Home The Book Dr Articles Products Message Boards Journal Articles Search Our Surveys Surgery ESWT Dr Messages Find Good Drs video

Heel Pain after Dr's shots & orthotics are now Arch Pain.

Posted by Janice L on 2/04/02 at 08:02 (072512)

Referred to orthopedic doctor/surgeon for heel pain. Had cortizone shot in left heel on first visit and got leather-like orthodics from lab in rear of his office. Had pain immediately with orthotics. Lab added some cushioning on orthotics. Went back two consecutive months for shots and more adjustments on orthotics. Complained each time that I was now having arch pain and was having difficulty wearing any of my shoes except one pair of Easy Spirits. PS - I have stopped using the orthotics and after 3 weeks can finally walk in most of my shoes (I use only good shoes - Easy Spirit, New Balance, SAS, Rockport, etc.). Standing and walking slowly is okay, but I cannot walk at a normal pace or quickly without pain in the arch. What has gone wrong? What do I do now?

Re: Heel Pain after Dr's shots & orthotics are now Arch Pain.

Richard, C.Ped on 2/04/02 at 11:59 (072529)

as a pedorthist, one of the first things that I think of now when someone says that they have arch pain, is forefoot varus. I make sure to check everyone, no matter what the diagnosis is, for forefoot varus. This will usually cause arch pain. Of course, there could be something else going besides that. This just popped in my head when I read the post.
Richard

Re: Heel Pain after Dr's shots & orthotics are now Arch Pain.

Mahatmelissama on 2/05/02 at 20:08 (072718)

Richard, pray tell, what is forefoot varus? I am following this conversation since I have comfy orthos but still get pain in heels and in arch if I stand too long.

Re: Heel Pain after Dr's shots & orthotics are now Arch Pain.

wendyn on 2/05/02 at 20:21 (072724)

I have a forefoot varus - but I'm not sure exactly what it means. I think it means that if you hold my foot straight at the heel - the fore foot is not straight. It's actually sort of twisted? I dunno.

Re: Heel Pain after Dr's shots & orthotics are now Arch Pain.

Richard, C.Ped on 2/06/02 at 08:42 (072766)

Hey Melissa,
I test for forefoot varus by having the patient stand facing away from me and balancing themselves with one hand on the wall, or anything else sturdy. I lift their lower leg towards me, so I can look straight down the sole of their foot. I then manipulate them in to subtalor neutral. As I am looking down the sole of their foot (toes pointing toward the floor) I can tell if they have forefoot varus, valgus or neutral.

If forefoot varus is present, I will basically see the first metatarsal head 'higher' then the fifth. I wish I could draw a picture so you can easily see. I will try to by using and 'X' to represent the first met head and an 'O' for the fifth met heads.

Looking down, I would basicall look like this: X
O

Now for my point. We have alot of patients that said their orthosis arches felt high. Instead of grinding the support from the arch, we simply started testing for forefoot varus. Nine times out of ten, the patient had forefoot varus. We simply added a wedge under the first met head to bring the floor up to the foot. For us, it has not failed yet.

so, you may want to check into this. This just may be the problem. You never know. :-)
Richard, C.Ped

Re: Heel Pain after Dr's shots & orthotics are now Arch Pain.

Janice L on 2/06/02 at 09:18 (072770)

Richard, C.Ped:
Thanks for the added info. I will have it checked out. However, I still wonder what caused the arch pain since I did not have it before I went to the doctor for the heel pain. I think if I knew what actually caused it, I could better follow up on a treatment to relieve it.

My doctor returned my phone call yesterday and as a follow-up, he suggested 'I see another doctor since his treatment didn't work'. I hung up the phone and then found myself getting really angry. I'm now worse than when I started with him, and HE has the nerve to dump ME!!

I'm now feeling very gunshy about doctors, orthotics, the works -- but I still need help. Anybody got some good advice?

Re: Heel Pain after Dr's shots & orthotics are now Arch Pain.

Carole C in NOLA on 2/06/02 at 12:12 (072791)

OK, here's what I think, as a fellow victim of foot pain.

Your doctor wasn't listening to you. From what you said in your first post, you kept telling him you were in pain, right from the start. There's no point in being concerned about who dumped who at this point; the good thing is that you aren't going to him. It's not the first time that a doctor and a patient didn't get along. Also some foot professionals know a huge amount about foot problems, and some know very little. Now that you are rid of this doctor, you can work on finding a doctor or podiatrist who knows his stuff and who you can communicate with!

Don't accept orthotics that hurt immediately. In my rather uninformed opinion, you ought to be able to wear them for at least a half hour or hour and feel better in them than you did before. Sometimes they need to be broken in, so you might not be able to wear them for longer.

Easy Spirits are very bendy, and they are too flexible and bendy in the arch area so they aggravate PF.

So much depends on what you do for you. Orthotics have been the main key to my recovery so far. I do not believe that I would be any better if I had not got my orthotics. But if I had just gone and got orthotics, and hadn't done anything else to help myself, I would not have healed. Rest, taping, icing, stretching, and so many other suggestions on this board and in the heel pain book really do help. There's so much that you can do too. :)

My advice would be to let no stone remain unturned. Get a new foot professional, one that you trust and can communicate with, and one that you feel knows his stuff. Try everything you can, and keep posting to let us know how it's going. We really do understand.

