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I've been reading the posts and I can't find an answer to this...

Posted by Carmel M on 8/09/01 at hrmin (056050)

Just to give you a brief history, since I haven't posted in great length since May. I'm a 34 year old female, not overweight, with a seemingly sudden onset of PF two years ago. Saw a Pod who suggested OTC inserts to see if it would get better. He also taped my foot. OTC inserts didn't work so I was casted for custom orthotics. I wore those with no problems from day one. My heel was tender but not extremely painfull for about 9 months (during that time I was pregnant). Then after we moved to a new state my heel became very painful. New Pod did first cortisone shot. I've had three total in about 6 months. The shots seemed to take away the pain but obviously it hasn't been a permanent fix. And I must admit, I only stretch and ice when it's hurting. I wear my New Balance shoes with the custom orthotics or my Birks all the time, right up until bed.

Here is my question: after the cortisone shots, the pain is gone, then as the pain slowly comes back, it is not at the point on the BOTTOM of the heel where the fascia inserts into the heel. The pain is on the back of my heel and on both sides. To give you an example: if I rest my foot on the coffee table the pain is at that point where the back of the heel touches the table. And if I squeeze my heel I can feel pain on both sides. Is this normal? I don't think it could be a stress fracture but maybe I'm wrong. When I saw the Pod in May he said if the pain comes back then he'd recommend physical therapy. Do you think I need an MRI first?

I know I should probably ask my Pod all this, but honestly I don't think he knows what to do with me. He seemed a little frustrated by the fact that my foot is not healing.

Thank you in advance for your advice.

Carmel

Re: Could be entrapment?

Carmen H on 8/09/01 at 16:38 (056072)

You could have entrapment of the first branch of the lateral plantar nerve....I am only speaking by what I read recently in an excerpt from the Journal of the American Podiatric Medical Association. They say MRI's and and bone Scans can rule out an inflammatory source of heel pain. It's Just a thought....
I am definitely no expert.

Re: I've been reading the posts and I can't find an answer to this...

Dr. Zuckerman on 8/09/01 at 17:04 (056081)

Yes, whenever there is pain with lateral compression of the heel bone you must consider a possible stress fracture. The area you are talking about is where the achilles tendon attaches to the back of the heel bone.

Has is the range of motion of your ankle bone. If the fat padding isn't in the correct place then you can also have pain on the back and bottom of the heel .

A second opinion, an mri, may be in order. Would need to know alittle more at this point.

Re: I've been reading the posts and I can't find an answer to this...

jane s on 8/09/01 at 20:37 (056103)

this sounds like my problem. only difference I seem to have a 2 heels. The underneath on the bottom of my protrudes down. It hurts 24/7. Did get some rest last nite. Wore Nice nite boot. Felt better this am than years. Wish it had lasted. My achilles is calcified. 4 years still looking for relief. Any suggestions?

Re: WHAT IS TREATMENT FOR STRESS FRACTURE? EOM

Donna M on 8/09/01 at 23:43 (056122)

.

Re: WHAT IS TREATMENT FOR STRESS FRACTURE? EOM

Dr.Zuckerman on 8/10/01 at 16:20 (056218)

Stress Fractures are usually treated with a cast. Sometimes a bone stimulator maybe be needed for the ones that just won't heal. In some very rare cases surgical drilling or decompression of the stress fracture site can be used.

Re: WHAT IS TREATMENT FOR STRESS FRACTURE? EOM

Donna M on 8/11/01 at 00:18 (056274)

Can they or will they heal with time? For that matter, will PF heal by itself at some time without treatment?

Thanks,

Donna

Re: WHAT IS TREATMENT FOR STRESS FRACTURE? EOM

Dr. Zuckerman on 8/11/01 at 01:27 (056275)

That is the six million dollar question. Why risk without treatment a stress fracture that can cause pain throughout the entire lower extremity due to compensation

Re: I have same problem as Jane S.

Cathy M on 8/13/01 at hrmin (056587)

I HAVE THE SAME PROBLEM AS JANE S. ONLY MINE IS COMPLICATED WITH LUPUS. COULD THIS HEEL PAIN HAVE SOMETHING TO DO WITH MY LUPUS? I AM ALREADY ON VIOXX.

Re: Could be entrapment?

Carmen H on 8/09/01 at 16:38 (056072)

You could have entrapment of the first branch of the lateral plantar nerve....I am only speaking by what I read recently in an excerpt from the Journal of the American Podiatric Medical Association. They say MRI's and and bone Scans can rule out an inflammatory source of heel pain. It's Just a thought....
I am definitely no expert.

Re: I've been reading the posts and I can't find an answer to this...

Dr. Zuckerman on 8/09/01 at 17:04 (056081)

Yes, whenever there is pain with lateral compression of the heel bone you must consider a possible stress fracture. The area you are talking about is where the achilles tendon attaches to the back of the heel bone.

Has is the range of motion of your ankle bone. If the fat padding isn't in the correct place then you can also have pain on the back and bottom of the heel .

A second opinion, an mri, may be in order. Would need to know alittle more at this point.

Re: I've been reading the posts and I can't find an answer to this...

jane s on 8/09/01 at 20:37 (056103)

this sounds like my problem. only difference I seem to have a 2 heels. The underneath on the bottom of my protrudes down. It hurts 24/7. Did get some rest last nite. Wore Nice nite boot. Felt better this am than years. Wish it had lasted. My achilles is calcified. 4 years still looking for relief. Any suggestions?

Re: WHAT IS TREATMENT FOR STRESS FRACTURE? EOM

Donna M on 8/09/01 at 23:43 (056122)

.

Re: WHAT IS TREATMENT FOR STRESS FRACTURE? EOM

Dr.Zuckerman on 8/10/01 at 16:20 (056218)

Stress Fractures are usually treated with a cast. Sometimes a bone stimulator maybe be needed for the ones that just won't heal. In some very rare cases surgical drilling or decompression of the stress fracture site can be used.

Re: WHAT IS TREATMENT FOR STRESS FRACTURE? EOM

Donna M on 8/11/01 at 00:18 (056274)

Can they or will they heal with time? For that matter, will PF heal by itself at some time without treatment?

Thanks,

Donna

Re: WHAT IS TREATMENT FOR STRESS FRACTURE? EOM

Dr. Zuckerman on 8/11/01 at 01:27 (056275)

That is the six million dollar question. Why risk without treatment a stress fracture that can cause pain throughout the entire lower extremity due to compensation

Re: I have same problem as Jane S.

Cathy M on 8/13/01 at hrmin (056587)

I HAVE THE SAME PROBLEM AS JANE S. ONLY MINE IS COMPLICATED WITH LUPUS. COULD THIS HEEL PAIN HAVE SOMETHING TO DO WITH MY LUPUS? I AM ALREADY ON VIOXX.