedic surgeon Wed. and will let you know what he has to say about it.

Has anyone else related their back problems to causing an incorrect gait, thus causing pf?

Re: PF AND BACK PROBLEMS

Dr. Biehler on 5/28/01 at 21:08 (049163)

Scoliosis can be a major factor in the cause of heel pain. As the back curves it can cause a hip to raise up and force the back bone to impinge on a nerve. It can also cause a functional limb length difference. Dr. B.

Re: PF AND BACK PROBLEMS

Rania H. on 5/28/01 at hrmin (049183)

Wow! I have scoliosis but never made the connection. Neither had any doctor I've ever seen for my PF. I'd love to read more about the connection. I was still looking for whether my past malaria or taking quenine for it had any impact on me that caused or aggrevated my PF. The theory of scoliosis now has me thinking with new light.

Re: PF AND BACK PROBLEMS

Kim W. on 5/29/01 at hrmin (049193)

I have tried icing, rest and all the other mentioned treatments on this site as well as those mentioned by my podiatrist religiously for seven months now. Being a very thin 21 year old I never considered excess wieght or old age as a possible cause off course. This is also why I have thought so little of my back problems too. I figured I was just sleeping wrong, or wearing night splints made me sleep in a funny position. I am starting to wonder if my difference in leg length and curvature of the spincould have increaswed in severity. Could this back thing could be the main problem and not the feet? I have been active my whole life and have worn any type of shoe I wanted too, but all these symptoms have gradually increased. I hope by shedding some light on my problem someone will post a solution and possibly some helpful information for those with similar symptoms as well. Thanks for the info so far.

Re: PF AND BACK PROBLEMS

Cynthia D on 5/29/01 at 09:01 (049204)

Kim, it's very important to wear the proper foot support. Have you had custom orthotics made? Do you know about the no barefoot rule? (Meaning always have some type of arch support)? Please read the PF or Foot Pain Book found on the Home Page here. I know it's long but you will learn so much that will help you. Have you tried the taping? Are you taking anything like Vioxx or Celebrex? There are a lot of things for you to try.

About the scoliosis. I had a major boating accident when I was 17, we crashed into a bridge. My left hip was shattered. It was repaired surgically, and I never had any follow-up treatment or exams - how stupid was that!! My left leg is 1/4 inch shorter because of this. It seems like some doctor at some point in time would know that a shorter leg issue would lead to spinal curvature, but did anyone ever suggest this? NO. I just found out last Thursday that I, too have developed scoliosis. I DEFINATELY believe this caused pf for me because it started in my left foot, and it took about two years for the right foot to join in the party and get pf, too! So now I've been in pain for five years.

You are 'lucky' in the sense that you found this site early and are getting the help you need now. I waited 4 1/2 years to even be seen by a doctor because I kept thinking the foot pain would just go away on it's own. Please read the book. I hope you find some useful information there. I definately see the link of my hip/back/feet!

Re: PF AND BACK PROBLEMS

Julie on 5/29/01 at 10:39 (049217)

Cynthia, I can't remember reading about your accident and your spinal problems before, but it certainly sounds as though your PF may be related.

Do you use an elevated shoe to equalize the genuine (as opposed to functional) difference in your leg lengths? This might make a difference to you now, even after the lapse of time.

Re: PF AND BACK PROBLEMS

Dr. Biehler on 5/29/01 at 20:33 (049281)

Scoliosis can cause a functional limb length difference by causing the hip to raise on one side. This is not the same an actual limb legth difference and just by wearing a larger heel on one side will not help if there is a nerve impinged in the back. Curvature of the spine is definatly related to PF and should be part of the PF exam. Dr. B.

Re: PF AND BACK PROBLEMS

Cynthia D on 5/29/01 at 20:41 (049282)

And in the reverse: Can functional limb length difference caused by a broken hip then lead to pf and scoliosis? I've been 1/4' shorter on one side for 23 years! You think someone would tell me I should do something about it? Thanks for your thoughts.

Re: PF AND BACK PROBLEMS - to Cynthia and Dr B

Julie on 5/30/01 at 01:31 (049302)

I hope I haven't confused the issue. I asked about the elevated heel, Cynthia, because it appeared from what you said that you do have an actual leg length difference caused by the accident and the shattering and rebuilding of your left hip, as opposed to a functional one (i.e. where one leg isn't really shorter, but behaves as if it is because one hip is higher due to scoliosis).

Dr B, please clarify. If Cynthia does have an actual leg length difference, which caused the scoliosis, as she surmises, wouldn't an elevated heel now remedy this? Or was this something that should have been done 23 years ago at the time of the accident, before the scoliosis set in, and is it now too late? If it is, is there anything you can suggest in its place?

