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Going back to work

Posted by Rachel W. on 4/17/02 at 05:22 (079945)

I have worked as a kitchen assistant since beginning of January and have since developed PF. My doctor signed me off work for 2 weeks. I'm due back to work next Monday but still in a lot of pain. I don't really want to take any more time off as I have only recently started the job.
My doctor said if I do go back to work then I wouldn't cause any more damage or make it worse.
So if I just try and bear the pain, is my doctor right in saying that I won't make it any worse by returning to work?

Re: Going back to work

Dr. Cozzarelli on 4/17/02 at 05:57 (079948)

Rachel:

What does your job entai? Do you stand on a hard surface? What type of shoes do you wear. Have you had any treatment and if so waht did they do?

Dr. John Cozzarelli

Re: Going back to work

Rachel W. on 4/17/02 at 06:53 (079950)

My job is an assistant cook at a school. Yes, I do stand on a hard surface. I wear trainers. The only treatment I have had have been prescribed anti-inflammatory tablets, but the doctor has just told me to stop taking them as the pain has not got any better and he was concerned about it could affect my stomach lining if I carried on taking them. I am waiting to hear from the foot clinic to which he has referred me. Still not heard anything yet. I am from england and the NHS can be a bit slow.
I bought last week a pair of heel cushions from a Scholl shop. Not sure if they are working either. Still in pain.

Re: Going back to work

Carmen on 4/17/02 at 07:33 (079954)

Sounds like you haven't done too much in the area of treatment...I would be concerned about going back to work without a program for treatment.
PT, orthotics, fatigue mat etc....

Re: Going back to work

Rachel W. on 4/17/02 at 10:40 (079974)

I don't suppose I'll know the programme for treatment until I attend the foot clinic. It seems to me that I either return to work on Monday and put up with the pain or I never return to work, as from what i've been reading about everyone else, its a problem that is going to last for years.

Re: Going back to work

Rachel W. on 4/17/02 at 10:45 (079975)

I would like to also point out that I'm 35 years old, not overweight but i'm even struggling at the moment to just do things around the house.

Re: Going back to work

dave on 4/17/02 at 12:06 (079988)

Im so sorry for your grief, I am also 35 and struggle around the house

Re: Going back to work

Carole C in NOLA on 4/17/02 at 13:25 (080001)

I'm 53, and in January I was struggling to do anything at all, and wasn't even able to do any housework or cooking. Now I'm able to walk for several hours (but not every day), I've cautiously begun exercising again, and my pain is much diminished.

PF doesn't HAVE to last for years. It can, and it probably will if you don't do what you need to like rest, ice, gentle stretching, never going barefoot, etc. See the heel pain book for the details. The earlier you start doing these things, and the more you do them, the faster you will heal, in all likelihood. Well, to a point. It's probably going to take at least a few months, but it doesn't always take years.

If you try to 'walk through the pain' you will really damage your feet, though.

Carole C

Re: Going back to work

AmyM on 4/17/02 at 16:30 (080025)

I don't know what the waiting lists are like in your part of the country, but I know the wait to see an NHS podiatrist in my area is a year. Do not wait a year before starting treatment!
Have a read of the heel pain book try some of the suggestions, if you do go back to work try and get a decent anti-fatigue mat. Some of the larger Boots shops sell shoe inserts called Orthoheel, (I think they have AOL stamped on the bottom) its quite likely that an NHS podiatrist will give you an insert like that in the first instance so you might want to give that a go now.
I don't know where you are in England but you might want to try Birkenstock shoes, they have a shop in Covent Garden in London or http://www.birkenstock.co.uk I had trouble with online ordering though, their server wasn't secure.

Re: Going back to work

Rachel W. on 4/18/02 at 04:53 (080086)

Thanks everyone for your suggestions and advice. I will give them a go.

