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E.S.W.T. ?

Posted by Andrew on 6/03/01 at hrmin (049808)

I have had heel pain for two years. I have been to 8-10 doctors and tried almost every non surgical treatment to no avail. My pain is in both feet and occurs during standing or walking. I do not have the classic sign of pain with the 1st few steps in the morning. It starts hurting after spending too much time on my feet (5 minutes). The pain is in the heel and very 'deep' and 'dull'. There is never a tingling or numbing sensation.

I am 27, normal weight, normal arch, perfect health, and no doctor has been able to find anything wrong on an MRI, bone scan, blood test, etc.

Should I try accupuncture, A.R.T. or E.S.W.T. ???? (Dr. Lowell Weil does the E.S.W.T. in my area) Or any other suggestions?

Re: E.S.W.T. ?

DR. Biehler on 6/04/01 at 21:14 (049934)

First you need a diagnosis as to what is causing the pain. If it is a bursitis or a periostal inflamation such as due to a decreaded fat pad under your heel, then the ESWT won't help. If it is the result of where the plantar fascia enters the heel bone, then ESWT may be your answer . Dr. B.

Re: E.S.W.T. ?

Andrew on 6/04/01 at 23:11 (049946)

Thanks for responding, DR. B. What is bursitis or a periostal inflamation? How do I know if I have these? I have been to many doctors in the Chicago area and none have mentioned those.

My pain is on the bottom of my heel. I had an ultrasound guided MRI that showed no inflammation and anti-inflammatories have not worked.

Thanks so much for helping!

Re: E.S.W.T. ?

Andrew on 6/05/01 at hrmin (049991)

How can I or tell if I have bursitis or periostal inflammmation or a decreased fat pad? How can I remedy these problems?

I don't think I had any great trauma to my feet. However I am a floor trader at the Chicago Board of Trade and stood all day from 1996-1999 and I assume this is how I developed this foot pain (my pain started in 1999). I have not been standing for almost a year now but still can't relieve the pain!

Thanks,

Andrew

Re: E.S.W.T. ?

Dr Zuckerman on 6/06/01 at 18:50 (050102)

Hi,

The bursitis and or periosteal can be be determined by a bone scan and or mri. The fat pad reduction is by examination and comparison by the treating doctor. Why do you think you have a fat pad reduction problem

Have you had alot of steriod injections.??

Re: E.S.W.T. ?

Andrew on 6/06/01 at hrmin (050115)

Dr. Z-
Thanks so much for responding! To answer your question, I have had 2 cortizone shots in my right foot over the past two years which gave me a lot of pain for about 2 weeks and then did not help at all. I have had a bone scan and an MRI and an Ultrasound guided MRI of my feet. All have revealed NO PROBLEMS! If you read the previous posts under this thread, bursitis and periosteal were ideas of Dr. Biehler but I think you have clarified to me that I don't have these since they didn't show up on an MRI or by doctor examination.
I recently saw a doctor who recommended E.S.W.T. because nothing has ever shown up as a problem and maybe I just have scar tissue in both heels which could be fixed by E.S.W.T.
However, I just got results yesterday from an MRI on my back that shows a mild bulging of the L4-5 disc. No disc herniation or stenosis is seen. I don't know if this is causing the bilateral heel pain that I feel or not! Maybe it is or maybe this is just a separate problem that I have. I am so confused and have been trying for 2 years just to get an accurate diagnosis of what I have. Then I can try to fix the problem.
What do you think?

Re: E.S.W.T. ?

DR. Biehler on 6/04/01 at 21:14 (049934)

First you need a diagnosis as to what is causing the pain. If it is a bursitis or a periostal inflamation such as due to a decreaded fat pad under your heel, then the ESWT won't help. If it is the result of where the plantar fascia enters the heel bone, then ESWT may be your answer . Dr. B.

Re: E.S.W.T. ?

Andrew on 6/04/01 at 23:11 (049946)

Thanks for responding, DR. B. What is bursitis or a periostal inflamation? How do I know if I have these? I have been to many doctors in the Chicago area and none have mentioned those.

My pain is on the bottom of my heel. I had an ultrasound guided MRI that showed no inflammation and anti-inflammatories have not worked.

Thanks so much for helping!

Re: E.S.W.T. ?

Andrew on 6/05/01 at hrmin (049991)

How can I or tell if I have bursitis or periostal inflammmation or a decreased fat pad? How can I remedy these problems?

I don't think I had any great trauma to my feet. However I am a floor trader at the Chicago Board of Trade and stood all day from 1996-1999 and I assume this is how I developed this foot pain (my pain started in 1999). I have not been standing for almost a year now but still can't relieve the pain!

Thanks,

Andrew

Re: E.S.W.T. ?

Dr Zuckerman on 6/06/01 at 18:50 (050102)

Hi,

The bursitis and or periosteal can be be determined by a bone scan and or mri. The fat pad reduction is by examination and comparison by the treating doctor. Why do you think you have a fat pad reduction problem

Have you had alot of steriod injections.??

Re: E.S.W.T. ?

Andrew on 6/06/01 at hrmin (050115)

Dr. Z-
Thanks so much for responding! To answer your question, I have had 2 cortizone shots in my right foot over the past two years which gave me a lot of pain for about 2 weeks and then did not help at all. I have had a bone scan and an MRI and an Ultrasound guided MRI of my feet. All have revealed NO PROBLEMS! If you read the previous posts under this thread, bursitis and periosteal were ideas of Dr. Biehler but I think you have clarified to me that I don't have these since they didn't show up on an MRI or by doctor examination.
I recently saw a doctor who recommended E.S.W.T. because nothing has ever shown up as a problem and maybe I just have scar tissue in both heels which could be fixed by E.S.W.T.
However, I just got results yesterday from an MRI on my back that shows a mild bulging of the L4-5 disc. No disc herniation or stenosis is seen. I don't know if this is causing the bilateral heel pain that I feel or not! Maybe it is or maybe this is just a separate problem that I have. I am so confused and have been trying for 2 years just to get an accurate diagnosis of what I have. Then I can try to fix the problem.
What do you think?