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Diagnosed

Posted by Carole C on 11/21/01 at 17:22 (065059)

I saw my rheumatologist today, and told him my symptoms; heel pain in the back of the bottom of both heels, especially the left heel, that's worse when I arise in the morning and worse when I walk on bare feet.

He had me walk barefoot for him, and he exclaimed that I could hardly walk (well duh! LOL). He x-rayed my heels, and on the bottom of each heel is a large, nipple shaped spur. Each stuck out more than a quarter or three eighths inch, I would estimate. That amazed me, since my left heel is much more painful, but the heel spurs were equally large. I didn't ask him why. No wonder my heels hurt!!!!!!!!

I asked him what the diagnosis was, bursitis, PF, or heel spurs, and he said all of those and more. Then he explained how they can all be part of the same process.

My doctor said the heel spurs were pretty well developed and he's not sure why I am suddenly having all this trouble at this time when I've just lost 70 pounds and started becoming more mobile, unless it was the increase in exercise; I have worked hard trying to regain normal mobility now that my arthritis is responding to medication. He mentioned surgery but he thinks the best approach for my heelspurs is not surgery for me at this time.

He is sending me to a good pedorthist for orthotics, which he says will probably help. I will ask the pedorthist about Birkenstocks too, since they are available there. I wonder if orthotics are better than Birkenstocks, or vice versa.

I also asked my doctor if I could up my dosage of Celebrex from 200 mg/day to 400 mg/day, and he OK'd it. (Thank goodness!!!) That should help a lot in getting me back on my feet.

My doctor didn't mention anything about ice or massage or anything else, really, but now that I have a diagnosis I think I should probably re-read the online book and try the things that are recommended here.

Thanks to all of you for your support, and especially to the man who suggested that I should ask for an x-ray. My doctor said my feet could just get worse if I ignored them, so I'm glad I am diagnosed and that I am going to take care of things.

Carole

Re: Diagnosed

Dr. Zuckerman on 11/21/01 at 17:40 (065061)

Glad that you had an examination. I am puzzled as to why a Rheumatologist is being used for your pf/heel spur pain problem. Some of the treatment you are doing are great. I would like to see a range of motion and an evaluation of your joint function. The orthotist will and should be this evaluation for you.

Most pf/heel spur pain that you are describing is from overuse . Weight has very little if noting to do with this quick onset. An excercise problem without proper stretching , shoes can cause this problem.

So far you are going in the right direction. Would rather see you under the care of a podiatrist due to seeing more heel pain but your Rheumatologist is on the right track of care

Re: Diagnosed

Carole C on 11/21/01 at 17:53 (065062)

I had a regular appointment with my rheumatologist, and since I was just on the verge of seeing a doctor I just waited for this appointment and asked him about my symptoms. I am seeing him for osteoarthritis, for which I have been taking 200 mg/day of Celebrex for the past 18 months (and it works quite well for me). I am glad to hear that he is on the right track. I didn't think to ask him to recommend a podiatrist, but maybe he would do that if I ask.

Is an orthotist the same as the pedorthist he is sending me to? I'm unfamiliar with the terms.

It's discouraging to think that exercise could be causing this, because I have been trying to regain mobility, but have not yet got to normalcy (for example, I was riding 0.5 miles/day on my exercycle until my heel pain, and that was pushing myself a little). Until I was put on Celebrex, and then lost 70 pounds or so, I was almost immobile with severe osteoarthritis in my knees.

Thank you for the informative response!

Re: range of motion

Carole C on 11/21/01 at 18:00 (065063)

I forgot to mention that my rheumatologist also did some range of motion tests for my feet, nothing elaborate, but he did that when he tested the range of motion for my knee. He didn't say anything about either one.

Carole

Re: range of motion

Dr. Zuckerman on 11/21/01 at 21:16 (065071)

Are you sure your rheumatologist was a podiatrist in a former life. The answer to your question about orthosis is yes they are the same.

Also make sure that if you limp in the am to stretch your feet out by moving your ankles up and down ten times and then with shoes on start to walk.

Re: range of motion

Carole C on 11/21/01 at 22:15 (065073)

LOL! I kept apologizing to my rheumatologist about bringing him a condition that wasn't within his specialty, and he said that his patients sometimes bring this sort of thing to him too, and it was ok. However, his specialties are supposed to be rheumatology and immunology. I suspect that if the condition doesn't improve dramatically with the orthotics, he will refer me to a more appropriate specialist.

Thanks for the tip about how to stretch my feet by moving my ankles up and down ten times before trying to walk in the morning. This will be a good thing to start, because i limp severely in the morning, and moderately during the rest of the day.

I also plan to print out the online book and read it over several times, and to try to add some things like stretching, ice packs, resting feet, massages, and so on, to my daily routines.

Carole

Re: Diagnosed

Dr. Zuckerman on 11/21/01 at 17:40 (065061)

Glad that you had an examination. I am puzzled as to why a Rheumatologist is being used for your pf/heel spur pain problem. Some of the treatment you are doing are great. I would like to see a range of motion and an evaluation of your joint function. The orthotist will and should be this evaluation for you.

Most pf/heel spur pain that you are describing is from overuse . Weight has very little if noting to do with this quick onset. An excercise problem without proper stretching , shoes can cause this problem.

So far you are going in the right direction. Would rather see you under the care of a podiatrist due to seeing more heel pain but your Rheumatologist is on the right track of care

Re: Diagnosed

Carole C on 11/21/01 at 17:53 (065062)

I had a regular appointment with my rheumatologist, and since I was just on the verge of seeing a doctor I just waited for this appointment and asked him about my symptoms. I am seeing him for osteoarthritis, for which I have been taking 200 mg/day of Celebrex for the past 18 months (and it works quite well for me). I am glad to hear that he is on the right track. I didn't think to ask him to recommend a podiatrist, but maybe he would do that if I ask.

Is an orthotist the same as the pedorthist he is sending me to? I'm unfamiliar with the terms.

It's discouraging to think that exercise could be causing this, because I have been trying to regain mobility, but have not yet got to normalcy (for example, I was riding 0.5 miles/day on my exercycle until my heel pain, and that was pushing myself a little). Until I was put on Celebrex, and then lost 70 pounds or so, I was almost immobile with severe osteoarthritis in my knees.

Thank you for the informative response!

Re: range of motion

Carole C on 11/21/01 at 18:00 (065063)

I forgot to mention that my rheumatologist also did some range of motion tests for my feet, nothing elaborate, but he did that when he tested the range of motion for my knee. He didn't say anything about either one.

Carole

Re: range of motion

Dr. Zuckerman on 11/21/01 at 21:16 (065071)

Are you sure your rheumatologist was a podiatrist in a former life. The answer to your question about orthosis is yes they are the same.

Also make sure that if you limp in the am to stretch your feet out by moving your ankles up and down ten times and then with shoes on start to walk.

Re: range of motion

Carole C on 11/21/01 at 22:15 (065073)

LOL! I kept apologizing to my rheumatologist about bringing him a condition that wasn't within his specialty, and he said that his patients sometimes bring this sort of thing to him too, and it was ok. However, his specialties are supposed to be rheumatology and immunology. I suspect that if the condition doesn't improve dramatically with the orthotics, he will refer me to a more appropriate specialist.

Thanks for the tip about how to stretch my feet by moving my ankles up and down ten times before trying to walk in the morning. This will be a good thing to start, because i limp severely in the morning, and moderately during the rest of the day.

I also plan to print out the online book and read it over several times, and to try to add some things like stretching, ice packs, resting feet, massages, and so on, to my daily routines.

Carole