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Dr's... need your opinon on course of treatment

Posted by EKC on 3/05/02 at 12:34 (075745)

My podiatrist got rid of my PF w/~4 months of PT. Now the neurologist has diagnosed TTS with a NCV.
THe podiatrist wants to start a new course of PT on the TTS (elec stim, ultrasound, massage) on the ankles.
Question: I have not had xrays in over 18 months. How can the podiatrist say it is truely TTS
and not something like calcaneal nerve compression, bursitis, heel spur, etc. My problem
is walking/standing is painful. I DO NOT have tingling/numbing/burning in feet. I do not
have Tinel's sign. My ankles feel fine and so do my arches. I truely belive the walking/standing pain
starts in my heels.
Should I go through new PT w/out having further xrays, mri, etc?

Re: Dr's... need your opinon on course of treatment

Ed Davis, DPM on 3/05/02 at 21:30 (075782)

NCVs are often not a very sensitive test but they can be fairly selective.
In other words, if the NCV is positive for TTS then the chance of having TTS is high. TTS often but not always manifests as tingling or numbness, sometimes just as pain. Considering that your podiatrist wants to proceed with conservative treatment, I think it is worth proceeding with his recommendations.
Ed

Re: Dr's... need your opinon on course of treatment

EKC on 3/06/02 at 06:31 (075797)

Thanks.
But given she hasn't taken xrays in a very long time, isnt it possible
that I might have a spur sitting on a nerve in the heel? This is
how my pain feels / I envision what might be happening.

Re: Dr's... need your opinon on course of treatment

John k on 3/06/02 at 19:33 (075871)

What is success ratio for TTS surgery?

Re: Dr's... need your opinon on course of treatment

Ed Davis on 3/07/02 at 17:19 (075923)

X-rays often provide limited information. Heel spurs are rarely the cause of heel pain.
Ed

Re: Dr's... need your opinon on course of treatment

Ed Davis on 3/07/02 at 17:26 (075927)

Not real good. About 50% to 75%. I think a lot depends on if there is an identifiable structure placing pressure on the nerve---increases chance of success.
Ed

Re: Dr's... need your opinon on course of treatment

Richard M on 3/08/02 at 13:13 (075962)

I have had plantar fascia for 11 months. I am unable to run and it is very diffucult for me even to walk. My podiatrist has given me everything he has. He gave me insoles and many exercises to try and none of them work. they cause even more pain. I feel sometimes that I am handicap. Being 14 yrs old, it is hard for me to do anything. I am unable to do P.E and I don't know what I should do?

Re: Dr's... need your opinon on course of treatment

EKC on 3/08/02 at 13:15 (075963)

I encourage you to try Physical Therapy. Electrical Stim, Ultrasound, massage. Stay off them and Ice as many times a day as possible.
It took me 4+ months, twice per week of this routine and it finally
worked. Good luck.

Re: Richard

Julie on 3/08/02 at 14:39 (075967)

Richard, I think you should start a new thread, and re-post your question so that the doctors are sure to see it. I wonder, as you are only 14, if what you have is really Sever's Disease (and not plantar fasciitis) which affects some young people. I believe they usually grow out of it - but you really ought to have a doctor's opinion, so do post your query again.

Meanwhile a couple of words of caution: don't go barefoot, make sure you always wear good stable shoes that give you good support, and take care with exercises. If they make you worse, they aren't right for you: pain is always a signal to stop doing whatever is causing the pain.

Re: Dr's... need your opinon on course of treatment

Ed Davis, DPM on 3/05/02 at 21:30 (075782)

NCVs are often not a very sensitive test but they can be fairly selective.
In other words, if the NCV is positive for TTS then the chance of having TTS is high. TTS often but not always manifests as tingling or numbness, sometimes just as pain. Considering that your podiatrist wants to proceed with conservative treatment, I think it is worth proceeding with his recommendations.
Ed

Re: Dr's... need your opinon on course of treatment

EKC on 3/06/02 at 06:31 (075797)

Thanks.
But given she hasn't taken xrays in a very long time, isnt it possible
that I might have a spur sitting on a nerve in the heel? This is
how my pain feels / I envision what might be happening.

Re: Dr's... need your opinon on course of treatment

John k on 3/06/02 at 19:33 (075871)

What is success ratio for TTS surgery?

Re: Dr's... need your opinon on course of treatment

Ed Davis on 3/07/02 at 17:19 (075923)

X-rays often provide limited information. Heel spurs are rarely the cause of heel pain.
Ed

Re: Dr's... need your opinon on course of treatment

Ed Davis on 3/07/02 at 17:26 (075927)

Not real good. About 50% to 75%. I think a lot depends on if there is an identifiable structure placing pressure on the nerve---increases chance of success.
Ed

Re: Dr's... need your opinon on course of treatment

Richard M on 3/08/02 at 13:13 (075962)

I have had plantar fascia for 11 months. I am unable to run and it is very diffucult for me even to walk. My podiatrist has given me everything he has. He gave me insoles and many exercises to try and none of them work. they cause even more pain. I feel sometimes that I am handicap. Being 14 yrs old, it is hard for me to do anything. I am unable to do P.E and I don't know what I should do?

Re: Dr's... need your opinon on course of treatment

EKC on 3/08/02 at 13:15 (075963)

I encourage you to try Physical Therapy. Electrical Stim, Ultrasound, massage. Stay off them and Ice as many times a day as possible.
It took me 4+ months, twice per week of this routine and it finally
worked. Good luck.

Re: Richard

Julie on 3/08/02 at 14:39 (075967)

Richard, I think you should start a new thread, and re-post your question so that the doctors are sure to see it. I wonder, as you are only 14, if what you have is really Sever's Disease (and not plantar fasciitis) which affects some young people. I believe they usually grow out of it - but you really ought to have a doctor's opinion, so do post your query again.

Meanwhile a couple of words of caution: don't go barefoot, make sure you always wear good stable shoes that give you good support, and take care with exercises. If they make you worse, they aren't right for you: pain is always a signal to stop doing whatever is causing the pain.