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PF Sufferer--Need Advice

Posted by Aims on 10/05/01 at 14:10 (062316)

Hi. I just found this site. I'm hoping someone can help. I've found the message board to be really helpful so far.
Here's my situation...................
I have been suffering from EXTREME heel pain for 10 months now. I injured my heel after a long walking trip to Disney. I have tried several NSAIDS and Cortisone injections and a night splint, as well as ICE,MASSAGE, and ORTHOTICS. Nothing seems to help. The pain is getting worse--spreading up to my ankle. My Podiatrist is out of ideas. What else can I do to alleviate this pain? X Rays 3 months ago revealed that there is no bone spur YET, but I'm afraid one will develop. Is surgery my next option?

Re: PF Sufferer--Need Advice

Andrea R. on 10/05/01 at 15:01 (062317)

Aims,

A walking cast, physical therapy, isopheresis, stretching, massage, ESWT, . . .

If your pod is out of ideas, get another opinion. Find an orthopedist who specializes in feet and ankles.

All conservative methods should be exhausted before surgery.

Read the PF Book on this site.

If you have questions just post them, we are all here to share ideas and know what you're going through.

Andrea

Re: Aims

Carmen H on 10/05/01 at 16:32 (062325)

What type of shoe are you wearing? Are you stretching or have you tried stretching yet?
What dose of NSAIDS were you on? Have you had an MRI? Where does the pain STOP?
How many injections have you had? Did they help at all?
What type of job do you have?
We'll try to help...need more detailed info though....

Re: PF Sufferer--Need Advice

Maria Z. on 10/06/01 at 14:40 (062390)

Has your massage included your calf? I've had huge improvement since I've been massaging my calf.
Have you been taping? Look around, theres lots of different taping styles maybe one will work for you.
Birkenstocks. Expensive but woth every penny in my opinion. I wish I would have found these shoes before I spent big bucks at the podiatrist.

Re: PF Sufferer--Need Advice

Steve P on 10/07/01 at 09:25 (062427)

Aims --- At 10 months, ESWT may be your best option. Since you've tried many conservative treatments without good results, consider looking into ESWT.

I would NEVER consider surgery before being first evaluated for ESWT.

Best........Steve

Re: PF Sufferer--Need Advice

john h on 10/08/01 at 16:01 (062487)

Aims: I echo Steve P's advice.

Re: PF Sufferer--Need Advice

Ed Davis, DPM on 10/08/01 at 17:21 (062491)

One thing to consider, before going further, is the possibility of a diagnosis other than plantar fasciitis. Please describe the pain you have--location, sharp or dull, throbbing, aching, etc. What time of day does it hurt most? Is the pain worse with activity? Are you standing most of the day at work? Swelling?
Ed

Re: PF Sufferer--Need Advice

Max K on 10/09/01 at 07:20 (062524)

I hope it's not RSD/CRPS = reflex sympathetic dystrophy / complex regional pain syndrome. I had to think of that when you mentioned pain that seems out of proportion to the injury, pain that gets worse over time for no apparent reason, and pain that spreads.

Re: PF Sufferer--Need Advice

Aims on 10/09/01 at 09:52 (062531)

First of all, I would like to thank each and every one of you who has responded to my inquiry. I was overwhelmed with the response I received and so happy to get them so quickly! Thanks to this board I was able to discuss some more treatment options with my Podiatrist. I had an appointment yesterday and he brought up the possibility of surgery. Well you can imagine that I freaked out, especially since I learned from reading this message board that there are other options available to me, including PT and ESWT. I was really surprised that he had not mentioned it before--it seemes as if he was only focusing on throwing more pills at me as a band-aid. I'm on yet another medicine now--Celebrex--and have gone back to taping. I'll try this for another week, and then I am either going to start PT and/or seek another opinion.

