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when surgery/when other treatment options

Posted by 0713oldpain on 7/11/01 at 19:59 (052874)

I had plantar fasciitis in the left foot, which took 18 monthes to heal. Know, I have it in the right foot, my present symptoms have been with me for the past six monthes, and are much worse than the left foot. When I had treatment in the past for my left foot, they tried medication (motrin caused a significant case of reflux), celebrex worked for awhile. Physical therapy didn't help significantly, cortisone was a total failure. The first shot was horrible, and the benefit was only for 10 days. The second shot took 5 days to recover from, and the benefit was only about 5 days. The third shot didn't work at all. Now, with the right foot, I'm seeing an orthopedic surgeon, vioxx caused an episode of vomiting, celebrex isn't kicking in yet. Some days, the pain is worse than others. However, I'm having a new symptom- the toes also fall asleep. The EMG I underwent today revealed no nerve damage, but now, they are dancing around with different diagnosis. What options are available to me, and would surgery be beneficial for me, as Cortisone failed me miserably the last time, and I'm afraid to try it this time. Any advice? I feel so alone with this thing, any help would be appreciated.

Re: when surgery/when other treatment options

Dr. Marlene Reid on 7/11/01 at hrmin (052889)

It sounds like you may be a good candidate for ESWT. You may just have the early signs of TTS that the EMG did not pick up. It is common to get TTS along with chronic plantar fasciitis. Feel free to call my office (630) 852-8650 for more info on ESWT after you review the info on the ESWT site here.

Re: when surgery/when other treatment options

Dr. Zuckerman on 7/12/01 at 00:46 (052900)

Hi,

ESWT has been very effective for the pain that you are having. We have done over two hundred ESWT procedure over the past 18 months with very effective pain relief. How did this start Can you think of anything that caused this to happen. Give us more information.

Re: when surgery/when other treatment options

ellen w on 7/12/01 at 17:29 (052972)

I am now taking a drug called Mobic, which is helping. I've never taken Celebrex or Vioxx, so can't offer any comparisons..but everyone's system is different and responds to drugs differently. That's why anti-inflammatories work for some people, not others.

Also never tried cortisone shots, but did do a 5-day dose pack. Incredible relief, which only lasted a short time -- but the inflammation was never as bad afterwards.

Are you using any complementary means to reduce inflammation. They may not cure, but they may help. I found a supplement called MSM helped, along with not drinking carbonated beverages. And take a look at the Jade Balm trial on the products page.

Also, I always wonder when people post that PT hasn't helped them exactly what they mean. Except for machine-based therapies or manipulations or exercises that you can't do elsewhere, physical therapy for me has meant a series of gentle exercises to do at home and incorporate into a daily schedule. It's a long slow process that, as least for me, didn't show immediate results but has been crucial to recovery. If your therapist didn't help you develop a routine, perhaps its time to try another therapist. Do a search for 'Rudy' on this site, and see the ankle exercises Julie recommends. They do help!

Finally, if you read some of the posts on this board, you will see that you are far from being alone.
good luck,
ellen

Re: when surgery/when other treatment options

Julie on 7/13/01 at 01:21 (053001)

Of course you aren't alone. There are lots of us out here, some still dealing with the pain of pf and its cousins the tendonitises, others more or less healed but still around and trying to help.

Ellen has given you excellent advice. Her comment on physical therapy hits the nail on the head. Healing from pf is a process: it can be a long and it requires patience and commitment. If you had a good therapist, s/he should have given you a series of exercises to do at home, specific for you and your condition. If that wasn't the case, find a new PT. If I'm not mis-reading you, there's a kind of defeated tone to your post which is sad. When you're dealing with pf (and not just pf, but with Life) when something 'doesn't work' you've gotta pick yourself up, dust yourself down, and start all over again - as the old song says.

Read the heel pain book (click on the link right here, now). Print it out. Read it several times. Digest the wealth of information in it. Get on with some of the treatments it suggests.

Taping, for example: it was more help to me than almost anything else. It rests the fascia, and thus contributes to the healing process, and while it's doing that it relieves the pain significantly. First try the simplest, two-strip method. If you have problems with it come back and ask questions. You need to experiment to get the right tension - don't just give up if it doesn't work at the first try.

Rest - but of course you must know this: you're trying to heal an injury, so stay off your feet as much as you can. You don't say what your job is - if it's one that requires you to be on your feet a lot, that in itself is contributing to your problems.

