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TTS and cortisone

Posted by Dona on 7/14/01 at 10:07 (053121)

I have PF and a heel spur that has resolved nicely after a cortisone injection this spring. Now, however, I seem to have developed TTS in the same foot. My dr said to try ice and double the Vioxx for 2 weeks to see if it helped. It didn't, but soon after, I started taking large doses of prednisone for a whopping case of poison oak. For almost 2 weeks, I had no pain in knees or foot (yee-ha!) and although the swelling at the arch under the ankle didn't go away completely, it did seem to lessen. Now that I'm off the prednisone, the swelling is more pronounced and the pain is even worse. It's a constant ache across the top of my foot just under the toes with occasional bursts of sharp pain if I step wrong. I lose the feeling on the bottom of my foot after I've been walking awhile. The calf muscles are tight and sore from the change in my gait. I'm back to taking the Vioxx just once a day (better for the stomach). My question is this: I do not want a cortisone shot, but would PT and cortisone cream work if used for a sufficient amount of time? I was very encouraged by the improvement with the prednisone, and just wonder if extended therapy with or without cortisone would be an option. (My dr said he has only seen 'a couple' cases of TTS in his career, and he's in his 60s.) Thanks.
Dona

Re: TTS and cortisone

Dr. Marlene Reid on 7/14/01 at hrmin (053132)

TTS is fairly common and often missed. Yes, I would try the PT and cortisone cream if you really do not want an injection. Injections are standard of care. The longer it goes on, the more likely you will nedd surgery for TTS. Sorry, I know you don't want to hear that.

Re: TTS and cortisone

Dona on 7/14/01 at 12:24 (053136)

Ok, if injections are a real probability, then I'll ask this: does it hurt as much as the injection in the heel for the spur? If it does, forget it. :) As far as surgery goes, does it matter if it's an ortho doc or a podiatrist? I think I need to find someone who has a little more experience with TTS than my current doc. And is the 'off the foot for one whole week' pretty standard after surgery? It would take some real finagling to figure out when that could happen around here. Thanks for all the information.
Dona

Re: TTS and cortisone

wendyn on 7/14/01 at 13:49 (053146)

Donna - you may want to travel over to the TTS board for a lot of first hand accounts of TTS surgery. Juding by others experiences - you will be out of commission a whole lot longer than a week.

Re: TTS and cortisone

Dr. Marlene Reid on 7/16/01 at 10:20 (053344)

Yes, being off your feet for at least a week is likely. You want to find a surgeon who does a lot of ankle work. You could call the American Board of Podiatric Surgeons or the American College of Foot and Ankle Surgeons for a listing of those in your area. Try ACFAS.org

Re: TTS and cortisone

Dr. Marlene Reid on 7/14/01 at hrmin (053132)

TTS is fairly common and often missed. Yes, I would try the PT and cortisone cream if you really do not want an injection. Injections are standard of care. The longer it goes on, the more likely you will nedd surgery for TTS. Sorry, I know you don't want to hear that.

Re: TTS and cortisone

Dona on 7/14/01 at 12:24 (053136)

Ok, if injections are a real probability, then I'll ask this: does it hurt as much as the injection in the heel for the spur? If it does, forget it. :) As far as surgery goes, does it matter if it's an ortho doc or a podiatrist? I think I need to find someone who has a little more experience with TTS than my current doc. And is the 'off the foot for one whole week' pretty standard after surgery? It would take some real finagling to figure out when that could happen around here. Thanks for all the information.
Dona

Re: TTS and cortisone

wendyn on 7/14/01 at 13:49 (053146)

Donna - you may want to travel over to the TTS board for a lot of first hand accounts of TTS surgery. Juding by others experiences - you will be out of commission a whole lot longer than a week.

Re: TTS and cortisone

Dr. Marlene Reid on 7/16/01 at 10:20 (053344)

Yes, being off your feet for at least a week is likely. You want to find a surgeon who does a lot of ankle work. You could call the American Board of Podiatric Surgeons or the American College of Foot and Ankle Surgeons for a listing of those in your area. Try ACFAS.org