Re: PF AND BACK PROBLEMS - to Cynthia and Dr B

Dr. Biehler on 5/30/01 at 06:41 (049317)

A limb length difference can usually be helped with a heel lift. What you have you watch out for are the accomadations and adjustments the body has already made. You can not undo them right away. Also scoliosis of the spine can cause a functional limb length difference. This usually starts in the spine and not the other way around. An actual limb length difference is usually adjusted for in the hip. This adjustment can have an effect on the back such as too much compression on one side usually resulting in a sholder drop on the longer limb side. The scoliosis usually results in a curvature of the spine,ie, 'S' shaped. Dr. B.

Re: PF AND BACK PROBLEMS - to Dr B

Julie on 5/30/01 at 13:34 (049361)

Dr B, I'm sorry to keep on about this, but I don't think you have answered Cynthia's question or mine.

Cynthia wanted to know if her _actual_ leg length difference, caused by her shattered and rebuilt hip, leaving one leg 1/4 inch shorter than the other, could have caused her scoliosis. Yes, as you say, it usually starts in the spine and not the other way around, but her question was, could it have happened the other way around?

I surmised, perhaps wrongly, that it could, and that therefore an elevated heel might be useful. I know that the adjustments the body has already made to scoliosis can't be undone immediately, and that an elevation can be harmful in such cases, but I wondered if the fact that the length difference was actual, not merely functional, and had caused the scoliosis, might make a difference.

My question was: if it is too late for an elevated shoe to be of any help to Cynthia, is there anything else you can suggest that she can do now to equalize her leg length and, by doing so, hopefully relieve her PF?

Re: PF AND BACK PROBLEMS - to Dr B

Dr. Biehler on 5/30/01 at 15:32 (049373)

A limb length difference will cause the hip on the longer leg side to ride up. This can cause the vertibrae on that side of the spine to start to ' pinch ' together. This can result in a nerve entrapment and possibly a slight bowing to the curve of the spine but it usually would not cause a scoliosis of the spine. Dr. B.

Re: PF AND BACK PROBLEMS - to Dr B

Julie on 5/30/01 at 16:25 (049376)

Many thanks. So - do you think that an elevated shoe might help Cynthia at this stage?

Re: PF AND BACK PROBLEMS - to Dr B

Dr. Biehler on 5/30/01 at 18:54 (049399)

Normaly if there is a 1/4' limb length difference the recomended adjustment is a heel lift of 1/8'. Before heel lifts are use you must make sure the arches are the same, ie. so one foot is not pronating while the other is supinating ( this is common in limb length differences ). When the arches are corrected a heel lift can be used. This becomes a ' balancing act ' when dealing with a true scoliosis ( should have a multi-doctor approch to treatment ) and adjustments are usually necessary as changes are adapted to. Dr. B.

Re: PF AND BACK PROBLEMS

Cynthia D on 5/31/01 at 16:35 (049496)

Thanks for having this conversation on my behalf! I was too depressed to write anything yesterday after my Mass General appt. They didn't seem to feel that the spinal curviture (scoloisis) has anything to do with pf. The 'Jr.' doctor said that everyone is a little crooked anyway and one thing shouldn't have anything to do with the other. I don't get it, I thought the 'neck bone connected to the head bone, etc., etc.,)

Anyway, I'm upset because he said I have atypical pf symptoms and he couldn't believe I've already been seen by four podiatrists and no one ever ordered further testing. I'm having a EMG-NCS (peripheral Neuropathy)week after next and am still in shock that I'm not the healthy, happy go lucky person I always thought I was. Who knows, maybe the test will be negative and I'll have a miraculous cure. Sorry to wine on, but that's the story. Thanks for your interest. BTW, should I see a different doc about heel lifts to try to correct the back problem? It'd be nice not to have any more back pain, too. Thanks.

Re: PF AND BACK PROBLEMS

Julie on 5/28/01 at 16:29 (049136)

I am not a doctor, Kim, but if you have scoliosis it is certainly possible that there is impingement on a nerve that could be contributing to your PF. (It could be the sciatic nerve: everyone has one and it can be irritated by a bulging disc.) I should think it would be worthwhile to consult a chiropractor for an evaluation of your back, and treatment if any is required.

You say you have tried almost everything, but have you been seen by a podiatrist and had your gait evaluated for a possible biomechanical fault which might be corrected by orthotics? Or been given other advice about treatment? Do you always wear shoes with good arch support, and never go barefoot? Have you tried taping to relieve the pain and rest the fascia? Icing to reduce inflammation? These are just a few of the things that have helped others.

