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Physiologically what does no morning pain mean?

Posted by CarlW on 1/31/02 at 16:16 (072107)

About 2 years ago when I developed PF I had the classic excruciating morning pain.
With proper morning warm up it went away after about 2 months. However my feet are now sore the longer I am on them but I have no morning pain or pain after sitting. Does this my body has given up on trying to heal itself while resting? Does no morning pain with severe pain after being on them for a limited time lead towards a different diagnosis or treatment method? I have tried most treatment methodologies short of surgery and ESWT. (cortisone, Anit inflams, stretching, physio, ART, Orthotics, Birks, taping,mega rest) and had various tests (blood work, MRI, X-ray, Bone Scan). Has anybody without morning pain but major pain with activity been able to help themselves with conservative approaches and is ESWT effective in cases on no morning pain?

Re: Physiologically what does no morning pain mean?

Carole C in NOLA on 1/31/02 at 16:31 (072109)

I'm not a medical professional or doctor.

That sounds really strange to me! Maybe your cured your PF and have some other problem. Where on your foot/feet does it hurt? The same places?

I am well on the road to recovery. Every morning I still do my gentle stretches before I slip on my Birkenstocks and stand up. Sometimes I do not feel much pain at that time, but by the time I have walked 30 feet to the kitchen, and have made coffee, and have walked 20 more feet to the sofa to sit down, they will be hurting.

I think that a lot of PF pain probably is due to tendons tightening up overnight and needing to be stretched and loosened up in the morning. Maybe you don't have tight tendons, but your plantar fascia are still strained and hurting for some reason.

Depending on your symptoms it might be worth going back to have your doctor look at them again; I don't know, what do you think? If he says it's still PF, then I'd consider myself lucky... one less symptom. If he says it's something else, then maybe there is a better treatment.

Carole

Re: Physiologically what does no morning pain mean?

Monte on 1/31/02 at 17:02 (072117)

Carl...i too have NO morning pain...but the pain starts to set in as I am shaving and getting ready for work. When I sat to walk, it feels better. I guess that is because each foot is momentarily off the floor. When I get up from sitting down for a while...no ripping pain. But standing in line is a killer. I have this for 13 months now and have gone through all the test as you did. I just went for a ESWT evaluation last night and may do it as soon as able. My arches have pain as well as my heels. The pain can mve around sometimes. I have a streching routine that I do at night and then I ice for 15 minutes. I also use Jade Balm at night and gently massage it in. I also do stretches and toe curls whiel sitting at my desk at work. I have it in both feet. I am really considering ESWT. I was offered cortisone in both feet, but I hear that it doesn't work very well. I have gotten my overpronation under control with custom made othotics. it is important that you fix the cause. If not, it is difficult to get rid or if at all. I am in pain everyday that I have to stand. I also tape my feet. That helps too. Look into ESWT. It cannot hurt to read about it and ask questions and get information.

Re: Physiologically what does no morning pain mean?

Dr. Marlene Reid on 2/01/02 at 16:56 (072227)

It could very well be a different or additional diagnosis, such as posterior tibialis tendon problems.

Re: Physiologically what does no morning pain mean?

BrianJ on 2/01/02 at 18:20 (072243)

Dr. Reid: What are the symptoms of posterior tibialis tendon problems, and how do we distinguish them from PF? Thank you for your input.

Re: Physiologically what does no morning pain mean?

Dr. Marlene Reid on 2/01/02 at 21:19 (072270)

Pain after being on your feet, pain with direct pressure behing the inside ankle bone, pain with certain movements, the sypmtoms vary with the degree of problems.

Re: Physiologically what does no morning pain mean?

Carmen H on 2/03/02 at 09:54 (072406)

I too had no morning pain. But found out after a long period of numerous tests I don't have anything else besides PF. It is a strange condition and I was told I could have PTTD or something SERIOUS because of the weird feelings I had. I had nervy pain in my tibial nerve area nad thought I had something more but it was just a phase my feet were in at the time.
who kows...everyone's case is different.

Re: Thanks for all the Responses

CarlW on 2/04/02 at 11:34 (072527)

Thanks for all the responses!

It just seems that when you dont fall in the 'typical' version of PF that it makes a difficult problem that much harder.

