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fascia related pain?

Posted by Chris C. on 9/28/01 at 10:35 (061795)

I have been suffering from plantar fasciitis for several years off and on. I do a good bit of running and biking and play tennis. I used custom orthotics which have served me well. This most recent outbreak has lasted over a year. By Feb. I decided to take an injection of cortisone to help speed healing, even though I had been resting since Sept. of 2000. I took injections again in Mar. and June, with the June shot working fairly well.
then in August, I thought I had landed funny on my right foot and now have pronounced pain in the forefoot, just behind the ball of my foot. I am in pain any time I put weight on the foot, although the degree of severity seems to change. I was the pain seems to involve the metatarsals as well as being sensitive at a particular point on the bottom of my foot. I had an x ray and mri done and neither shows any fundamental problem, yet I am still in agony. The orthopod that I went to that ordered the mri simply said to rest and take it easy, she is stumped. At this point I have been in a great deal of pain since August 20, and wonder what I should do now.
I am frustrated not knowing why the pain is located there and why it is so severe and different from the fasciitis pain. Any suggestions?

Re: fascia related pain?

Ed Davis, DPM on 9/28/01 at 18:47 (061824)

The plantar fascia extends from the heel to the forefoot. Most plantar fascial injuries are in the heel and arch although some can be in the forefoot. Such a variant of plantar fasciitis is a possiblity but it is hard to speculate without seeing your foot. The next step is to see a foot specialist. I may know someone in your area or you can query http://www.acfas.org
Ed

Re: fascia related pain?

Dr. Zuckerman on 9/28/01 at 20:51 (061836)

Hi

Could be a neuroma secondary to trauma. Sometimes the mri just can't see the
problem. May want to use a three phase bone scan to pin point the exact area of trauma if your doctor just can't palpate the problem on examination

good luck.

Re: fascia related pain?

Chris C. on 9/29/01 at 07:43 (061844)

Thanks, I had just started to consider a bone scan, since some other reading seemed to indicate that a bone scan may be more precise in some cases than an MRI. I appreciate your feedback.

Re: fascia related pain?

Chris C. on 9/29/01 at 07:49 (061845)

Thanks for your help. I have been going to one here in Gainesville, FL and will continue to do so. I think I may have only confused the issue with my visit to an orthopedist, one that seemed to be somewhat disinterested in my problem. I imagine rest, ice and the like are called for at a minimum?

Re: fascia related pain?

Dr. Zuckerman on 9/29/01 at 13:35 (061867)

If will help to locate the source of your pain. It measures increase blood
flow to an area which can be caused by infection , trauma. After localization via the bone scan then maybe a CAT . Usually physical examination is what determines what is wrong with you. Maybe time to find
a very skilled podiatric physician with some experience. I was taught may
years ago tests confirm what you physical examination already knows!!

Re: fascia related pain?

Ed Davis, DPM on 9/28/01 at 18:47 (061824)

The plantar fascia extends from the heel to the forefoot. Most plantar fascial injuries are in the heel and arch although some can be in the forefoot. Such a variant of plantar fasciitis is a possiblity but it is hard to speculate without seeing your foot. The next step is to see a foot specialist. I may know someone in your area or you can query http://www.acfas.org
Ed

Re: fascia related pain?

Dr. Zuckerman on 9/28/01 at 20:51 (061836)

Hi

Could be a neuroma secondary to trauma. Sometimes the mri just can't see the
problem. May want to use a three phase bone scan to pin point the exact area of trauma if your doctor just can't palpate the problem on examination

good luck.

Re: fascia related pain?

Chris C. on 9/29/01 at 07:43 (061844)

Thanks, I had just started to consider a bone scan, since some other reading seemed to indicate that a bone scan may be more precise in some cases than an MRI. I appreciate your feedback.

Re: fascia related pain?

Chris C. on 9/29/01 at 07:49 (061845)

Thanks for your help. I have been going to one here in Gainesville, FL and will continue to do so. I think I may have only confused the issue with my visit to an orthopedist, one that seemed to be somewhat disinterested in my problem. I imagine rest, ice and the like are called for at a minimum?

Re: fascia related pain?

Dr. Zuckerman on 9/29/01 at 13:35 (061867)

If will help to locate the source of your pain. It measures increase blood
flow to an area which can be caused by infection , trauma. After localization via the bone scan then maybe a CAT . Usually physical examination is what determines what is wrong with you. Maybe time to find
a very skilled podiatric physician with some experience. I was taught may
years ago tests confirm what you physical examination already knows!!