Read the heel pain book (on line on this site) for information and ideas about these and other conservative treatments.

Above all have you stayed off your feet as much as possible in order to give the fascia time to heal?

Re: PF AND BACK PROBLEMS

Cynthia D on 5/28/01 at 17:52 (049149)

Hi Kim, sorry to hear about your problems. I was just going to start a thread to see if anyone else has scoliosis and/or other back problems that may have contributed to pf/heel spurs. I had sciatica while pregnant, and that is so SHARP at times, it's hard to breathe. PF, for me anyway, is so constant, chronic.

I'm seeing an orthopedic surgeon Wed. and will let you know what he has to say about it.

Has anyone else related their back problems to causing an incorrect gait, thus causing pf?

Re: PF AND BACK PROBLEMS

Dr. Biehler on 5/28/01 at 21:08 (049163)

Scoliosis can be a major factor in the cause of heel pain. As the back curves it can cause a hip to raise up and force the back bone to impinge on a nerve. It can also cause a functional limb length difference. Dr. B.

Re: PF AND BACK PROBLEMS

Rania H. on 5/28/01 at hrmin (049183)

Wow! I have scoliosis but never made the connection. Neither had any doctor I've ever seen for my PF. I'd love to read more about the connection. I was still looking for whether my past malaria or taking quenine for it had any impact on me that caused or aggrevated my PF. The theory of scoliosis now has me thinking with new light.

Re: PF AND BACK PROBLEMS

Kim W. on 5/29/01 at hrmin (049193)

I have tried icing, rest and all the other mentioned treatments on this site as well as those mentioned by my podiatrist religiously for seven months now. Being a very thin 21 year old I never considered excess wieght or old age as a possible cause off course. This is also why I have thought so little of my back problems too. I figured I was just sleeping wrong, or wearing night splints made me sleep in a funny position. I am starting to wonder if my difference in leg length and curvature of the spincould have increaswed in severity. Could this back thing could be the main problem and not the feet? I have been active my whole life and have worn any type of shoe I wanted too, but all these symptoms have gradually increased. I hope by shedding some light on my problem someone will post a solution and possibly some helpful information for those with similar symptoms as well. Thanks for the info so far.

Re: PF AND BACK PROBLEMS

Cynthia D on 5/29/01 at 09:01 (049204)

Kim, it's very important to wear the proper foot support. Have you had custom orthotics made? Do you know about the no barefoot rule? (Meaning always have some type of arch support)? Please read the PF or Foot Pain Book found on the Home Page here. I know it's long but you will learn so much that will help you. Have you tried the taping? Are you taking anything like Vioxx or Celebrex? There are a lot of things for you to try.

About the scoliosis. I had a major boating accident when I was 17, we crashed into a bridge. My left hip was shattered. It was repaired surgically, and I never had any follow-up treatment or exams - how stupid was that!! My left leg is 1/4 inch shorter because of this. It seems like some doctor at some point in time would know that a shorter leg issue would lead to spinal curvature, but did anyone ever suggest this? NO. I just found out last Thursday that I, too have developed scoliosis. I DEFINATELY believe this caused pf for me because it started in my left foot, and it took about two years for the right foot to join in the party and get pf, too! So now I've been in pain for five years.

You are 'lucky' in the sense that you found this site early and are getting the help you need now. I waited 4 1/2 years to even be seen by a doctor because I kept thinking the foot pain would just go away on it's own. Please read the book. I hope you find some useful information there. I definately see the link of my hip/back/feet!

Re: PF AND BACK PROBLEMS

Julie on 5/29/01 at 10:39 (049217)

Cynthia, I can't remember reading about your accident and your spinal problems before, but it certainly sounds as though your PF may be related.

Do you use an elevated shoe to equalize the genuine (as opposed to functional) difference in your leg lengths? This might make a difference to you now, even after the lapse of time.

Re: PF AND BACK PROBLEMS

Dr. Biehler on 5/29/01 at 20:33 (049281)

Scoliosis can cause a functional limb length difference by causing the hip to raise on one side. This is not the same an actual limb legth difference and just by wearing a larger heel on one side will not help if there is a nerve impinged in the back. Curvature of the spine is definatly related to PF and should be part of the PF exam. Dr. B.

Re: PF AND BACK PROBLEMS

Cynthia D on 5/29/01 at 20:41 (049282)

And in the reverse: Can functional limb length difference caused by a broken hip then lead to pf and scoliosis? I've been 1/4' shorter on one side for 23 years! You think someone would tell me I should do something about it? Thanks for your thoughts.

