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PF & TTS

Posted by Kori E. on 11/12/01 at 10:28 (064720)

I've been diagnosed as having PF and TTS. I've tried the anti-inflammatories, the cortizone shots, I have the custom made orthotics and I am now going through physical therapy. Nothing seems to help, it's getting worse. I have 4 children (ages 8 to 12) and work full-time so the resting part doesn't seem to work very well for me. My doctor is wanting me to have the surgery but I keep putting it off. I go back to him on 11/21 and he says that we can try the cast next and he wants me to continue getting the cortizone shots. Am I prolonging the inevitable? I'm scared to have the surgery but I'm also tired of the pain. Can someone tell me if they have had success with the cast and the shots or would I get more relief from just having the surgery. Thank you.

Re: PF & TTS

john h on 11/13/01 at 11:25 (064752)

kori: it seems that most writings suggest not more than 3 cortizone shots in a 12 month period or you could do damage to your feet. do not rush to surgery as it can make it worse. start by reading scott's heelspur book and posting your questions on this board. this is a very slow healing disease so you must be patient. make sure you add ice to your daily regime. cast have worked for some people and not for others. you might give a night splint a go as they are inexpensive and you should look at taping your foot on a daily basis. there are several taping methods described on this board. how long have you had the condition? if you are getting worse it may be time to try another doctor and get his/her opinion. your very very very last resort is surgery.

Re: PF & TTS

Andrea R. on 11/13/01 at 14:12 (064753)

Kori,

I agree with John. You can also add massage and non-weight bearing stretching before you get out of bed in the morning.

Surgery is the last resort and often doesn't work. If your doctor is pushing surgery you really should get another opinion. You should definitely try a night splint. I got mine from my orthopedist and insurance covered it. I also had the cast for five to six weeks. It allows the plantar fascia to rest. However if they try to cast you with your toes pointing down, don't let them. The foot should be in a neutral position or with the toes point up a little.

If you are having physical therapy ask about iontophoresis.

Re: PF & TTS

Carol B. on 11/13/01 at 22:29 (064766)

I see an orthopedic surgeon who has told me that evev after just 1 cortisone injection, the risk of rupture of the fascia is very high. I had PF in my right foot 2 yrs. ago. It completely resolved in about 7 months but I had so many different treatments (night splint,physical therapy, one shot of cortisone, plaster cast for 6 weeks, and orthotics) it is not clear what cured it. I think it was the cast or the night splint. The orthotics made it worse for me. However, I now have had PF in my left foot for about 5 months and there is no sign of healing. I was not compliant with a plaster cast because it was so heavy and hot this summer that I ended up ditching it after 2 weeks. One shot of cortisone helped a lot, but the effect lasted only 2 or 3 weeks. My Dr. will let me have only one more if I want it. It was not as painful as I thought it would be. I have been told never to consider surgery so do your homework re: surgery. At this point I am considering ESWT, the newest, but prohibitively expensive procedure for PF. I am being patient but it is hard. THis is a chronic process but I did have success in ridding myself of it before so I am hopeful again. Good luck. I would definitely try stretching and a night splint as a first line of treatment. See if you can get an air cast instead of a plaster one, if you decide on a cast.

Re: PF & TTS

Kori E. on 11/14/01 at 15:29 (064794)

Thank you all for responding, you helped me alot. I made an appt with another doc for a second opinion and I'm going to hold off on the surgery. I have an appt with my doc next week and that would be my 3rd cortizone shot in 2 months. I've had the condition for about 5 months. I don't know how some of you have done it, having it for a couple years. Sometimes the pain and swelling is so bad I can't stand it and makes me want to just go ahead with the surgery. Anything to make it stop. The tingling and numbness in my toes has gotten better but now the heel of my foot has lost feeling. I will continue the icing and massage and will read up on the taping, I hadn't heard of this. Thanks again!

Re: PF & TTS

Carole C on 11/17/01 at 10:08 (064904)

Kori, having PF with 4 kids and working full time sounds like anybody's worst nightmare! I really feel for you because I am a mom too, and even though my kid is grown and gone I remember how physically demanding life was when she was younger.

You didn't mention your shoes, but you really NEED good shoes. I mean *excellent* shoes, the best you can find, ones that help your PF. Even though you may not have a lot of extra money to squander (with four children to feed and clothe), for their sake you need to spend whatever it takes on shoes that help your feet. You might need to buy several different kinds before you find the right ones for you, too.

People here recommend Birkenstocks. I don't have those yet, though I probably will get some soon. If you can't find them right away and don't want to buy them online, I suggest that you try some other good brands of shoes in the meantime. I bought some new Easy Spirit shoes ('Amigos') that are not perfect but really seem to be helping me (before that, I had been wearing some shoes that were getting a little old and were ready to be replaced). My Easy Spirits look clunky; they tie and have a very rounded toe, and fit my foot very well. They are ok for work so I wear them almost every waking minute, and I believe they have made a big difference for me.

