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foot and heel pain

Posted by pj on 10/17/01 at 17:36 (063181)

A few months ago I had heel pain and the Doc said it appeared to be caused by inflamation of the Posterior Tibial Tendon. We tried a cortisone injection in the heel and then after no relief and it getting worse he casted it for three weeks. It did get better. Now the pain is back and much worse, the more I am on it the worse it gets. It does hurt in the morning right away, but the pain throughout the day is a burning pain in my heel and across my arch. Yesterday I noticed a shocky feeling that shot into my toes when I was barefoot. The burning is unreal. When I get home at night after resting awhile I can barely walk, the pain is so bad. I have to walk on the outside of my foot. I can't even let the heel hit the ground. Last night I had to almost crawl to my room it was so bad. But again in the morning I get up and walk with only mild pain at first that gets worse all day. Even when at home and just sitting it feels like the inside and bottom of me foot are on fire. I have tried taking anti-inflamatories, both otc and presciption. I have also tried ice. I have tried severl different shoe inserts and arch supports. Most seem to make it worse. Nothing seems to help. Any other suggestions before I go back to the Doc. I really don't want to deal with the cast thing again. thanks

Re: foot and heel pain

Ed Davis, DPM on 10/17/01 at 18:21 (063185)

The cast was something that needed to be done in order to allow healing and it may need to be repeated. What was done after the cast was removed the first time? If you have biomechanical problems that require attention, it is important to go beyond treating the acute symptoms otherwise recurrence is likely. Orthotics are one modality that can address biomechanical problems.
Ed

Re: foot and heel pain

pj on 10/17/01 at 21:51 (063202)

After the cast was removed I wore a lace up ankle brace for several weeks. I quit wearing that when all the pain was gone. I did purchase a new pair of walking shoes and wore the arch support with them. The pain eventually began to come back and now is as bad as it was right before the cast was on. My job requires me to be on my feet a lot. I have tried the shoe with the support, with the lace up brace and even tried gel insoles. Nothing seems to help. I am also now noticing that the burning pain is starting to shoot up around my ankle as well. My ortho did check the arch in both of my feet and said that they looked like they were fine. I also had an mri and there was an area where there was a fluid build up, near the area where it now hurts. But he said that it looked fine besides that. I can say that I this evening I am home and now find it near impossible to walk on that foot without a shoe on and even painful with the shoe. I guess that after reading some of the posts about people with serious foot problems I should consider myself lucky if all I would have to do is hobble around in a cast for awhile again. I just wonder if there is anything I can do to prevent this from happening again besides the things I have tried (ankle brace, arch supports. gel insoles). Is it to late to try something else now that it has gotten this bad again?

Re: foot and heel pain

Andrea R. on 10/18/01 at 06:48 (063206)

PJ,

One of the best recommendations I received from this board was DO NOT GO BAREFOOT. Birkenstock are one of the often suggested solutions. I even have a pair I can wear in the shower.

Do you do any stretching or message? Have you had any physical therapy?

My ortho had me in a cast for five weeks and then gave me exercises to do to strengthen my ankle.

Before you get up after sitting around in the evening, try flexing and stretching before you get up.

Is your ortho a foot and ankle specialist? If not you might want to get another opinion from one who is or a podiatrist.

Good Luck,

Andrea

Re: foot and heel pain

pj on 10/18/01 at 14:46 (063233)

Thanks for the input. I will keep my shoes on when I walk. Just came back form the Doc and am supposed to use crutches and rest it for the next two weeks. Not easy to do at work, actually not quite possible but I will do my best! He also told me to change the arch support from a rigid one to a soft one. He said if it didn't settle down again we could look at immobilization again and then getting some custom supports. Not sure if it is the tendon now or the nerve. May have to repeat the MRI and have some nerve studies done. Well for the next two weeks I guess I won't be going dancing :). (just kidding)Thanks again for your suggestions and God Bless!

