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Surgery Advice

Posted by Christine F on 1/17/02 at 11:31 (070270)

Hello I am 23yrs. old 5ft.6in and 122lbs. (just so you know loosing weight isn't another option for me)and have had pf pain for 7 months, I was a runner and have very high arches, I think this how it develpoed. I strech about 30 times a day, use a night splint, seek phy.ther. 3 times a week,have reduced my hours at work, and two weeks ago my pod. reluctantly gave me 8 cortosone shots in my right foot,...the pain is still as bad as the left. I retuned to my pod yesterday and although he is known for being conservative, said that my only other option is surgery or to wait it out. He nor my two phy. therapists have ever seen a pf as tight as mine without any change in 7 months of therapy. I am seeking a second opion on Tues, but I have a feeling he will say the same thing. I do not have pain in just one spot, mine starts at my toes throughout my arch to my heel, I do not have a spur, I just need the plantar fa. released. Any other advice for me????

Re: !

wendyn on 1/17/02 at 12:02 (070273)

8 shots!!!!???? I hope this is a typo.

Re: !

Christine F on 1/17/02 at 13:25 (070280)

No mame, I recived 6-8 I forget exactly how many, maybe they were not full shots, but Dr. spreaded them out in 6-8 different spots along my arch.

Re: Surgery Advice - Try ART, or possibly ESWT

Donna SL on 1/17/02 at 16:22 (070292)

Hi Christine,

Active release technique (ART) performed by a chiropractor helped me tremendously. I have very high arches, and at one time my entire fascia was so tight on both feet, I thought they were going to explode. They are now almost normal feeling. I had 6 months of traditional physical therapy which was practically useless. I can't repost all the info, and don't have much time to spend on the board these days, but around April 01, and after I did extensive posting on the subject. Do a search on this board. Some of the titles are under Active release therapy, ART, or active release technique. Do a boolean search with my initials Donna SL.

I had not only PF, but in addition have bilateral tarsal tunnel syndrome which was also greatly helped by ART. In addition I have had, and am still receiving acupuncture treatments for both conditions, but mainly for the TTS, and some back problems, but the ART was the most helpful for the tight fascia. I woundn't say I'm totatlly cured yet, and occasionally the arch/heel pain will flare up sooner, but most days I usually can walk/stand anywhere from 3 to sometimes 6 hours, instead of 10 minutes. It's hard to tell, but I think most of the flare-ups are from nerve injury from the TTS, or possibly from a small amount of remaing nerve entrapment. Also I had other complications including lower back disc injuries. You don't seem to have the problems that I did, so it may only take a month, or so of ART sessions to loosen/release the fascia. If it helped me, I'm sure it would help you.

If the ART didn't work which it should, then you should consider acupunture, and/or ESWT before ever condsidering surgery. Have any anti-inflammatories been prescribed for you like vioxx? That would help also. It's important to be on some type of pain meds, so chronic pain syndrome doesn't develop.

If you have any stabbing, burning pain, dull aches, etc, an MRI, and nerve conduction studies would be helpful. Sometimes when there is pain in the entire sole of the foot TTS should be considered, and other conditions besides PF should be ruled out. All your pain may just be from tight/irritated fascia, in the feet, ankles, calves, etc., but it's important to make sure that's all it is. An inexpensive ultra-sound would also help to see the condition of the fascia. Has your doctor done any diagnostic test like that before he started discussing surgery? Even a simple x-ray?

If all other conditions are ruled out, and you couldn't find an ART practitioner then traditional myofascial release techniques might help somewhat, but you don't get the dramatic effects like you do with the ART.

Donna

Re: Welcome back, Donna

Julie on 1/17/02 at 16:48 (070302)

It's good to see your name again, and your informative post - hope you'll stick around now.

You must be getting nearer to coming to England?

All the best

Julie

Re: Thanks Julie

Donna SL on 1/17/02 at 18:01 (070315)

Hi Julie,

Nice to hear from you too. There have been many times I have wanted to post, but have not had much time lately.