Re: Going back to work

Dr. Cozzarelli on 4/18/02 at 05:28 (080087)

Rachel:

Everyone has suggested excellent treatment options. Here is what I would recommend until you get to the Doc. Number one get the book that has been suggested. Next, swithc shoes from a flat to a wedge type shoe. Next get a roung cylinder tpe bottle and fill it with water and freeze if. Make a large cylinder type ice cube. Apply the ice to the bottom of the heel where the fascia is painful daily 10 minutes on 20 off. Next get a night splint. Next begin wall achilles strectn. Next, when getting out of bed in the A.M. do not stand barefot. Have a slipper with a wedge to elevate the heel. The most important aspect of everything is using a night splint ot begin passive strecthing. I hope this helps.

Dr. John Cozzarelli

Re: Going back to work

Rich on 4/18/02 at 08:15 (080116)

Hi Rachel....everyone has made wonderful suggestions. This will heal and not necessarily last forever! My left foot took between 6-8 months to heal. There is a tender spot, but no pain walking at all.

I understand your fear about working. It's important to be able to take breaks to give your foot a rest. Being in a kitchen, you will have access to ice. Ice whenever you get a chance. For a long time, I wouldn't take a break to get off my feet because of the pain when I stood back up. So, I would just stay on my feet for long periods. My morning pain was severe and even after twenty minutes sitting, it would return. But, I was stubborn and my healing time took longer. I am learning from my mistakes now that I have PF in my other foot.

I used the water bottle method, because it didn't make such a mess at work, but find that the ice cups give more relief. You get an edge from the cup that gets into the insertion point when massaging. It melts fast so you have to have a towel handy, but feels really good.

I have finally accepted my limitations around the house and assigned chores to everyone. My girls are 6 and 3 and they are even helping, by the hardest! LOL They empty small wastebaskets, put away the flatware, feed the cats, 'help' with the dishes..then get the mop, LOL, picking up their toys. If anyone offers to help, learn to accept it. My sister comes in once a week to do my heavy cleaning, for a small fee to cover her babysitter. I don't recommend any 'eating off the floors' but I don't think we will catch any diseases, either! I dust what's in reach and wheel around in my office chair cleaning counters and cooking 'oven' things.

And when things get really bad, I pick up a book and just lose myself in it!

When (not if) you go back to work, wear sensible shoes, get a good mat to stand on, ice, stretch, and take short breaks whenever possible. Good Luck to you and I will keep you in my prayers!

Rich

Re: Going back to work

Rachel W. on 4/18/02 at 18:26 (080204)

Thanks again for your advice and suggestions. I'm not sure if a mat would be any good at my work as it's a big kitchen and most of the time I'm almost running around apart from when I'm washing up, so I think I'd need mats all over the place. Also I don't get a chance for breaks, we're always working against the clock. I have five sons so there pretty useless around the house despite my nagging. but, I must say my husband's absolutely great. He does alot of cooking and washing up, vacuuming and
gardening, so I can't fault him.
As for going back to work. I've come to the conclusion that I'm going to take a big break as long as it takes because your health is more important than anything.

Re: Going back to work

Pete R on 4/19/02 at 12:13 (080311)

I'm also from England and know from bitter experience that the NHS are pretty useless in their treatment and diagnosis of PF. The orthotics from Boots are an excellent suggestion and cost about £20. I purchased these at the start of my pf and they helped, if I'd have known to stretch / ice / rest etc at that time then I may have still not been suffering 2 years later ! This site has more info on than any other source I've known so make regular visits.

Also, do not, like I did, wait 4 months to be fitted for some NHS orthotics and then to find they are useless.

Wish you luck

Re: Resources for orthotics, pods, etc. in the UK

Donna SL on 4/19/02 at 17:26 (080355)

I live in the US, and have shelled out thousands of dollars for a bunch of useless orthotics. I have a whole bag full of them. Some actually caused harm. Many times I've waited a long time to get them too. I think it is a matter of luck in finding the right doctor that understands your biomechanics, no matter where you live. The same goes for treating PF, etc. It can be both an expensive, and frustrating task.

I've seen tons of doctors here that had no idea how to treat PF, and TTS, let alone make a decent pair of orthotics. I've learned more from other heel pain sufferers, and the doctors that contribute to this board than from any doctor I've seen on my own. I think the doctors that write in to this board are exceptional, and rare.