Never go barefoot (did you know that? Did anyone tell you?) Always wear good, supportive shoes. Birkenstock sandals are what some of us live in; and good athletic shoes.

You may need orthotics to correct a biomechanical fault. Was your gait ever evaluated to determine this?

You don't say what kind of doctor you saw - was it someone who really knows something about feet and ankles? It sounds as though all your treatment has been medication - all stuff 'done to you' . Now it's time to find a foot doctor who can help you. With that help, and with the knowledge you gain from the heel pain book, you can start actively involving yourself in a treatment programme that will, with patience and commitment, return you to full foot health.

I wish you all the best.

Re: when surgery/when other treatment options

Dr. Marlene Reid on 7/11/01 at hrmin (052889)

It sounds like you may be a good candidate for ESWT. You may just have the early signs of TTS that the EMG did not pick up. It is common to get TTS along with chronic plantar fasciitis. Feel free to call my office (630) 852-8650 for more info on ESWT after you review the info on the ESWT site here.

Re: when surgery/when other treatment options

Dr. Zuckerman on 7/12/01 at 00:46 (052900)

Hi,

ESWT has been very effective for the pain that you are having. We have done over two hundred ESWT procedure over the past 18 months with very effective pain relief. How did this start Can you think of anything that caused this to happen. Give us more information.

Re: when surgery/when other treatment options

ellen w on 7/12/01 at 17:29 (052972)

I am now taking a drug called Mobic, which is helping. I've never taken Celebrex or Vioxx, so can't offer any comparisons..but everyone's system is different and responds to drugs differently. That's why anti-inflammatories work for some people, not others.

Also never tried cortisone shots, but did do a 5-day dose pack. Incredible relief, which only lasted a short time -- but the inflammation was never as bad afterwards.

Are you using any complementary means to reduce inflammation. They may not cure, but they may help. I found a supplement called MSM helped, along with not drinking carbonated beverages. And take a look at the Jade Balm trial on the products page.

Also, I always wonder when people post that PT hasn't helped them exactly what they mean. Except for machine-based therapies or manipulations or exercises that you can't do elsewhere, physical therapy for me has meant a series of gentle exercises to do at home and incorporate into a daily schedule. It's a long slow process that, as least for me, didn't show immediate results but has been crucial to recovery. If your therapist didn't help you develop a routine, perhaps its time to try another therapist. Do a search for 'Rudy' on this site, and see the ankle exercises Julie recommends. They do help!

Finally, if you read some of the posts on this board, you will see that you are far from being alone.
good luck,
ellen

Re: when surgery/when other treatment options

Julie on 7/13/01 at 01:21 (053001)

Of course you aren't alone. There are lots of us out here, some still dealing with the pain of pf and its cousins the tendonitises, others more or less healed but still around and trying to help.

Ellen has given you excellent advice. Her comment on physical therapy hits the nail on the head. Healing from pf is a process: it can be a long and it requires patience and commitment. If you had a good therapist, s/he should have given you a series of exercises to do at home, specific for you and your condition. If that wasn't the case, find a new PT. If I'm not mis-reading you, there's a kind of defeated tone to your post which is sad. When you're dealing with pf (and not just pf, but with Life) when something 'doesn't work' you've gotta pick yourself up, dust yourself down, and start all over again - as the old song says.

Read the heel pain book (click on the link right here, now). Print it out. Read it several times. Digest the wealth of information in it. Get on with some of the treatments it suggests.

Taping, for example: it was more help to me than almost anything else. It rests the fascia, and thus contributes to the healing process, and while it's doing that it relieves the pain significantly. First try the simplest, two-strip method. If you have problems with it come back and ask questions. You need to experiment to get the right tension - don't just give up if it doesn't work at the first try.

Rest - but of course you must know this: you're trying to heal an injury, so stay off your feet as much as you can. You don't say what your job is - if it's one that requires you to be on your feet a lot, that in itself is contributing to your problems.

Never go barefoot (did you know that? Did anyone tell you?) Always wear good, supportive shoes. Birkenstock sandals are what some of us live in; and good athletic shoes.

You may need orthotics to correct a biomechanical fault. Was your gait ever evaluated to determine this?

You don't say what kind of doctor you saw - was it someone who really knows something about feet and ankles? It sounds as though all your treatment has been medication - all stuff 'done to you' . Now it's time to find a foot doctor who can help you. With that help, and with the knowledge you gain from the heel pain book, you can start actively involving yourself in a treatment programme that will, with patience and commitment, return you to full foot health.

I wish you all the best.