My husband is getting itchy, and wants to get back to the UK within the next year, or so. I'm the one that's holding things up, mainly because of some on-going dental work I'm waiting to have completed (implants).

Also, I'm crazy about my doctor (physiatrist), who has done so much for me, and am afraid to leave him. Ha Ha. Hopefully I can find someone like him when I move to the UK if I still need treatment. He's one in a million. He's a certified pain managment specialist, medical acupuncturist, spine specialist, and has extensive experience in treating feet, because his office is centered in sports medicine/dance clinic. He even has me going to Pilates classes now. He personally practices yoga extensively, but recommmended the pilates for me.

I had read some of Carmen's post on NST, and in some ways it seems similar to ART. I only occassionaly go for ART treatments now, but if I ever needed them in the future it appears that NST (Bowen therapy) is very popular in the UK, as is acupuncture. Are my observations correct?

BTW did you ever find a Richard CPed clone? I gave up on my pod here.

I hope we can meet one day when I get there. We almost went over for Christmas, but changed our minds. When we do go over I'll let you know through the board. I'm sure we'll visit again several times before the final move.

Regards,

Donna

Re: Surgery Advice

Ed Davis, DPM on 1/17/02 at 18:38 (070324)

Christine:

Please describe exactly how the pain feels. Worse after rest?
Before thinking about different types of treatment, it is important to be certain about the diagnosis.
Ed

Re: Surgery Advice

Christine F on 1/18/02 at 14:26 (070413)

EWST I don't think is an option for me because I have pain all over the bottom of my feet, not just in one place. I do not have bunning pain or stabbing pain,...just pain like you get when you are on your feet all day,...times 100!!! It still hurts in the AM when I wake, as long as I am off my feet it isn't too bad, but anti-inflamitory's haven't helped at all, and I have tried many. If I am working at my standing job, and they hurt and I sit for say 20min., and then get up again, yes it hurts worse than it did before I sit down. I think I am going to try acupuncture, but will this relese my tight faciia (sp)or just relieve pain???

Re: Surgery Advice

BG CPed on 1/18/02 at 21:54 (070461)

That is a sad story. What state are you in? I would find a real pratitioner to do a full eval on the function of your foot, lower extremities , footwear, inserts etc. If you are a runner list the shoe you wear now and what you had a year ago. Dont get anymore shots, your pain is not from a lack of cortisone in your body.
If you have a real high arch there are a few tricks you can try before you get fascia cut, that is a last resort

Re: Surgery Advice

Christine F on 1/20/02 at 09:36 (070632)

I live in Aspen. A real practitoner?? Isn't that who I have been seeing a pod.? I was a runner, haven't ran, or even been able to tke a stroll around town in 7 months,..I wear New Balance, I have had them checked they are perfect shoes for my foot, and I have been also told my orthodix that were made for me are also good. No,....no more shots for me,..hurt, and didn't do a damn thing! I know surgury is a last resort, but I have tried everything I think, I can't tell you how flexable I am no from streching. No change in tightness though,....I have been told that my pf has always been this tight and something (all the miles I was putting in running) just made it flare up or something. I think this is true, because I can't remember it beeing loose, I haven't noticed a change in the way my feet feel from now or 2 years ago,...only that they hurt like hell. I am not able to be optimistic about this anymore, I am depresed all the time, and I know that I can't deal with this much longer, I am 22 years old and can't even go out dancing or to concerts with my friends or boyfriend anymore, I have become, in my eyes,......a cripple. The only reason I want to try sergury is because I will not and can't choose to live with this for months or even in muy case I think will be years. Does anyone else cry constantly and just feel awful,...how do you guys keep your spirits up?

Re: Surgery Advice

BG CPed on 1/20/02 at 15:39 (070666)

I should correct my previous post. I didnt mean to say 'real' practitioner, I meant to say different, Was a slip. If you can have somebody take a picture of your feet standing from front and back, also a pic of your orthotics and your running shoe and everyday shoe I amy be able to help.