There are many fine podiatry schools in the UK, that may be able to refer pf sufferers to the right podiatrist, or have an on-site clinic. Here's a list of them below from the UK society of chiropodists, and podiatrist.

http://www.scpod.org/resource/ad_schools.html

Also, the owner of RX laboratories (an orthotics lab in Somerset) by the name of Ray Anthony is very knowledgeable about orthotics, and many of the biomechanical podiatrist throughout the UK, and may be of some help. A few podiatrist I have worked with here know of him, and have done some lectures in the UK. Take a look at the 'summer school' information on the site offered on the 'professional side'.

http://www.rxlabs.com/main.htm

There is contact info on this site, and it would be very benefical to contact him. If you scroll down on the 'who are RX laboratories' after clicking on the 'public area' you will find the telephone number at the bottom.

This uk org may be of some help too.

http://www.feetforlife.org/

Also the Univerisity of Salford
http://www.salford.ac.uk/
has a large orthotics/prosthetics department. Some people may have better luck with an orthotist for orthotics.

The Orving clinic http://www.ovingclinic.co.uk/index.html
also has been doing ESWT for a while. Their cost is very reasonable. I'm sure there are others. The manufactures of the shock wave machines listed on this site under ESWT, and the international society for musculoskeletal shock wave therapy http://www.ismst.com may be of some help in locating them. ESWT has been in use much longer in Europe than the US.

One other place I know of is Chelsea physiotherapy for ESWT. I don't know how much expertise they have. I don't think it is done by an md, or podiatrist though, but rather a PT.

http://www.physio-chelsea.co.uk/

Of course you may have to pay out of pocket like I did here for orthotics, and other treatments with no guarantees. Many insurance companies here don't pay for orthotics, or only pay for one pair every three years, or so, and will not pay for a second pair if you are unsatisfied. Also, most pay little, or nothing for alternative treatments. Orthotics may not even be the answer to your problem, or only a part of the total solution.

Again, it can sometimes take a lot of searching to find the right professionals to help you no matter where you are located.

Donna

Re: Resources for orthotics, pods, etc. in the UK

Sharon W on 4/19/02 at 17:33 (080356)

Donna,

WOW! I'm impressed. Either you knew all that off the top of your head, or you are an EXCELLENT researcher! (Or maybe both...)

-- Sharon

Re: Resources for orthotics, pods, etc. in the UK

Donna SL on 4/19/02 at 18:39 (080366)

Thanks Sharon,

I'm constantly doing research on many different resources in the UK, because I will be moving there in the future. There is so much more than I've listed. Also, my husband is British, and most of his family lives there, and I visited the UK many times. It suprises me sometimes that people don't know what's available in thier own back yard. I think there are more podiatry schools in the UK then there are in the US. (I think there are only 7 in the US, vs at least 13 in the UK.) Per capita that is roughly four times as many, so I think one could find a good podiatrist in the UK.

Donna

Re: Resources for orthotics, pods, etc. in the UK

Sharon W on 4/19/02 at 18:54 (080374)

Donna,

For your sake, I certainly hope so. I don't know much about medicine in the UK. I do know that when we lived in Chile, we had very GOOD medical care. (I miss it, sometimes...)

Have you ever been an expatriate before?

-- Sharon

Re: Resources for orthotics, pods, etc. in the UK

Donna SL on 4/19/02 at 19:14 (080376)

Hi Sharon,

I'm not an expatriate. I'm an American born citizen who has lived in the US my whole life.

Donna

Re: Resources for orthotics, pods, etc. in the UK

Sharon W on 4/19/02 at 19:33 (080379)

Donna,

I know that you are an American; I wondered if you had ever lived overseas before. I was an expatriate, when I lived in Chile, but of course I am no longer an expatriate now that I'm back in the U.S.

Sorry, I didn't mean to offend.