In response to Dr. Davis' comment--the pain started 10 months ago. We were on vacation to Disney and did extensive fast walking that day (about 10-12 hours)--we were trying to see all the sites. By the end of the day my right foot was hurting severely--the best I can describe is that it felt like I was walking on ice skate blades (or a knife) except the pain was more on the outside right side of my foot (underneath--from my little toe to my heel). Prior to this incident I never had any pain in that foot. The pain was sharp, and by the next day, was throbbing and sharp. For the rest of my trip I stayed off my foot as much as possible. At the end of the first week it wasn't getting better. I started having my husband massage my foot (very painful I might add) along the underneath side of the foot to give me some sort of relief. He felt (what I describe as crunchies) underneath my skin) and after about 2 months of massaging, the crunchies were smooth again and the pain was more bearable, and the area was just sore,like a bruise. More of a dull aching pain. After about 4-5 months, the pain moved to the center of my heel (bottom) and has remained there. It is a sometimes sharp and sometimes dull aching pain. Often, I feel a burning ripping sensation in my heel (outer right side). The pain is bad throughout the day. I have a desk job, so I'm sitting most of the day, thankfully. The pain is often worse in the morning (although not always) and most definitely gets worse with standing or walking. I try not to walk around my house without shoes, as this seems to aggravate my condition. (I hate having anything on my feet and prior to this walked around barefoot so this is a big deal for me!) Also at times (even while sitting) I will get a SHARP knife like pain in the bottom of my heel. There are days when the pain is at a minimum (on a scale of 1-10--around a 3) and other days when it is off the charts. I try not to 'aggravate' my foot any and continue doing stretches (which has helped some). I went to my family physician who took X-Rays (had me use a cloth to stretch my heel to take the XRay) to check for a heel spur. He did not find one and I suffered a couple more months before starting to see a Podiatrist. I was really unhappy with his approach. They took another series of Xrays and did not find anything. He just threw cortisone and drugs at me. I'm giving him one more chance and hopefully I'll be starting PT soon. If not, then I think I'm going to get another opinion. I've lived with this long enough and its time to take action, not cover it up with drugs. Let me know what you think.
Thanks again for your consideration. (Sorry this post is so long).

Re: PF Sufferer--Need Advice

Aims on 10/09/01 at 09:57 (062533)

Forgot to mention that the pain is spreading to my ankle and there is some swelling. I imagine its from my feet 'rolling' when I walk. I'm sure I am not walking correctly in order to avoid the pain and this may be causing other problems--another reason to be concerned.
Thanks.

Re: PF Sufferer--Need Advice

Aims on 10/09/01 at 09:58 (062534)

Forgot to mention that the pain is spreading to my ankle and there is some swelling in the ankle. I imagine its from my feet 'rolling' when I walk. I'm sure I am not walking correctly in order to avoid the pain and this may be causing other problems--another reason to be concerned.
Thanks.

Re: PF Sufferer--Need Advice

ellen w on 10/09/01 at 14:24 (062551)

Dear Aims,
Reducing inflammation is one of the keys to healing. Like you, regular NSAIDs didn't help me at all. If Celebrex doesn't work for you, keep trying other alternatives. Some posters have noted that Vioxx works better for them than Celebrex. I've had some success with Mobic. You may want to try some complimentary methods -- Jade Balm (search back posts for this)or cherry juice concentrate are two of the things posters seem to be currently trying. For a previous problem -- retrocalcaneal bursitis -- which I had before my current bout with PF, I found MSM (an herbal supplement)and going cold turkey on stopping diet soda (which I think added to swelling because of all the sodium) helpful.

In physical therapy, in addition to stretching exercises, I'm getting ultrasound and electrical stimulation to reduce inflammation. This is applied not only to the heel of my foot, where I have pain, but throughout the arch and ball of the foot, where she says I feel tight. My therapist also has me doing what she calls an ice massage -- you freeze a dixie cup, peel down the first inch or so of paper, then rub the exposed end over the bottom of your foot and ankle, for 5 minutes.