CarlW

Re: Thanks for all the Responses

Sage R on 2/05/02 at 10:35 (072632)

It might be a different diagnosis. I have had PF 2 or 3 times. When my arches started hurting I assumed it was PF again, but i had no morning pain & the longer i was on my feet the worse it got & arch support hurt rather than helping. So, I went to the doctor yesterday & it turns out not to be PF this time but that the tendon on the bottom of the foot that attaches to the big toe was inflammed due to orthotics for PF. If i bend my toes back it kind of pops out (very exposed) so it's easy to get inflamed.

Re: Thanks for all the Responses

JudyS on 2/05/02 at 11:23 (072638)

Sage, forgive my confusion here......isn't that tendon you've described the Plantar itself?

Re: PTT -Dr. Reid, Orthodudes

JudyS on 2/05/02 at 11:32 (072639)

I remember that my husband got PTT after his release surgery and his problem was quickly fixed with orthotics. (ice scraper style). But he has highly over-pronating feet.
What about we poor high-arched people who may have PTT but can't tolerate any kind of insert against the arch?

Re: Thanks for all the Responses

Sage R on 2/05/02 at 11:39 (072640)

i dont think so. i wish i remember what the name of the tendon is, but it's a very small tendon as opposed to the the plantar fascia which is a thicker 'band'.

Re: PTT -Dr. Reid, Orthodudes

BG CPed on 2/05/02 at 18:37 (072693)

It can be a chicken or egg question. Many folks that over pronate get pf, usually they will get it on and off before a real case of ptt sets in. If you have a pf release done you weaken the supporting structure. This will usually allow the midfoot to collapse more especially if the pt has tight heel cords. This added motion causes a traction pull on the ptt where it inserts and under and around the inside ankle bone. It is like saying you had a bad heart so you rode an exercise bike to help, but you had a heart attack from the bike, may be circular and silly but it makes sense???

If you have a true cavus foot structure it is not common to get true case of ptt, it can happen but it is rare in my experience. Ask them to re evaluate your foot and possibly reduce the arch 10 to 15 percent if it is too high to tolerate. May want to just have the foot held in a more neutral position or reduce correction a bit. If you have a foot that pronates, that motion is what will usually incite the ptt, usually a high arch foot will cause the peroneal tendon on opposite side to flare up. I would have them re check your foot and device

Re: PTT -Dr. Reid, Orthodudes

Dr. Marlene Reid on 2/07/02 at 23:35 (072987)

I would question the dx if you have a high arch foot. PTT is not usually found with a high arch foot (unless it flattens significantly with weight bearing and then you actually have a type of flat foot, not a high arch foot).

Re: Thanks for all the Responses

monte on 2/19/02 at 16:10 (074323)

so what happened now...i seem to have the same pains like you have. What did your doctor do or say?

thanks

Re: Physiologically what does no morning pain mean?

Carole C in NOLA on 1/31/02 at 16:31 (072109)

I'm not a medical professional or doctor.

That sounds really strange to me! Maybe your cured your PF and have some other problem. Where on your foot/feet does it hurt? The same places?

I am well on the road to recovery. Every morning I still do my gentle stretches before I slip on my Birkenstocks and stand up. Sometimes I do not feel much pain at that time, but by the time I have walked 30 feet to the kitchen, and have made coffee, and have walked 20 more feet to the sofa to sit down, they will be hurting.

I think that a lot of PF pain probably is due to tendons tightening up overnight and needing to be stretched and loosened up in the morning. Maybe you don't have tight tendons, but your plantar fascia are still strained and hurting for some reason.

Depending on your symptoms it might be worth going back to have your doctor look at them again; I don't know, what do you think? If he says it's still PF, then I'd consider myself lucky... one less symptom. If he says it's something else, then maybe there is a better treatment.

Carole

Re: Physiologically what does no morning pain mean?

Monte on 1/31/02 at 17:02 (072117)

Carl...i too have NO morning pain...but the pain starts to set in as I am shaving and getting ready for work. When I sat to walk, it feels better. I guess that is because each foot is momentarily off the floor. When I get up from sitting down for a while...no ripping pain. But standing in line is a killer. I have this for 13 months now and have gone through all the test as you did. I just went for a ESWT evaluation last night and may do it as soon as able. My arches have pain as well as my heels. The pain can mve around sometimes. I have a streching routine that I do at night and then I ice for 15 minutes. I also use Jade Balm at night and gently massage it in. I also do stretches and toe curls whiel sitting at my desk at work. I have it in both feet. I am really considering ESWT. I was offered cortisone in both feet, but I hear that it doesn't work very well. I have gotten my overpronation under control with custom made othotics. it is important that you fix the cause. If not, it is difficult to get rid or if at all. I am in pain everyday that I have to stand. I also tape my feet. That helps too. Look into ESWT. It cannot hurt to read about it and ask questions and get information.