-- Sharon

Re: Resources for orthotics, pods, etc. in the UK

Donna SL on 4/19/02 at 19:41 (080380)

Hi Sharon,

You didn't offend me at all. Maybe it came off that way, because I'm writing fast, and trying to get out the door. I understand what an expatriot is, and there is nothing negative about it, but I wasn't sure if you knew I was an American born citizen. I

Donna

Re: Going back to work

Dr. Cozzarelli on 4/17/02 at 05:57 (079948)

Rachel:

What does your job entai? Do you stand on a hard surface? What type of shoes do you wear. Have you had any treatment and if so waht did they do?

Dr. John Cozzarelli

Re: Going back to work

Rachel W. on 4/17/02 at 06:53 (079950)

My job is an assistant cook at a school. Yes, I do stand on a hard surface. I wear trainers. The only treatment I have had have been prescribed anti-inflammatory tablets, but the doctor has just told me to stop taking them as the pain has not got any better and he was concerned about it could affect my stomach lining if I carried on taking them. I am waiting to hear from the foot clinic to which he has referred me. Still not heard anything yet. I am from england and the NHS can be a bit slow.
I bought last week a pair of heel cushions from a Scholl shop. Not sure if they are working either. Still in pain.

Re: Going back to work

Carmen on 4/17/02 at 07:33 (079954)

Sounds like you haven't done too much in the area of treatment...I would be concerned about going back to work without a program for treatment.
PT, orthotics, fatigue mat etc....

Re: Going back to work

Rachel W. on 4/17/02 at 10:40 (079974)

I don't suppose I'll know the programme for treatment until I attend the foot clinic. It seems to me that I either return to work on Monday and put up with the pain or I never return to work, as from what i've been reading about everyone else, its a problem that is going to last for years.

Re: Going back to work

Rachel W. on 4/17/02 at 10:45 (079975)

I would like to also point out that I'm 35 years old, not overweight but i'm even struggling at the moment to just do things around the house.

Re: Going back to work

dave on 4/17/02 at 12:06 (079988)

Im so sorry for your grief, I am also 35 and struggle around the house

Re: Going back to work

Carole C in NOLA on 4/17/02 at 13:25 (080001)

I'm 53, and in January I was struggling to do anything at all, and wasn't even able to do any housework or cooking. Now I'm able to walk for several hours (but not every day), I've cautiously begun exercising again, and my pain is much diminished.

PF doesn't HAVE to last for years. It can, and it probably will if you don't do what you need to like rest, ice, gentle stretching, never going barefoot, etc. See the heel pain book for the details. The earlier you start doing these things, and the more you do them, the faster you will heal, in all likelihood. Well, to a point. It's probably going to take at least a few months, but it doesn't always take years.

If you try to 'walk through the pain' you will really damage your feet, though.

Carole C

Re: Going back to work

AmyM on 4/17/02 at 16:30 (080025)

I don't know what the waiting lists are like in your part of the country, but I know the wait to see an NHS podiatrist in my area is a year. Do not wait a year before starting treatment!
Have a read of the heel pain book try some of the suggestions, if you do go back to work try and get a decent anti-fatigue mat. Some of the larger Boots shops sell shoe inserts called Orthoheel, (I think they have AOL stamped on the bottom) its quite likely that an NHS podiatrist will give you an insert like that in the first instance so you might want to give that a go now.
I don't know where you are in England but you might want to try Birkenstock shoes, they have a shop in Covent Garden in London or http://www.birkenstock.co.uk I had trouble with online ordering though, their server wasn't secure.

Re: Going back to work

Rachel W. on 4/18/02 at 04:53 (080086)

Thanks everyone for your suggestions and advice. I will give them a go.

Re: Going back to work

Dr. Cozzarelli on 4/18/02 at 05:28 (080087)

Rachel:

Everyone has suggested excellent treatment options. Here is what I would recommend until you get to the Doc. Number one get the book that has been suggested. Next, swithc shoes from a flat to a wedge type shoe. Next get a roung cylinder tpe bottle and fill it with water and freeze if. Make a large cylinder type ice cube. Apply the ice to the bottom of the heel where the fascia is painful daily 10 minutes on 20 off. Next get a night splint. Next begin wall achilles strectn. Next, when getting out of bed in the A.M. do not stand barefot. Have a slipper with a wedge to elevate the heel. The most important aspect of everything is using a night splint ot begin passive strecthing. I hope this helps.