Re: Surgery Advice

Christine F on 1/21/02 at 09:52 (070743)

Are you a doctor? Pod.? I am getting a second opion on tues.,....tomorrow, I will keep you posted.

Re: Surgery Advice

BG CPed on 1/21/02 at 17:53 (070796)

I am not a Dr I aM a pedorthist. I specialize in custom orthotics and particularly high arch cavus feet. If you can send those pics I may be able to help with your orthotics and or shoe solution.

Re: !

wendyn on 1/17/02 at 12:02 (070273)

8 shots!!!!???? I hope this is a typo.

Re: !

Christine F on 1/17/02 at 13:25 (070280)

No mame, I recived 6-8 I forget exactly how many, maybe they were not full shots, but Dr. spreaded them out in 6-8 different spots along my arch.

Re: Surgery Advice - Try ART, or possibly ESWT

Donna SL on 1/17/02 at 16:22 (070292)

Hi Christine,

Active release technique (ART) performed by a chiropractor helped me tremendously. I have very high arches, and at one time my entire fascia was so tight on both feet, I thought they were going to explode. They are now almost normal feeling. I had 6 months of traditional physical therapy which was practically useless. I can't repost all the info, and don't have much time to spend on the board these days, but around April 01, and after I did extensive posting on the subject. Do a search on this board. Some of the titles are under Active release therapy, ART, or active release technique. Do a boolean search with my initials Donna SL.

I had not only PF, but in addition have bilateral tarsal tunnel syndrome which was also greatly helped by ART. In addition I have had, and am still receiving acupuncture treatments for both conditions, but mainly for the TTS, and some back problems, but the ART was the most helpful for the tight fascia. I woundn't say I'm totatlly cured yet, and occasionally the arch/heel pain will flare up sooner, but most days I usually can walk/stand anywhere from 3 to sometimes 6 hours, instead of 10 minutes. It's hard to tell, but I think most of the flare-ups are from nerve injury from the TTS, or possibly from a small amount of remaing nerve entrapment. Also I had other complications including lower back disc injuries. You don't seem to have the problems that I did, so it may only take a month, or so of ART sessions to loosen/release the fascia. If it helped me, I'm sure it would help you.

If the ART didn't work which it should, then you should consider acupunture, and/or ESWT before ever condsidering surgery. Have any anti-inflammatories been prescribed for you like vioxx? That would help also. It's important to be on some type of pain meds, so chronic pain syndrome doesn't develop.

If you have any stabbing, burning pain, dull aches, etc, an MRI, and nerve conduction studies would be helpful. Sometimes when there is pain in the entire sole of the foot TTS should be considered, and other conditions besides PF should be ruled out. All your pain may just be from tight/irritated fascia, in the feet, ankles, calves, etc., but it's important to make sure that's all it is. An inexpensive ultra-sound would also help to see the condition of the fascia. Has your doctor done any diagnostic test like that before he started discussing surgery? Even a simple x-ray?

If all other conditions are ruled out, and you couldn't find an ART practitioner then traditional myofascial release techniques might help somewhat, but you don't get the dramatic effects like you do with the ART.

Donna

Re: Welcome back, Donna

Julie on 1/17/02 at 16:48 (070302)

It's good to see your name again, and your informative post - hope you'll stick around now.

You must be getting nearer to coming to England?

All the best

Julie

Re: Thanks Julie

Donna SL on 1/17/02 at 18:01 (070315)

Hi Julie,

Nice to hear from you too. There have been many times I have wanted to post, but have not had much time lately.

My husband is getting itchy, and wants to get back to the UK within the next year, or so. I'm the one that's holding things up, mainly because of some on-going dental work I'm waiting to have completed (implants).

Also, I'm crazy about my doctor (physiatrist), who has done so much for me, and am afraid to leave him. Ha Ha. Hopefully I can find someone like him when I move to the UK if I still need treatment. He's one in a million. He's a certified pain managment specialist, medical acupuncturist, spine specialist, and has extensive experience in treating feet, because his office is centered in sports medicine/dance clinic. He even has me going to Pilates classes now. He personally practices yoga extensively, but recommmended the pilates for me.