You may need to try different drugs/things at different times, in different combinations, before you find something that works for you. For example, with the bursitis, nothing seemed to work until I took a 5-day dose pack of oral steroids. Although that wasn't the silver bullet that provided the cure, it did bring some of the inflammation down enough so that the healing process began and some of the less powerful drugs/complimentary treatments were able to have some effect. You may also find that as your inflammation lessens, treatments that didn't work and you previously discarded may be helpful. Right now, for example, a night splint seems to be helping -- I don't think it would have earlier in treatment.

Dr. Davis once posted to the effect that treatment needs to be the right treatment at the right time in the right order, which seems to me like sound advice.

good luck
Ellen

Re: have you had bone scan?

Paula G. on 10/09/01 at 15:51 (062559)

Right before I scheduled surgery, my doctor did a bone scan to see if there were any stress fractures that x-ray did not pick up.

Re: PF Sufferer--Need Advice

john h on 10/10/01 at 10:08 (062626)

In 7-8 years i never took one medication except a medrol dose pack that reduced the pain in my feet and this list of meds i tried is to long for me to even remember. of course, medrol can not be taken on a regular basis as it is a steroid. I had a steriod shot into the foot that reduced pain for about one week. I continue to use Jade because i started using it at about the same time as my last ESWT treatment which has at long last produced some positive results.

Re: PF Sufferer--Need Advice

Ed Davis, DPM on 10/10/01 at 16:37 (062673)

Is there pain when you squeeze the bottom of the heel bone, side to side?

Ed

Re: PF Sufferer--Need Advice

Aims on 10/11/01 at 14:16 (062753)

Yes there is pain if I squeeze the bottom of the heel from side to side.

Re: PF Sufferer--Need Advice

Ed Davis, DPM on 10/11/01 at 18:19 (062787)

Consider a bone scan as mentioned by Paula to rule out the possibility of a stress fracture.
Ed

Re: PF Sufferer--Need Advice

Dr. Zuckerman on 10/11/01 at 18:25 (062789)

Until you find out the cause of this pain . Off your foot. Get into a boot cast. Three phase bone scan and or mri could help to find out what is going
on with your foot. Get another opinion. One set of feet must last a life time. Not joking. I just read this thread . What is going on here. This is going on way to long to be just normal healing and typical plantar fasciitis.

Re: PF Sufferer--Need Advice

Andrea R. on 10/05/01 at 15:01 (062317)

Aims,

A walking cast, physical therapy, isopheresis, stretching, massage, ESWT, . . .

If your pod is out of ideas, get another opinion. Find an orthopedist who specializes in feet and ankles.

All conservative methods should be exhausted before surgery.

Read the PF Book on this site.

If you have questions just post them, we are all here to share ideas and know what you're going through.

Andrea

Re: Aims

Carmen H on 10/05/01 at 16:32 (062325)

What type of shoe are you wearing? Are you stretching or have you tried stretching yet?
What dose of NSAIDS were you on? Have you had an MRI? Where does the pain STOP?
How many injections have you had? Did they help at all?
What type of job do you have?
We'll try to help...need more detailed info though....

Re: PF Sufferer--Need Advice

Maria Z. on 10/06/01 at 14:40 (062390)

Has your massage included your calf? I've had huge improvement since I've been massaging my calf.
Have you been taping? Look around, theres lots of different taping styles maybe one will work for you.
Birkenstocks. Expensive but woth every penny in my opinion. I wish I would have found these shoes before I spent big bucks at the podiatrist.

Re: PF Sufferer--Need Advice

Steve P on 10/07/01 at 09:25 (062427)

Aims --- At 10 months, ESWT may be your best option. Since you've tried many conservative treatments without good results, consider looking into ESWT.

I would NEVER consider surgery before being first evaluated for ESWT.

Best........Steve

Re: PF Sufferer--Need Advice

john h on 10/08/01 at 16:01 (062487)

Aims: I echo Steve P's advice.