Dr. John Cozzarelli

Re: Going back to work

Rich on 4/18/02 at 08:15 (080116)

Hi Rachel....everyone has made wonderful suggestions. This will heal and not necessarily last forever! My left foot took between 6-8 months to heal. There is a tender spot, but no pain walking at all.

I understand your fear about working. It's important to be able to take breaks to give your foot a rest. Being in a kitchen, you will have access to ice. Ice whenever you get a chance. For a long time, I wouldn't take a break to get off my feet because of the pain when I stood back up. So, I would just stay on my feet for long periods. My morning pain was severe and even after twenty minutes sitting, it would return. But, I was stubborn and my healing time took longer. I am learning from my mistakes now that I have PF in my other foot.

I used the water bottle method, because it didn't make such a mess at work, but find that the ice cups give more relief. You get an edge from the cup that gets into the insertion point when massaging. It melts fast so you have to have a towel handy, but feels really good.

I have finally accepted my limitations around the house and assigned chores to everyone. My girls are 6 and 3 and they are even helping, by the hardest! LOL They empty small wastebaskets, put away the flatware, feed the cats, 'help' with the dishes..then get the mop, LOL, picking up their toys. If anyone offers to help, learn to accept it. My sister comes in once a week to do my heavy cleaning, for a small fee to cover her babysitter. I don't recommend any 'eating off the floors' but I don't think we will catch any diseases, either! I dust what's in reach and wheel around in my office chair cleaning counters and cooking 'oven' things.

And when things get really bad, I pick up a book and just lose myself in it!

When (not if) you go back to work, wear sensible shoes, get a good mat to stand on, ice, stretch, and take short breaks whenever possible. Good Luck to you and I will keep you in my prayers!

Rich

Re: Going back to work

Rachel W. on 4/18/02 at 18:26 (080204)

Thanks again for your advice and suggestions. I'm not sure if a mat would be any good at my work as it's a big kitchen and most of the time I'm almost running around apart from when I'm washing up, so I think I'd need mats all over the place. Also I don't get a chance for breaks, we're always working against the clock. I have five sons so there pretty useless around the house despite my nagging. but, I must say my husband's absolutely great. He does alot of cooking and washing up, vacuuming and
gardening, so I can't fault him.
As for going back to work. I've come to the conclusion that I'm going to take a big break as long as it takes because your health is more important than anything.

Re: Going back to work

Pete R on 4/19/02 at 12:13 (080311)

I'm also from England and know from bitter experience that the NHS are pretty useless in their treatment and diagnosis of PF. The orthotics from Boots are an excellent suggestion and cost about £20. I purchased these at the start of my pf and they helped, if I'd have known to stretch / ice / rest etc at that time then I may have still not been suffering 2 years later ! This site has more info on than any other source I've known so make regular visits.

Also, do not, like I did, wait 4 months to be fitted for some NHS orthotics and then to find they are useless.

Wish you luck

Re: Resources for orthotics, pods, etc. in the UK

Donna SL on 4/19/02 at 17:26 (080355)

I live in the US, and have shelled out thousands of dollars for a bunch of useless orthotics. I have a whole bag full of them. Some actually caused harm. Many times I've waited a long time to get them too. I think it is a matter of luck in finding the right doctor that understands your biomechanics, no matter where you live. The same goes for treating PF, etc. It can be both an expensive, and frustrating task.

I've seen tons of doctors here that had no idea how to treat PF, and TTS, let alone make a decent pair of orthotics. I've learned more from other heel pain sufferers, and the doctors that contribute to this board than from any doctor I've seen on my own. I think the doctors that write in to this board are exceptional, and rare.