Carole C

Re: Heel Pain after Dr's shots & orthotics are now Arch Pain.

paula on 2/06/02 at 20:26 (072855)

richard c ped just wondering where you are located for any of us who want to get orthotics from you.

Re: Heel Pain after Dr's shots & orthotics are now Arch Pain.

Richard, C.Ped on 2/07/02 at 10:23 (072905)

Columbia, South Carolina. two miles off Interstate 26. :-)
Richard

Re: Heel Pain after Dr's shots & orthotics are now Arch Pain.

Richard, C.Ped on 2/04/02 at 11:59 (072529)

as a pedorthist, one of the first things that I think of now when someone says that they have arch pain, is forefoot varus. I make sure to check everyone, no matter what the diagnosis is, for forefoot varus. This will usually cause arch pain. Of course, there could be something else going besides that. This just popped in my head when I read the post.
Richard

Re: Heel Pain after Dr's shots & orthotics are now Arch Pain.

Mahatmelissama on 2/05/02 at 20:08 (072718)

Richard, pray tell, what is forefoot varus? I am following this conversation since I have comfy orthos but still get pain in heels and in arch if I stand too long.

Re: Heel Pain after Dr's shots & orthotics are now Arch Pain.

wendyn on 2/05/02 at 20:21 (072724)

I have a forefoot varus - but I'm not sure exactly what it means. I think it means that if you hold my foot straight at the heel - the fore foot is not straight. It's actually sort of twisted? I dunno.

Re: Heel Pain after Dr's shots & orthotics are now Arch Pain.

Richard, C.Ped on 2/06/02 at 08:42 (072766)

Hey Melissa,
I test for forefoot varus by having the patient stand facing away from me and balancing themselves with one hand on the wall, or anything else sturdy. I lift their lower leg towards me, so I can look straight down the sole of their foot. I then manipulate them in to subtalor neutral. As I am looking down the sole of their foot (toes pointing toward the floor) I can tell if they have forefoot varus, valgus or neutral.

If forefoot varus is present, I will basically see the first metatarsal head 'higher' then the fifth. I wish I could draw a picture so you can easily see. I will try to by using and 'X' to represent the first met head and an 'O' for the fifth met heads.

Looking down, I would basicall look like this: X
O

Now for my point. We have alot of patients that said their orthosis arches felt high. Instead of grinding the support from the arch, we simply started testing for forefoot varus. Nine times out of ten, the patient had forefoot varus. We simply added a wedge under the first met head to bring the floor up to the foot. For us, it has not failed yet.

so, you may want to check into this. This just may be the problem. You never know. :-)
Richard, C.Ped

Re: Heel Pain after Dr's shots & orthotics are now Arch Pain.

Janice L on 2/06/02 at 09:18 (072770)

Richard, C.Ped:
Thanks for the added info. I will have it checked out. However, I still wonder what caused the arch pain since I did not have it before I went to the doctor for the heel pain. I think if I knew what actually caused it, I could better follow up on a treatment to relieve it.

My doctor returned my phone call yesterday and as a follow-up, he suggested 'I see another doctor since his treatment didn't work'. I hung up the phone and then found myself getting really angry. I'm now worse than when I started with him, and HE has the nerve to dump ME!!

I'm now feeling very gunshy about doctors, orthotics, the works -- but I still need help. Anybody got some good advice?

Re: Heel Pain after Dr's shots & orthotics are now Arch Pain.

Carole C in NOLA on 2/06/02 at 12:12 (072791)

OK, here's what I think, as a fellow victim of foot pain.

Your doctor wasn't listening to you. From what you said in your first post, you kept telling him you were in pain, right from the start. There's no point in being concerned about who dumped who at this point; the good thing is that you aren't going to him. It's not the first time that a doctor and a patient didn't get along. Also some foot professionals know a huge amount about foot problems, and some know very little. Now that you are rid of this doctor, you can work on finding a doctor or podiatrist who knows his stuff and who you can communicate with!

Don't accept orthotics that hurt immediately. In my rather uninformed opinion, you ought to be able to wear them for at least a half hour or hour and feel better in them than you did before. Sometimes they need to be broken in, so you might not be able to wear them for longer.

Easy Spirits are very bendy, and they are too flexible and bendy in the arch area so they aggravate PF.

So much depends on what you do for you. Orthotics have been the main key to my recovery so far. I do not believe that I would be any better if I had not got my orthotics. But if I had just gone and got orthotics, and hadn't done anything else to help myself, I would not have healed. Rest, taping, icing, stretching, and so many other suggestions on this board and in the heel pain book really do help. There's so much that you can do too. :)

My advice would be to let no stone remain unturned. Get a new foot professional, one that you trust and can communicate with, and one that you feel knows his stuff. Try everything you can, and keep posting to let us know how it's going. We really do understand.

Carole C

Re: Heel Pain after Dr's shots & orthotics are now Arch Pain.

paula on 2/06/02 at 20:26 (072855)

richard c ped just wondering where you are located for any of us who want to get orthotics from you.

Re: Heel Pain after Dr's shots & orthotics are now Arch Pain.

Richard, C.Ped on 2/07/02 at 10:23 (072905)

Columbia, South Carolina. two miles off Interstate 26. :-)
Richard