Re: PF Sufferer--Need Advice

Ed Davis, DPM on 10/08/01 at 17:21 (062491)

One thing to consider, before going further, is the possibility of a diagnosis other than plantar fasciitis. Please describe the pain you have--location, sharp or dull, throbbing, aching, etc. What time of day does it hurt most? Is the pain worse with activity? Are you standing most of the day at work? Swelling?
Ed

Re: PF Sufferer--Need Advice

Max K on 10/09/01 at 07:20 (062524)

I hope it's not RSD/CRPS = reflex sympathetic dystrophy / complex regional pain syndrome. I had to think of that when you mentioned pain that seems out of proportion to the injury, pain that gets worse over time for no apparent reason, and pain that spreads.

Re: PF Sufferer--Need Advice

Aims on 10/09/01 at 09:52 (062531)

First of all, I would like to thank each and every one of you who has responded to my inquiry. I was overwhelmed with the response I received and so happy to get them so quickly! Thanks to this board I was able to discuss some more treatment options with my Podiatrist. I had an appointment yesterday and he brought up the possibility of surgery. Well you can imagine that I freaked out, especially since I learned from reading this message board that there are other options available to me, including PT and ESWT. I was really surprised that he had not mentioned it before--it seemes as if he was only focusing on throwing more pills at me as a band-aid. I'm on yet another medicine now--Celebrex--and have gone back to taping. I'll try this for another week, and then I am either going to start PT and/or seek another opinion.

In response to Dr. Davis' comment--the pain started 10 months ago. We were on vacation to Disney and did extensive fast walking that day (about 10-12 hours)--we were trying to see all the sites. By the end of the day my right foot was hurting severely--the best I can describe is that it felt like I was walking on ice skate blades (or a knife) except the pain was more on the outside right side of my foot (underneath--from my little toe to my heel). Prior to this incident I never had any pain in that foot. The pain was sharp, and by the next day, was throbbing and sharp. For the rest of my trip I stayed off my foot as much as possible. At the end of the first week it wasn't getting better. I started having my husband massage my foot (very painful I might add) along the underneath side of the foot to give me some sort of relief. He felt (what I describe as crunchies) underneath my skin) and after about 2 months of massaging, the crunchies were smooth again and the pain was more bearable, and the area was just sore,like a bruise. More of a dull aching pain. After about 4-5 months, the pain moved to the center of my heel (bottom) and has remained there. It is a sometimes sharp and sometimes dull aching pain. Often, I feel a burning ripping sensation in my heel (outer right side). The pain is bad throughout the day. I have a desk job, so I'm sitting most of the day, thankfully. The pain is often worse in the morning (although not always) and most definitely gets worse with standing or walking. I try not to walk around my house without shoes, as this seems to aggravate my condition. (I hate having anything on my feet and prior to this walked around barefoot so this is a big deal for me!) Also at times (even while sitting) I will get a SHARP knife like pain in the bottom of my heel. There are days when the pain is at a minimum (on a scale of 1-10--around a 3) and other days when it is off the charts. I try not to 'aggravate' my foot any and continue doing stretches (which has helped some). I went to my family physician who took X-Rays (had me use a cloth to stretch my heel to take the XRay) to check for a heel spur. He did not find one and I suffered a couple more months before starting to see a Podiatrist. I was really unhappy with his approach. They took another series of Xrays and did not find anything. He just threw cortisone and drugs at me. I'm giving him one more chance and hopefully I'll be starting PT soon. If not, then I think I'm going to get another opinion. I've lived with this long enough and its time to take action, not cover it up with drugs. Let me know what you think.
Thanks again for your consideration. (Sorry this post is so long).

Re: PF Sufferer--Need Advice

Aims on 10/09/01 at 09:57 (062533)

Forgot to mention that the pain is spreading to my ankle and there is some swelling. I imagine its from my feet 'rolling' when I walk. I'm sure I am not walking correctly in order to avoid the pain and this may be causing other problems--another reason to be concerned.
Thanks.