There are many fine podiatry schools in the UK, that may be able to refer pf sufferers to the right podiatrist, or have an on-site clinic. Here's a list of them below from the UK society of chiropodists, and podiatrist.

http://www.scpod.org/resource/ad_schools.html

Also, the owner of RX laboratories (an orthotics lab in Somerset) by the name of Ray Anthony is very knowledgeable about orthotics, and many of the biomechanical podiatrist throughout the UK, and may be of some help. A few podiatrist I have worked with here know of him, and have done some lectures in the UK. Take a look at the 'summer school' information on the site offered on the 'professional side'.

http://www.rxlabs.com/main.htm

There is contact info on this site, and it would be very benefical to contact him. If you scroll down on the 'who are RX laboratories' after clicking on the 'public area' you will find the telephone number at the bottom.

This uk org may be of some help too.

http://www.feetforlife.org/

Also the Univerisity of Salford
http://www.salford.ac.uk/
has a large orthotics/prosthetics department. Some people may have better luck with an orthotist for orthotics.

The Orving clinic http://www.ovingclinic.co.uk/index.html
also has been doing ESWT for a while. Their cost is very reasonable. I'm sure there are others. The manufactures of the shock wave machines listed on this site under ESWT, and the international society for musculoskeletal shock wave therapy http://www.ismst.com may be of some help in locating them. ESWT has been in use much longer in Europe than the US.

One other place I know of is Chelsea physiotherapy for ESWT. I don't know how much expertise they have. I don't think it is done by an md, or podiatrist though, but rather a PT.

http://www.physio-chelsea.co.uk/

Of course you may have to pay out of pocket like I did here for orthotics, and other treatments with no guarantees. Many insurance companies here don't pay for orthotics, or only pay for one pair every three years, or so, and will not pay for a second pair if you are unsatisfied. Also, most pay little, or nothing for alternative treatments. Orthotics may not even be the answer to your problem, or only a part of the total solution.

Again, it can sometimes take a lot of searching to find the right professionals to help you no matter where you are located.

Donna

Re: Resources for orthotics, pods, etc. in the UK

Sharon W on 4/19/02 at 17:33 (080356)

Donna,

WOW! I'm impressed. Either you knew all that off the top of your head, or you are an EXCELLENT researcher! (Or maybe both...)

-- Sharon

Re: Resources for orthotics, pods, etc. in the UK

Donna SL on 4/19/02 at 18:39 (080366)

Thanks Sharon,

I'm constantly doing research on many different resources in the UK, because I will be moving there in the future. There is so much more than I've listed. Also, my husband is British, and most of his family lives there, and I visited the UK many times. It suprises me sometimes that people don't know what's available in thier own back yard. I think there are more podiatry schools in the UK then there are in the US. (I think there are only 7 in the US, vs at least 13 in the UK.) Per capita that is roughly four times as many, so I think one could find a good podiatrist in the UK.

Donna

Re: Resources for orthotics, pods, etc. in the UK

Sharon W on 4/19/02 at 18:54 (080374)

Donna,

For your sake, I certainly hope so. I don't know much about medicine in the UK. I do know that when we lived in Chile, we had very GOOD medical care. (I miss it, sometimes...)

Have you ever been an expatriate before?

-- Sharon

Re: Resources for orthotics, pods, etc. in the UK

Donna SL on 4/19/02 at 19:14 (080376)

Hi Sharon,

I'm not an expatriate. I'm an American born citizen who has lived in the US my whole life.

Donna

Re: Resources for orthotics, pods, etc. in the UK

Sharon W on 4/19/02 at 19:33 (080379)

Donna,

I know that you are an American; I wondered if you had ever lived overseas before. I was an expatriate, when I lived in Chile, but of course I am no longer an expatriate now that I'm back in the U.S.

Sorry, I didn't mean to offend.

-- Sharon

Re: Resources for orthotics, pods, etc. in the UK

Donna SL on 4/19/02 at 19:41 (080380)

Hi Sharon,

You didn't offend me at all. Maybe it came off that way, because I'm writing fast, and trying to get out the door. I understand what an expatriot is, and there is nothing negative about it, but I wasn't sure if you knew I was an American born citizen. I

Donna