Re: PF AND BACK PROBLEMS - to Cynthia and Dr B

Julie on 5/30/01 at 01:31 (049302)

I hope I haven't confused the issue. I asked about the elevated heel, Cynthia, because it appeared from what you said that you do have an actual leg length difference caused by the accident and the shattering and rebuilding of your left hip, as opposed to a functional one (i.e. where one leg isn't really shorter, but behaves as if it is because one hip is higher due to scoliosis).

Dr B, please clarify. If Cynthia does have an actual leg length difference, which caused the scoliosis, as she surmises, wouldn't an elevated heel now remedy this? Or was this something that should have been done 23 years ago at the time of the accident, before the scoliosis set in, and is it now too late? If it is, is there anything you can suggest in its place?

Re: PF AND BACK PROBLEMS - to Cynthia and Dr B

Dr. Biehler on 5/30/01 at 06:41 (049317)

A limb length difference can usually be helped with a heel lift. What you have you watch out for are the accomadations and adjustments the body has already made. You can not undo them right away. Also scoliosis of the spine can cause a functional limb length difference. This usually starts in the spine and not the other way around. An actual limb length difference is usually adjusted for in the hip. This adjustment can have an effect on the back such as too much compression on one side usually resulting in a sholder drop on the longer limb side. The scoliosis usually results in a curvature of the spine,ie, 'S' shaped. Dr. B.

Re: PF AND BACK PROBLEMS - to Dr B

Julie on 5/30/01 at 13:34 (049361)

Dr B, I'm sorry to keep on about this, but I don't think you have answered Cynthia's question or mine.

Cynthia wanted to know if her _actual_ leg length difference, caused by her shattered and rebuilt hip, leaving one leg 1/4 inch shorter than the other, could have caused her scoliosis. Yes, as you say, it usually starts in the spine and not the other way around, but her question was, could it have happened the other way around?

I surmised, perhaps wrongly, that it could, and that therefore an elevated heel might be useful. I know that the adjustments the body has already made to scoliosis can't be undone immediately, and that an elevation can be harmful in such cases, but I wondered if the fact that the length difference was actual, not merely functional, and had caused the scoliosis, might make a difference.

My question was: if it is too late for an elevated shoe to be of any help to Cynthia, is there anything else you can suggest that she can do now to equalize her leg length and, by doing so, hopefully relieve her PF?

Re: PF AND BACK PROBLEMS - to Dr B

Dr. Biehler on 5/30/01 at 15:32 (049373)

A limb length difference will cause the hip on the longer leg side to ride up. This can cause the vertibrae on that side of the spine to start to ' pinch ' together. This can result in a nerve entrapment and possibly a slight bowing to the curve of the spine but it usually would not cause a scoliosis of the spine. Dr. B.

Re: PF AND BACK PROBLEMS - to Dr B

Julie on 5/30/01 at 16:25 (049376)

Many thanks. So - do you think that an elevated shoe might help Cynthia at this stage?

Re: PF AND BACK PROBLEMS - to Dr B

Dr. Biehler on 5/30/01 at 18:54 (049399)

Normaly if there is a 1/4' limb length difference the recomended adjustment is a heel lift of 1/8'. Before heel lifts are use you must make sure the arches are the same, ie. so one foot is not pronating while the other is supinating ( this is common in limb length differences ). When the arches are corrected a heel lift can be used. This becomes a ' balancing act ' when dealing with a true scoliosis ( should have a multi-doctor approch to treatment ) and adjustments are usually necessary as changes are adapted to. Dr. B.

Re: PF AND BACK PROBLEMS

Cynthia D on 5/31/01 at 16:35 (049496)

Thanks for having this conversation on my behalf! I was too depressed to write anything yesterday after my Mass General appt. They didn't seem to feel that the spinal curviture (scoloisis) has anything to do with pf. The 'Jr.' doctor said that everyone is a little crooked anyway and one thing shouldn't have anything to do with the other. I don't get it, I thought the 'neck bone connected to the head bone, etc., etc.,)

Anyway, I'm upset because he said I have atypical pf symptoms and he couldn't believe I've already been seen by four podiatrists and no one ever ordered further testing. I'm having a EMG-NCS (peripheral Neuropathy)week after next and am still in shock that I'm not the healthy, happy go lucky person I always thought I was. Who knows, maybe the test will be negative and I'll have a miraculous cure. Sorry to wine on, but that's the story. Thanks for your interest. BTW, should I see a different doc about heel lifts to try to correct the back problem? It'd be nice not to have any more back pain, too. Thanks.