Home The Book Dr Articles Products Message Boards Journal Articles Search Our Surveys Surgery ESWT Dr Messages Find Good Drs video

Heel Spur Surgery

Posted by Angie on 9/25/01 at 19:19 (061568)

I have had PF and a small heel spur for the last 15 months. I have tried everything. Anti-inflamatories, cortisone shots, night splint, heel pads, orthotic. physio, and acupuncture. I stopped working five months ago as the pain went from my heel (but still being able to walk). To traveling up the back of my ankle and also giving me very severe pain and swelling around the inside of my heel all the way down to the arch . I have been unable to do any stretching for the calf or fascia as it seems to makethe pain t worse. I can't take hot baths or walk very far without making it worse. I have just finished three sessions of accupuncture. It seems to have helped the swelling , but the pain on the inside of my heel is still very sore, also the bottom of the heel. I have been told that no more can be done for me and I should consider having the heel spur removed, but leave the fascia alone. What do you think doctor? Also can you tell me why ultra sound would give me severe pain. My foot reacts to it in the same manner as if I had re- injured it. Then it is extremly painful for a week or more.

Re: Heel Spur Surgery

Dr.PeterW on 9/26/01 at 08:25 (061611)

Dear Angie,

First, I have a question for you -- is the pain a sharp tingling pain? There may be a nerve that is entrapped. Or, you might have a stress fracture and that is why the ultrasound made it worse. These are all possibilities. Also, it is impossible to have the spur removed without cutting the fascia because the fascia attaches to the bone. Get the above checked out and if you don't have these problems (trapped nerve or stress fracture), ESWT will be right for you.

Sincerely,
Dr. Peter A. Wishnie
Family Foot & Ankle Specialists
footdocs@bellatlantic.net
732.968.7622

Re: Heel Spur Surgery

Angie on 9/26/01 at 13:26 (061634)

Thanks for your response. In answer to your question my nerves were involved. I had numbness , burning, tingling along the outside of the foot into my toes. I also had it along the inside of the foot where I had severe swelling from the back of the heel down along the inside towards the arch. I no longer have these symptoms. I believe the rest and the acupuncture which reduced the swelling has taken a lot of the pressure of the nerve. The Physiotherapist also said I had very little rotation in my ankle as it was compressed. When she did the acupuncture, she also did pulls on my ankle. It reduced the swelling but unfortunatley not the pain. I did have an MRI. but It didn't show any stress fractures just the heel spur. Since there is no stress fracture any other ideas on why ultra sount would cause such pain? Another question I have is. If stretching of the fascia is suppose to benefit., why is it when I do any stretching I am in severe pain after. It may last up to a week, especially if I do a stair stretch on the calf?

Re: Heel Spur Surgery

Dr.PeterW on 9/28/01 at 12:21 (061799)

Dear Angie,
Pain can be normal when stretching due to the severe tightness of the P.F. You might want to ask your doctor about Tarsal Tunnel Syndrome. It is like carpal tunnel but in the foot. Your orthodics might need to be changed. Do you have hard or soft ones? Let me know.
Sincerely,
Dr. Peter A. Wishnie
Family Foot & Ankle Specialists
footdocs@bellatlantic.net
732.968.7622

Re: Heel Spur Surgery

Angie on 9/28/01 at 15:33 (061816)

Thanks Dr Peters for your insight. I have just gotten a new orthotic 10 days ago. I have been breaking them in a few hours each day. It is a soft material , but feel very uncomfortable on my heel. Yesterday I noticed my arches on BOTH feet were very sore. I t seems to put a lot of pressure on the inside of my foot, running along the insole betweenmy heel and arch. This is where I had the swelling and always have pain in this area. I am going to stop wearing the orthotic until my normal foot feels better. My Birkenstocks feel so good on my feet. Somehow seem to take the pressure of that area and my heel pad. I'm begining to think Birkenstocks are better for me than the orthotic Are you familiar with them? Can you make a comment on it. I have asked about Tarsal Tunnel and I was told it didn't seem likley.

Re: Heel Spur Surgery

Dr.PeterW on 10/04/01 at 08:34 (062206)

Dear Angie,

Berkinstocks are great!! I make customized ones for my patients. Good idea to stop using the orthodics until your doctor reevaluates them. He should be able to make them more comfortable.

Stay Well!
Dr.PW

Re: Heel Spur Surgery

Dr.PeterW on 9/26/01 at 08:25 (061611)

Dear Angie,

First, I have a question for you -- is the pain a sharp tingling pain? There may be a nerve that is entrapped. Or, you might have a stress fracture and that is why the ultrasound made it worse. These are all possibilities. Also, it is impossible to have the spur removed without cutting the fascia because the fascia attaches to the bone. Get the above checked out and if you don't have these problems (trapped nerve or stress fracture), ESWT will be right for you.

Sincerely,
Dr. Peter A. Wishnie
Family Foot & Ankle Specialists
footdocs@bellatlantic.net
732.968.7622

Re: Heel Spur Surgery

Angie on 9/26/01 at 13:26 (061634)

Thanks for your response. In answer to your question my nerves were involved. I had numbness , burning, tingling along the outside of the foot into my toes. I also had it along the inside of the foot where I had severe swelling from the back of the heel down along the inside towards the arch. I no longer have these symptoms. I believe the rest and the acupuncture which reduced the swelling has taken a lot of the pressure of the nerve. The Physiotherapist also said I had very little rotation in my ankle as it was compressed. When she did the acupuncture, she also did pulls on my ankle. It reduced the swelling but unfortunatley not the pain. I did have an MRI. but It didn't show any stress fractures just the heel spur. Since there is no stress fracture any other ideas on why ultra sount would cause such pain? Another question I have is. If stretching of the fascia is suppose to benefit., why is it when I do any stretching I am in severe pain after. It may last up to a week, especially if I do a stair stretch on the calf?

Re: Heel Spur Surgery

Dr.PeterW on 9/28/01 at 12:21 (061799)

Dear Angie,
Pain can be normal when stretching due to the severe tightness of the P.F. You might want to ask your doctor about Tarsal Tunnel Syndrome. It is like carpal tunnel but in the foot. Your orthodics might need to be changed. Do you have hard or soft ones? Let me know.
Sincerely,
Dr. Peter A. Wishnie
Family Foot & Ankle Specialists
footdocs@bellatlantic.net
732.968.7622

Re: Heel Spur Surgery

Angie on 9/28/01 at 15:33 (061816)

Thanks Dr Peters for your insight. I have just gotten a new orthotic 10 days ago. I have been breaking them in a few hours each day. It is a soft material , but feel very uncomfortable on my heel. Yesterday I noticed my arches on BOTH feet were very sore. I t seems to put a lot of pressure on the inside of my foot, running along the insole betweenmy heel and arch. This is where I had the swelling and always have pain in this area. I am going to stop wearing the orthotic until my normal foot feels better. My Birkenstocks feel so good on my feet. Somehow seem to take the pressure of that area and my heel pad. I'm begining to think Birkenstocks are better for me than the orthotic Are you familiar with them? Can you make a comment on it. I have asked about Tarsal Tunnel and I was told it didn't seem likley.

Re: Heel Spur Surgery

Dr.PeterW on 10/04/01 at 08:34 (062206)

Dear Angie,

Berkinstocks are great!! I make customized ones for my patients. Good idea to stop using the orthodics until your doctor reevaluates them. He should be able to make them more comfortable.

Stay Well!
Dr.PW