Carole

Re: PF & TTS

Carole C on 11/17/01 at 10:10 (064905)

Well, now I feel really stupid. I went back and read your post again, and noticed that you have custom orthotics, so you have thought of all this already. Never mind! Boy, do I feel dumb. oh well! LOL

Carole

Re: PF & TTS

john h on 11/13/01 at 11:25 (064752)

kori: it seems that most writings suggest not more than 3 cortizone shots in a 12 month period or you could do damage to your feet. do not rush to surgery as it can make it worse. start by reading scott's heelspur book and posting your questions on this board. this is a very slow healing disease so you must be patient. make sure you add ice to your daily regime. cast have worked for some people and not for others. you might give a night splint a go as they are inexpensive and you should look at taping your foot on a daily basis. there are several taping methods described on this board. how long have you had the condition? if you are getting worse it may be time to try another doctor and get his/her opinion. your very very very last resort is surgery.

Re: PF & TTS

Andrea R. on 11/13/01 at 14:12 (064753)

Kori,

I agree with John. You can also add massage and non-weight bearing stretching before you get out of bed in the morning.

Surgery is the last resort and often doesn't work. If your doctor is pushing surgery you really should get another opinion. You should definitely try a night splint. I got mine from my orthopedist and insurance covered it. I also had the cast for five to six weeks. It allows the plantar fascia to rest. However if they try to cast you with your toes pointing down, don't let them. The foot should be in a neutral position or with the toes point up a little.

If you are having physical therapy ask about iontophoresis.

Re: PF & TTS

Carol B. on 11/13/01 at 22:29 (064766)

I see an orthopedic surgeon who has told me that evev after just 1 cortisone injection, the risk of rupture of the fascia is very high. I had PF in my right foot 2 yrs. ago. It completely resolved in about 7 months but I had so many different treatments (night splint,physical therapy, one shot of cortisone, plaster cast for 6 weeks, and orthotics) it is not clear what cured it. I think it was the cast or the night splint. The orthotics made it worse for me. However, I now have had PF in my left foot for about 5 months and there is no sign of healing. I was not compliant with a plaster cast because it was so heavy and hot this summer that I ended up ditching it after 2 weeks. One shot of cortisone helped a lot, but the effect lasted only 2 or 3 weeks. My Dr. will let me have only one more if I want it. It was not as painful as I thought it would be. I have been told never to consider surgery so do your homework re: surgery. At this point I am considering ESWT, the newest, but prohibitively expensive procedure for PF. I am being patient but it is hard. THis is a chronic process but I did have success in ridding myself of it before so I am hopeful again. Good luck. I would definitely try stretching and a night splint as a first line of treatment. See if you can get an air cast instead of a plaster one, if you decide on a cast.

Re: PF & TTS

Kori E. on 11/14/01 at 15:29 (064794)

Thank you all for responding, you helped me alot. I made an appt with another doc for a second opinion and I'm going to hold off on the surgery. I have an appt with my doc next week and that would be my 3rd cortizone shot in 2 months. I've had the condition for about 5 months. I don't know how some of you have done it, having it for a couple years. Sometimes the pain and swelling is so bad I can't stand it and makes me want to just go ahead with the surgery. Anything to make it stop. The tingling and numbness in my toes has gotten better but now the heel of my foot has lost feeling. I will continue the icing and massage and will read up on the taping, I hadn't heard of this. Thanks again!

Re: PF & TTS

Carole C on 11/17/01 at 10:08 (064904)

Kori, having PF with 4 kids and working full time sounds like anybody's worst nightmare! I really feel for you because I am a mom too, and even though my kid is grown and gone I remember how physically demanding life was when she was younger.

You didn't mention your shoes, but you really NEED good shoes. I mean *excellent* shoes, the best you can find, ones that help your PF. Even though you may not have a lot of extra money to squander (with four children to feed and clothe), for their sake you need to spend whatever it takes on shoes that help your feet. You might need to buy several different kinds before you find the right ones for you, too.

People here recommend Birkenstocks. I don't have those yet, though I probably will get some soon. If you can't find them right away and don't want to buy them online, I suggest that you try some other good brands of shoes in the meantime. I bought some new Easy Spirit shoes ('Amigos') that are not perfect but really seem to be helping me (before that, I had been wearing some shoes that were getting a little old and were ready to be replaced). My Easy Spirits look clunky; they tie and have a very rounded toe, and fit my foot very well. They are ok for work so I wear them almost every waking minute, and I believe they have made a big difference for me.

Carole

Re: PF & TTS

Carole C on 11/17/01 at 10:10 (064905)

Well, now I feel really stupid. I went back and read your post again, and noticed that you have custom orthotics, so you have thought of all this already. Never mind! Boy, do I feel dumb. oh well! LOL

Carole