Re: PF Sufferer--Need Advice

Aims on 10/09/01 at 09:58 (062534)

Forgot to mention that the pain is spreading to my ankle and there is some swelling in the ankle. I imagine its from my feet 'rolling' when I walk. I'm sure I am not walking correctly in order to avoid the pain and this may be causing other problems--another reason to be concerned.
Thanks.

Re: PF Sufferer--Need Advice

ellen w on 10/09/01 at 14:24 (062551)

Dear Aims,
Reducing inflammation is one of the keys to healing. Like you, regular NSAIDs didn't help me at all. If Celebrex doesn't work for you, keep trying other alternatives. Some posters have noted that Vioxx works better for them than Celebrex. I've had some success with Mobic. You may want to try some complimentary methods -- Jade Balm (search back posts for this)or cherry juice concentrate are two of the things posters seem to be currently trying. For a previous problem -- retrocalcaneal bursitis -- which I had before my current bout with PF, I found MSM (an herbal supplement)and going cold turkey on stopping diet soda (which I think added to swelling because of all the sodium) helpful.

In physical therapy, in addition to stretching exercises, I'm getting ultrasound and electrical stimulation to reduce inflammation. This is applied not only to the heel of my foot, where I have pain, but throughout the arch and ball of the foot, where she says I feel tight. My therapist also has me doing what she calls an ice massage -- you freeze a dixie cup, peel down the first inch or so of paper, then rub the exposed end over the bottom of your foot and ankle, for 5 minutes.

You may need to try different drugs/things at different times, in different combinations, before you find something that works for you. For example, with the bursitis, nothing seemed to work until I took a 5-day dose pack of oral steroids. Although that wasn't the silver bullet that provided the cure, it did bring some of the inflammation down enough so that the healing process began and some of the less powerful drugs/complimentary treatments were able to have some effect. You may also find that as your inflammation lessens, treatments that didn't work and you previously discarded may be helpful. Right now, for example, a night splint seems to be helping -- I don't think it would have earlier in treatment.

Dr. Davis once posted to the effect that treatment needs to be the right treatment at the right time in the right order, which seems to me like sound advice.

good luck
Ellen

Re: have you had bone scan?

Paula G. on 10/09/01 at 15:51 (062559)

Right before I scheduled surgery, my doctor did a bone scan to see if there were any stress fractures that x-ray did not pick up.

Re: PF Sufferer--Need Advice

john h on 10/10/01 at 10:08 (062626)

In 7-8 years i never took one medication except a medrol dose pack that reduced the pain in my feet and this list of meds i tried is to long for me to even remember. of course, medrol can not be taken on a regular basis as it is a steroid. I had a steriod shot into the foot that reduced pain for about one week. I continue to use Jade because i started using it at about the same time as my last ESWT treatment which has at long last produced some positive results.

Re: PF Sufferer--Need Advice

Ed Davis, DPM on 10/10/01 at 16:37 (062673)

Is there pain when you squeeze the bottom of the heel bone, side to side?

Ed

Re: PF Sufferer--Need Advice

Aims on 10/11/01 at 14:16 (062753)

Yes there is pain if I squeeze the bottom of the heel from side to side.

Re: PF Sufferer--Need Advice

Ed Davis, DPM on 10/11/01 at 18:19 (062787)

Consider a bone scan as mentioned by Paula to rule out the possibility of a stress fracture.
Ed

Re: PF Sufferer--Need Advice

Dr. Zuckerman on 10/11/01 at 18:25 (062789)

Until you find out the cause of this pain . Off your foot. Get into a boot cast. Three phase bone scan and or mri could help to find out what is going
on with your foot. Get another opinion. One set of feet must last a life time. Not joking. I just read this thread . What is going on here. This is going on way to long to be just normal healing and typical plantar fasciitis.