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Arch and Heel Pain Question

Posted by Doug P on 8/16/01 at hrmin (056954)

I have had bilateral PF for six years and have tried everything with little success. I have seen Dr. Z respond to others that ESWT will not help those who have arch pain. I guess I have both arch and heel pain. It is tender if I push on my heel where the pf inserts, but it is also tender all up the arch. Could ESWT help me somewhat? I wonder if ESWT would help those with arch pain if they received it in smaller doses in different places along the arch?

Re: Arch and Heel Pain Question

BrianJ on 8/17/01 at 10:46 (056980)

Hi Doug --

Sorry you've been suffering for so long. I've had bilateral PF for about 4 years, so I know it's no fun.

If you've been diligent about conservative treatment but have had no results, ESWT is certainly worth a try for your heel and arch pain. Heel pain frequently radiates forward into the arch even if the arch is not actually injured. Thus, you may be able to lessen (or eliminate) the arch pain by treating the heel pain. Make sense?

Re: Arch and Heel Pain Question

Dr. Zuckerman on 8/17/01 at 17:08 (057022)

Hi,

You can treat the heel and see how the arch pain responds. You can also consider treating the insertion of the posterior tibial tendon at the navicular bone.

Re: Arch and Heel Pain Question

Doug P on 8/17/01 at hrmin (057050)

Dr Z,

Could you elaborate on what you mean by insertion of the posterial tibial tendon at the navicular bone? Where is this?

I'm worried that this treatment may not help me. I spoke with a Dr. Galea up in Toronto about two years ago when Ossatron wasn't available in the US. He said to get an ultrasound of the feet to determine if there is a thickening of the plantar fascia where it attaches to the heel bone. This is a good indication that Ossatron would help me. I got the ultrasound and there was no thickening at the heel. Is this a good indicator of the how effective ESWT might be?

My Podiatrist is Dr. Weil who I guess is championing ESWT a lot these days. I remember mentioning it to him two years ago and didn't know much about it! I can go see him if you think it will help me. Thanks!!

-Doug

Re: Arch and Heel Pain Question

Dr. Zuckerman on 8/17/01 at 22:39 (057057)

This is where the navicular bone is . Let see how do I show you this. It is the arch area. Press on the bone. As to ultasound. Yes thickening is helpfl to determine if there is damage or injury at the insertion. As to whether it has to be present. This is something I don't believe has been studied. If you had the thickening it would be avery excellent indicator as to whether you have inserional pf. Dr. Galea has alot of experience with the ossatron and ESWT treatments.

Re: Arch and Heel Pain Question

BrianJ on 8/17/01 at 10:46 (056980)

Hi Doug --

Sorry you've been suffering for so long. I've had bilateral PF for about 4 years, so I know it's no fun.

If you've been diligent about conservative treatment but have had no results, ESWT is certainly worth a try for your heel and arch pain. Heel pain frequently radiates forward into the arch even if the arch is not actually injured. Thus, you may be able to lessen (or eliminate) the arch pain by treating the heel pain. Make sense?

Re: Arch and Heel Pain Question

Dr. Zuckerman on 8/17/01 at 17:08 (057022)

Hi,

You can treat the heel and see how the arch pain responds. You can also consider treating the insertion of the posterior tibial tendon at the navicular bone.

Re: Arch and Heel Pain Question

Doug P on 8/17/01 at hrmin (057050)

Dr Z,

Could you elaborate on what you mean by insertion of the posterial tibial tendon at the navicular bone? Where is this?

I'm worried that this treatment may not help me. I spoke with a Dr. Galea up in Toronto about two years ago when Ossatron wasn't available in the US. He said to get an ultrasound of the feet to determine if there is a thickening of the plantar fascia where it attaches to the heel bone. This is a good indication that Ossatron would help me. I got the ultrasound and there was no thickening at the heel. Is this a good indicator of the how effective ESWT might be?

My Podiatrist is Dr. Weil who I guess is championing ESWT a lot these days. I remember mentioning it to him two years ago and didn't know much about it! I can go see him if you think it will help me. Thanks!!

-Doug

Re: Arch and Heel Pain Question

Dr. Zuckerman on 8/17/01 at 22:39 (057057)

This is where the navicular bone is . Let see how do I show you this. It is the arch area. Press on the bone. As to ultasound. Yes thickening is helpfl to determine if there is damage or injury at the insertion. As to whether it has to be present. This is something I don't believe has been studied. If you had the thickening it would be avery excellent indicator as to whether you have inserional pf. Dr. Galea has alot of experience with the ossatron and ESWT treatments.