I had read some of Carmen's post on NST, and in some ways it seems similar to ART. I only occassionaly go for ART treatments now, but if I ever needed them in the future it appears that NST (Bowen therapy) is very popular in the UK, as is acupuncture. Are my observations correct?

BTW did you ever find a Richard CPed clone? I gave up on my pod here.

I hope we can meet one day when I get there. We almost went over for Christmas, but changed our minds. When we do go over I'll let you know through the board. I'm sure we'll visit again several times before the final move.

Regards,

Donna

Re: Surgery Advice

Ed Davis, DPM on 1/17/02 at 18:38 (070324)

Christine:

Please describe exactly how the pain feels. Worse after rest?
Before thinking about different types of treatment, it is important to be certain about the diagnosis.
Ed

Re: Surgery Advice

Christine F on 1/18/02 at 14:26 (070413)

EWST I don't think is an option for me because I have pain all over the bottom of my feet, not just in one place. I do not have bunning pain or stabbing pain,...just pain like you get when you are on your feet all day,...times 100!!! It still hurts in the AM when I wake, as long as I am off my feet it isn't too bad, but anti-inflamitory's haven't helped at all, and I have tried many. If I am working at my standing job, and they hurt and I sit for say 20min., and then get up again, yes it hurts worse than it did before I sit down. I think I am going to try acupuncture, but will this relese my tight faciia (sp)or just relieve pain???

Re: Surgery Advice

BG CPed on 1/18/02 at 21:54 (070461)

That is a sad story. What state are you in? I would find a real pratitioner to do a full eval on the function of your foot, lower extremities , footwear, inserts etc. If you are a runner list the shoe you wear now and what you had a year ago. Dont get anymore shots, your pain is not from a lack of cortisone in your body.
If you have a real high arch there are a few tricks you can try before you get fascia cut, that is a last resort

Re: Surgery Advice

Christine F on 1/20/02 at 09:36 (070632)

I live in Aspen. A real practitoner?? Isn't that who I have been seeing a pod.? I was a runner, haven't ran, or even been able to tke a stroll around town in 7 months,..I wear New Balance, I have had them checked they are perfect shoes for my foot, and I have been also told my orthodix that were made for me are also good. No,....no more shots for me,..hurt, and didn't do a damn thing! I know surgury is a last resort, but I have tried everything I think, I can't tell you how flexable I am no from streching. No change in tightness though,....I have been told that my pf has always been this tight and something (all the miles I was putting in running) just made it flare up or something. I think this is true, because I can't remember it beeing loose, I haven't noticed a change in the way my feet feel from now or 2 years ago,...only that they hurt like hell. I am not able to be optimistic about this anymore, I am depresed all the time, and I know that I can't deal with this much longer, I am 22 years old and can't even go out dancing or to concerts with my friends or boyfriend anymore, I have become, in my eyes,......a cripple. The only reason I want to try sergury is because I will not and can't choose to live with this for months or even in muy case I think will be years. Does anyone else cry constantly and just feel awful,...how do you guys keep your spirits up?

Re: Surgery Advice

BG CPed on 1/20/02 at 15:39 (070666)

I should correct my previous post. I didnt mean to say 'real' practitioner, I meant to say different, Was a slip. If you can have somebody take a picture of your feet standing from front and back, also a pic of your orthotics and your running shoe and everyday shoe I amy be able to help.

Re: Surgery Advice

Christine F on 1/21/02 at 09:52 (070743)

Are you a doctor? Pod.? I am getting a second opion on tues.,....tomorrow, I will keep you posted.

Re: Surgery Advice

BG CPed on 1/21/02 at 17:53 (070796)

I am not a Dr I aM a pedorthist. I specialize in custom orthotics and particularly high arch cavus feet. If you can send those pics I may be able to help with your orthotics and or shoe solution.