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Plantar Faciitus Getting Worse

Posted by Klingonwoman on 9/06/01 at 23:28 (059329)

I have been diagnosed with Plantar Fasciitus. It has gotten so severe that I must literally crawl to the phone in the A.M. upon first awakening. I am now noticing that I am walking on the outsides of my feet. I am using foam insoles that work well for awhile, but towards the end of the day, I am in a lot of pain.My doctor wants to try Electro=Acuscope next; if that fails, he will cast each foot,one at a time, for a 6-week period. Will this pain ever go away? Can Plantar Fasciitus be an ongoing problem through one's life? And one final question, if you please. Could working on hard concrete for just 2 hours a day, 7 days a week over a period of a few years cause this problem? Thank you for your time.

Re: Plantar Faciitus Getting Worse

Andrew Carver DPM FACFAS on 9/07/01 at 01:31 (059331)

Dear Klingonwoman,

Yes, most plantar fasciitis pain goes away, on it's own, but unfortunately that can take many years. 'Hard flooring' can bring on the syndrome and /or make it worse.

The best initial methods of treatment in my practice of 20 years are the following:

1. Limit standing, and walking as much as possible until pain improves.

2. Wear thick, soft ruberized shoe soles, with at least a 1/2-1' heel raise in the back of the shoe. This will put some slack in the calf muscles and plantar fascia.

3. Ice the heel(s) for 5 minutes before getting out of bed and after any long or hard activity.

4. Wear some type of 'arch' in your shoes, either soft 'over-the-counter arches' or soft custom orthotics.

5. Try anti-inflamatory pills, heel cortisone injections, etc. for a period. I have had only temporary success with physical therapy, and I feel that 'stretching devices' are the worst things to do, because the problem is being caused mainly by the 'stretching' that standing and walking cause, to the facsia.

6. If 3-6 months of this fails, then, shock wave therapy is next and partial small-incision plantar fascia release, should be done at the mid arch and not at the level of pain.

Good luck!
Andrew Carver DPM FACFAS
San Francisco, CA
carver@well.com

Re: Plantar Faciitus Getting Worse

Pauline on 9/07/01 at 09:46 (059356)

Dr. Carver,
I think many people will benefit from your treatment outline. Your treatment plan is easy to follow and I'm sure your patients appreciate getting it in a printed out form.

Re: Plantar Faciitus Getting Worse **ATTN: DR. CARVER**

Lisa C on 9/08/01 at 02:58 (059450)

Welcome Dr. Carver! I am so glad you decided to look into this website. We will all benifit from you sharing your time and knowledge with us!
PS. To heelspurs regulars, THIS is the San Fransico Dr. (of KGO radio fame) that I went to see. The Dr. who gives the painless shots! Tried the ice this morning. I will continue to do so as long as I can get someone to go fetch it for me. Its going to be hard to break the A.M. stretching habit though!

Re: Plantar Faciitus Getting Worse

JudyS on 9/08/01 at 09:40 (059466)

Welcome, Dr. Carver, and thank you for your list of tips here. Many of us are familiar with many of the items on your list but I was wondering if I could ask about #3....icing. You advise to ice before getting out of bed, but most of us have found just the opposite to be necessary - that is, to 'warm' the feet by gentle limbering and massage before getting up. This to have them as flexible as possible before taking that infamous first step. Would you have any thoughts on that?

Re: Plantar Faciitus Getting Worse

sandra on 10/03/01 at 14:30 (062165)

Hello,
I have an electro acuscope and the myopulse units, they work for almost any type of pain. I give treatments to many people and have had great results. Give it a try, it can't do any harm.

Re: Plantar Faciitus Getting Worse

Andrew Carver DPM FACFAS on 9/07/01 at 01:31 (059331)

Dear Klingonwoman,

Yes, most plantar fasciitis pain goes away, on it's own, but unfortunately that can take many years. 'Hard flooring' can bring on the syndrome and /or make it worse.

The best initial methods of treatment in my practice of 20 years are the following:

1. Limit standing, and walking as much as possible until pain improves.

2. Wear thick, soft ruberized shoe soles, with at least a 1/2-1' heel raise in the back of the shoe. This will put some slack in the calf muscles and plantar fascia.

3. Ice the heel(s) for 5 minutes before getting out of bed and after any long or hard activity.

4. Wear some type of 'arch' in your shoes, either soft 'over-the-counter arches' or soft custom orthotics.

5. Try anti-inflamatory pills, heel cortisone injections, etc. for a period. I have had only temporary success with physical therapy, and I feel that 'stretching devices' are the worst things to do, because the problem is being caused mainly by the 'stretching' that standing and walking cause, to the facsia.

6. If 3-6 months of this fails, then, shock wave therapy is next and partial small-incision plantar fascia release, should be done at the mid arch and not at the level of pain.

Good luck!
Andrew Carver DPM FACFAS
San Francisco, CA
carver@well.com

Re: Plantar Faciitus Getting Worse

Pauline on 9/07/01 at 09:46 (059356)

Dr. Carver,
I think many people will benefit from your treatment outline. Your treatment plan is easy to follow and I'm sure your patients appreciate getting it in a printed out form.

Re: Plantar Faciitus Getting Worse **ATTN: DR. CARVER**

Lisa C on 9/08/01 at 02:58 (059450)

Welcome Dr. Carver! I am so glad you decided to look into this website. We will all benifit from you sharing your time and knowledge with us!
PS. To heelspurs regulars, THIS is the San Fransico Dr. (of KGO radio fame) that I went to see. The Dr. who gives the painless shots! Tried the ice this morning. I will continue to do so as long as I can get someone to go fetch it for me. Its going to be hard to break the A.M. stretching habit though!

Re: Plantar Faciitus Getting Worse

JudyS on 9/08/01 at 09:40 (059466)

Welcome, Dr. Carver, and thank you for your list of tips here. Many of us are familiar with many of the items on your list but I was wondering if I could ask about #3....icing. You advise to ice before getting out of bed, but most of us have found just the opposite to be necessary - that is, to 'warm' the feet by gentle limbering and massage before getting up. This to have them as flexible as possible before taking that infamous first step. Would you have any thoughts on that?

Re: Plantar Faciitus Getting Worse

sandra on 10/03/01 at 14:30 (062165)

Hello,
I have an electro acuscope and the myopulse units, they work for almost any type of pain. I give treatments to many people and have had great results. Give it a try, it can't do any harm.