Re: Physiologically what does no morning pain mean?

Dr. Marlene Reid on 2/01/02 at 16:56 (072227)

It could very well be a different or additional diagnosis, such as posterior tibialis tendon problems.

Re: Physiologically what does no morning pain mean?

BrianJ on 2/01/02 at 18:20 (072243)

Dr. Reid: What are the symptoms of posterior tibialis tendon problems, and how do we distinguish them from PF? Thank you for your input.

Re: Physiologically what does no morning pain mean?

Dr. Marlene Reid on 2/01/02 at 21:19 (072270)

Pain after being on your feet, pain with direct pressure behing the inside ankle bone, pain with certain movements, the sypmtoms vary with the degree of problems.

Re: Physiologically what does no morning pain mean?

Carmen H on 2/03/02 at 09:54 (072406)

I too had no morning pain. But found out after a long period of numerous tests I don't have anything else besides PF. It is a strange condition and I was told I could have PTTD or something SERIOUS because of the weird feelings I had. I had nervy pain in my tibial nerve area nad thought I had something more but it was just a phase my feet were in at the time.
who kows...everyone's case is different.

Re: Thanks for all the Responses

CarlW on 2/04/02 at 11:34 (072527)

Thanks for all the responses!

It just seems that when you dont fall in the 'typical' version of PF that it makes a difficult problem that much harder.

CarlW

Re: Thanks for all the Responses

Sage R on 2/05/02 at 10:35 (072632)

It might be a different diagnosis. I have had PF 2 or 3 times. When my arches started hurting I assumed it was PF again, but i had no morning pain & the longer i was on my feet the worse it got & arch support hurt rather than helping. So, I went to the doctor yesterday & it turns out not to be PF this time but that the tendon on the bottom of the foot that attaches to the big toe was inflammed due to orthotics for PF. If i bend my toes back it kind of pops out (very exposed) so it's easy to get inflamed.

Re: Thanks for all the Responses

JudyS on 2/05/02 at 11:23 (072638)

Sage, forgive my confusion here......isn't that tendon you've described the Plantar itself?

Re: PTT -Dr. Reid, Orthodudes

JudyS on 2/05/02 at 11:32 (072639)

I remember that my husband got PTT after his release surgery and his problem was quickly fixed with orthotics. (ice scraper style). But he has highly over-pronating feet.
What about we poor high-arched people who may have PTT but can't tolerate any kind of insert against the arch?

Re: Thanks for all the Responses

Sage R on 2/05/02 at 11:39 (072640)

i dont think so. i wish i remember what the name of the tendon is, but it's a very small tendon as opposed to the the plantar fascia which is a thicker 'band'.

Re: PTT -Dr. Reid, Orthodudes

BG CPed on 2/05/02 at 18:37 (072693)

It can be a chicken or egg question. Many folks that over pronate get pf, usually they will get it on and off before a real case of ptt sets in. If you have a pf release done you weaken the supporting structure. This will usually allow the midfoot to collapse more especially if the pt has tight heel cords. This added motion causes a traction pull on the ptt where it inserts and under and around the inside ankle bone. It is like saying you had a bad heart so you rode an exercise bike to help, but you had a heart attack from the bike, may be circular and silly but it makes sense???

If you have a true cavus foot structure it is not common to get true case of ptt, it can happen but it is rare in my experience. Ask them to re evaluate your foot and possibly reduce the arch 10 to 15 percent if it is too high to tolerate. May want to just have the foot held in a more neutral position or reduce correction a bit. If you have a foot that pronates, that motion is what will usually incite the ptt, usually a high arch foot will cause the peroneal tendon on opposite side to flare up. I would have them re check your foot and device

Re: PTT -Dr. Reid, Orthodudes

Dr. Marlene Reid on 2/07/02 at 23:35 (072987)

I would question the dx if you have a high arch foot. PTT is not usually found with a high arch foot (unless it flattens significantly with weight bearing and then you actually have a type of flat foot, not a high arch foot).

Re: Thanks for all the Responses

monte on 2/19/02 at 16:10 (074323)

so what happened now...i seem to have the same pains like you have. What did your doctor do or say?

thanks