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heel spur

Posted by nini on 10/18/01 at 20:33 (063255)

I've just gone to a doctor for heel pain and had x-rays done. Doc says spurs on both heels but only one hurts all the time. He gave me exercises and anti-inflamatory meds, soaking and ice. So after all this whats next? I'm terrified of shots in the heel and some people on this board seem to have been better off not having surgery. I am only getting more nervous by the minute. The pain is so bad in the morning and after walking or standing, and of course sitting for more than 10 minutes is a serious no-no. I am over weight but working on that but at this point will losing weight help now that the spurs are here?? I will welcome any advice.

Re: heel spur

Andrea R. on 10/19/01 at 10:55 (063289)

Nini,

Before you agree to a cortizone shot, ask the doctor to prescribe a night splint. (You need a script so insurance will cover it). My ortho said he cut the number of cortizone shots for PF down by over 50% by trying the night splint first.

Also: never go barefoot. I always wear my Birkenstock even for short trips. Before you get out of bed or up from a long resting period stretch and massage your foot.

There are alot of conservative methods to try before any surgery.

Good luck,

Andrea

Re: heel spur

Ed Davis, DPM on 10/19/01 at 21:22 (063322)

Nini:

There are a lot of alternatives to cortisone shots. Don't try to find one modality as a single 'magic bullet.' A comprehensive treatment program combining a number of effective modalities always works best. night splints can be a terrific modality for the right persons but they are not effective for everyone. A doctor who can give you a thorough exam and provide the right combination of modalities is the way to go. Some sources of qualified docs include http://www.acfas.org I may know someone in your area if you list your locale.
Ed

Re: heel spur

Nini on 10/27/01 at 18:58 (063690)

Thanks for your reply doc. I hope the doc I have feels the same way! What about insurance covering surgery if I don't go through with the shots? I started therapy and it feels good at the time but when I leave it's back. I feel more pain coming back now that the steriods have worn off. If I don't get shots then whats next? The splint doesn't sound bad and I've looked it on the pc but what keeps the pain away for good?

Re: heel spur

Ed Davis, DPM on 10/28/01 at 14:08 (063732)

Nini:

Better than 95% of heel pain is effectively treated without surgery. Don't waste time focusing on 'what if' you are in that 5%. Instead, make sure you are getting all the treatment necessary...orthotics, night splints, physical therapy. Physical therapy takes time for the relief to start to hold. That may or may not happen if your foot biomechanics are placing too much strain on the plantar fascia. It is the excess tension on the fascia that causes the pain. That tension must be relieved if you are going to relieve the pain permanently.
Ed

Re: heel spur

Nini on 10/28/01 at 17:38 (063737)

Hey doc, thank you for advice and will keep you informed, helps to have 2nd source of advice.

Re: heel spur

Stephanie Adams on 10/30/01 at 09:57 (063820)

Nini,
try any alteratives before surgery. I was first told I had bilateral heel spurs in 1996, I too was afraid of the cortisone and just did stretching for the first year and took Lodine, then the pain got worse, so I then went with the shots, the first lasted about 8 months, at that time I had custom orthotics made this worked great, the combination of the orthotics, Lodine and stretching exericises before I got out of bed was my answer for a long time. I did have the left foot spur removed when I had surgery for TTS and PF in May 2001, just because they were in there. The right is still fine, it never hurt as much as the left. I have had alot of problems since my surgery.....ie....infection, lateral column syndrome, loss of some ROM, pain, numbness..... I think it would be better for you to try alot of different things before you opt for surgery. I too am over weight and my feet felt better when I did not have so much to carry around And losing some weight still will help the spurs because it will be less pressure on your feet and plus you will feel better all around. and as soon as I can walk any distance and do the exercises I need to do My feet will feel better also.
Good Luck

Re: heel spur

Nini on 10/30/01 at 16:35 (063838)

Hi Stephanie, thanks for the advice. I'm trying to lose weight and have lost 20 since May but have been holding. I do whatever the therapist says and take his advice but I've been getting pain again in the morning and in the evening. I just get tired of being in pain.I go back to doc in a week so we'll see what he says then. Again, thank you!

Re: heel spur

Andrea R. on 10/19/01 at 10:55 (063289)

Nini,

Before you agree to a cortizone shot, ask the doctor to prescribe a night splint. (You need a script so insurance will cover it). My ortho said he cut the number of cortizone shots for PF down by over 50% by trying the night splint first.

Also: never go barefoot. I always wear my Birkenstock even for short trips. Before you get out of bed or up from a long resting period stretch and massage your foot.

There are alot of conservative methods to try before any surgery.

Good luck,

Andrea

Re: heel spur

Ed Davis, DPM on 10/19/01 at 21:22 (063322)

Nini:

There are a lot of alternatives to cortisone shots. Don't try to find one modality as a single 'magic bullet.' A comprehensive treatment program combining a number of effective modalities always works best. night splints can be a terrific modality for the right persons but they are not effective for everyone. A doctor who can give you a thorough exam and provide the right combination of modalities is the way to go. Some sources of qualified docs include http://www.acfas.org I may know someone in your area if you list your locale.
Ed

Re: heel spur

Nini on 10/27/01 at 18:58 (063690)

Thanks for your reply doc. I hope the doc I have feels the same way! What about insurance covering surgery if I don't go through with the shots? I started therapy and it feels good at the time but when I leave it's back. I feel more pain coming back now that the steriods have worn off. If I don't get shots then whats next? The splint doesn't sound bad and I've looked it on the pc but what keeps the pain away for good?

Re: heel spur

Ed Davis, DPM on 10/28/01 at 14:08 (063732)

Nini:

Better than 95% of heel pain is effectively treated without surgery. Don't waste time focusing on 'what if' you are in that 5%. Instead, make sure you are getting all the treatment necessary...orthotics, night splints, physical therapy. Physical therapy takes time for the relief to start to hold. That may or may not happen if your foot biomechanics are placing too much strain on the plantar fascia. It is the excess tension on the fascia that causes the pain. That tension must be relieved if you are going to relieve the pain permanently.
Ed

Re: heel spur

Nini on 10/28/01 at 17:38 (063737)

Hey doc, thank you for advice and will keep you informed, helps to have 2nd source of advice.

Re: heel spur

Stephanie Adams on 10/30/01 at 09:57 (063820)

Nini,
try any alteratives before surgery. I was first told I had bilateral heel spurs in 1996, I too was afraid of the cortisone and just did stretching for the first year and took Lodine, then the pain got worse, so I then went with the shots, the first lasted about 8 months, at that time I had custom orthotics made this worked great, the combination of the orthotics, Lodine and stretching exericises before I got out of bed was my answer for a long time. I did have the left foot spur removed when I had surgery for TTS and PF in May 2001, just because they were in there. The right is still fine, it never hurt as much as the left. I have had alot of problems since my surgery.....ie....infection, lateral column syndrome, loss of some ROM, pain, numbness..... I think it would be better for you to try alot of different things before you opt for surgery. I too am over weight and my feet felt better when I did not have so much to carry around And losing some weight still will help the spurs because it will be less pressure on your feet and plus you will feel better all around. and as soon as I can walk any distance and do the exercises I need to do My feet will feel better also.
Good Luck

Re: heel spur

Nini on 10/30/01 at 16:35 (063838)

Hi Stephanie, thanks for the advice. I'm trying to lose weight and have lost 20 since May but have been holding. I do whatever the therapist says and take his advice but I've been getting pain again in the morning and in the evening. I just get tired of being in pain.I go back to doc in a week so we'll see what he says then. Again, thank you!