Re: foot and heel pain

Ed Davis, DPM on 10/19/01 at 20:42 (063314)

A good biomechanical workup is in order. You may benefit from orthotics (professionally dispensed or prescribed), physical therapy. A good look at the mechanics of the problem can better determine what your needs are and if they have been met. Consider finding a good podiatrist is your area via http://www.acfas.org I may know someone in your area if you tell me where you live.
Ed

Re: foot and heel pain

Dr. Zuckerman on 10/21/01 at 13:21 (063386)

Hi,

I would recommend Dr. Lowell Scott Weil SR or Jr. They are in the Chicago area and they both are podiatrists for the Chicago White Sox Baseball Team

Dr. Weil will also be able to evaluate you for TTS and or any other local or systemic neuropathy type pain. Good Luck . Always here to answer and help you out.

Re: foot and heel pain

Ed Davis, DPM on 10/17/01 at 18:21 (063185)

The cast was something that needed to be done in order to allow healing and it may need to be repeated. What was done after the cast was removed the first time? If you have biomechanical problems that require attention, it is important to go beyond treating the acute symptoms otherwise recurrence is likely. Orthotics are one modality that can address biomechanical problems.
Ed

Re: foot and heel pain

pj on 10/17/01 at 21:51 (063202)

After the cast was removed I wore a lace up ankle brace for several weeks. I quit wearing that when all the pain was gone. I did purchase a new pair of walking shoes and wore the arch support with them. The pain eventually began to come back and now is as bad as it was right before the cast was on. My job requires me to be on my feet a lot. I have tried the shoe with the support, with the lace up brace and even tried gel insoles. Nothing seems to help. I am also now noticing that the burning pain is starting to shoot up around my ankle as well. My ortho did check the arch in both of my feet and said that they looked like they were fine. I also had an mri and there was an area where there was a fluid build up, near the area where it now hurts. But he said that it looked fine besides that. I can say that I this evening I am home and now find it near impossible to walk on that foot without a shoe on and even painful with the shoe. I guess that after reading some of the posts about people with serious foot problems I should consider myself lucky if all I would have to do is hobble around in a cast for awhile again. I just wonder if there is anything I can do to prevent this from happening again besides the things I have tried (ankle brace, arch supports. gel insoles). Is it to late to try something else now that it has gotten this bad again?

Re: foot and heel pain

Andrea R. on 10/18/01 at 06:48 (063206)

PJ,

One of the best recommendations I received from this board was DO NOT GO BAREFOOT. Birkenstock are one of the often suggested solutions. I even have a pair I can wear in the shower.

Do you do any stretching or message? Have you had any physical therapy?

My ortho had me in a cast for five weeks and then gave me exercises to do to strengthen my ankle.

Before you get up after sitting around in the evening, try flexing and stretching before you get up.

Is your ortho a foot and ankle specialist? If not you might want to get another opinion from one who is or a podiatrist.

Good Luck,

Andrea

Re: foot and heel pain

pj on 10/18/01 at 14:46 (063233)

Thanks for the input. I will keep my shoes on when I walk. Just came back form the Doc and am supposed to use crutches and rest it for the next two weeks. Not easy to do at work, actually not quite possible but I will do my best! He also told me to change the arch support from a rigid one to a soft one. He said if it didn't settle down again we could look at immobilization again and then getting some custom supports. Not sure if it is the tendon now or the nerve. May have to repeat the MRI and have some nerve studies done. Well for the next two weeks I guess I won't be going dancing :). (just kidding)Thanks again for your suggestions and God Bless!

Re: foot and heel pain

Ed Davis, DPM on 10/19/01 at 20:42 (063314)

A good biomechanical workup is in order. You may benefit from orthotics (professionally dispensed or prescribed), physical therapy. A good look at the mechanics of the problem can better determine what your needs are and if they have been met. Consider finding a good podiatrist is your area via http://www.acfas.org I may know someone in your area if you tell me where you live.
Ed

Re: foot and heel pain

Dr. Zuckerman on 10/21/01 at 13:21 (063386)

Hi,

I would recommend Dr. Lowell Scott Weil SR or Jr. They are in the Chicago area and they both are podiatrists for the Chicago White Sox Baseball Team

Dr. Weil will also be able to evaluate you for TTS and or any other local or systemic neuropathy type pain. Good Luck . Always here to answer and help you out.