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Confused by different surgical opinions

Posted by Jana on 6/28/01 at hrmin (051751)

The saga continues --
I have now met with four surgeons and have four completely different stories about what should be done. I have plantar fasciitis symptoms (for the last two years), an MRI that confirms symptoms consistent with plantar fasciitis, and a positive nerve conduction study for tarsal tunnel syndrome (bilateral).

1. One surgeon (podiatrist, sports medicine) said do the PF release surgery but don't do the TTS surgery because it is so risky and so seldom successful.

2. Another surgeon (orthopedic surgeon, foot/ankle/sports medicine) said the opposite, don't do the PF release surgery because it leaves your foot so unstable and will cause pain in other places. She said do the TTS surgery because the positive nerve conduction study confirms the diagnosis. She said she would also remove some section of the pf but not do a full release, retaining my foot's stability and arch.

3, The podiatrist I've been working with for two years won't give me an opinion or commit to whether or not I should have any surgery. He has only seen 10 cases of tarsal tunnel in his career (about 25 years).

4. A fourth surgeon (podiatrist) said he questions the tarsal tunnel diagnosis because I don't have classic symptoms, only a positive nerve conduction study. I also have bilateral carpal tunnel and ulner nerve pain so he questions that I don't have some other neurological disorder.

Now what? You would think after talking to four people at least two of them might agree. Nope_

So, I guess I'm left to figure this out myself. I have researched the TTS websites and I don't fit a lot of those patterns. I do have pain (throbbing/tender) on the inside of my ankles in the tarsal tunnel area, arch pain, and plantar facia pain (like a nail has been pounded into my foot just in front of my heel, at the back of the pf). I have a positive nerve conduction as I said. But, I do not have shooting pain when the tarsal tunnel is tapped, I do not have numbness or tingling, my feet are not particularly cold or hot, I do not have a loss of sensation in any area of either foot. Is a nerve conduction study and pain in the tarsal tunnel area enough to confirm the TTS diagnosis? And is it enough to warrant surgery? And, how do you know which surgery to get and who should do it?

Re: Confused by different surgical opinions

Dr. Zuckerman on 6/29/01 at 19:39 (051896)

My feeling is that you should only do the least amount of foot surgery to get the best possible results. Once you had surgery no turing back the clock. I would either do miminial incision heel spur surgery or ESWT before any of the extensive heel/TTS procedure they are talking about.

You are always going to get ten different opinion pick the one from the doctor you trust.!!

Re: Confused by different surgical opinions

Dr. Zuckerman on 6/29/01 at 19:39 (051896)

My feeling is that you should only do the least amount of foot surgery to get the best possible results. Once you had surgery no turing back the clock. I would either do miminial incision heel spur surgery or ESWT before any of the extensive heel/TTS procedure they are talking about.

You are always going to get ten different opinion pick the one from the doctor you trust.!!