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another opinion

Posted by Lisa G on 4/29/02 at 17:49 (081632)

hi gentlemen,
i am so glad to have found this website (with help from my orthopedist)...amd i will take advantage of getting another professional opinion without having to traipse around town going from dr to dr...

i have had PF for about 8 years now...and have done everything that can be done to fix this problem...this morning i had a second opinion on having EPF surg on both feet...both the podiatrist and the orthopedist agree that surgery is really my only option...unfortunately this morning when i saw my orthopedist i forgot to mention that i also have pain that radiates from my inner ankle to my knee...and i have a spot on my calf that if i press on it...it will send shooting pain up and down my leg...

neither the pod or ortho guy could tell me if having the EPF done would help with my VERY VERY tight achilles tendons and my very tight calves (i stretch my calves several times daily)

so i guess what i want to know is...EPF or no...and what about the shooting/radiating pains...and about the tight achilles tendon and calves...

thank you in advance for your time...lisa

Re: another opinion

Dr. Cozzarelli on 4/29/02 at 19:49 (081656)

Hi Lisa:

Surgery is not your only option. Do you know about ESWT? This is a non-invassive treatment that has very high success rates. I have personally stopped doing EPF'S. We have the endoscope in our office and it has been collecting dust for the last year. ESWT far out weighs the downsides to EPF'S. If you would like information on this treatment please go to my website and e-mail me. I will be happy to send inforamtion about the treatment.

Dr. John Cozzarelli

Re: another opinion

Dr. David S. Wander on 4/29/02 at 20:32 (081672)

Lisa, although ESWT is an excellent alternative to surgery/EPF for chronic plantar fasciitis/heel pain, it appears that you may have something else contributing to your pain. I perform ESWT and this will not help a tight tendon and some of the other calf pain you describe. My suggestion is to understand that ESWT can have a very high success rate when dealing with plantar fasciitis and/or insertional Achilles tendinitis. But realize that the pains in your calf and tightness may still persist. Get everything checked out prior to any procedure. I would highly recommend ESWT over EPF. Good luck.

Re: another opinion

Lisa G on 4/29/02 at 23:57 (081704)

thank you for your responses...i have heard of the technique...have a friend who had it done...and is very pleased with the results...unfortunately i do not think it is an option for me at this time...i will look into it more before i go under the knife ;) i will try just about anything to find relief at this point though...

lisa

Re: another opinion

Daniel C. on 4/30/02 at 04:03 (081714)

Lisa,

Have you tried physical therapy? If you did, did you find it helpful at all? Just wanted to know. I did not find pt to be helpful for plantar fasciitis.

Re: another opinion

Lisa G on 4/30/02 at 08:01 (081735)

hi daniel...yes! physical therapy which included: ultrasound, electric stim, stretching (which i know i am doing correctly), exercises, deep tissue work, and a program called flexible feet...night splints, injections, and orthotics...if i don't wear my orthotics...i can't walk...but i still have TERRIBLE pain with them...ok...that's all i've done so far...

lisa

Re: another opinion

Ed Davis, DPM on 4/30/02 at 14:19 (081802)

Lisa:

The opinion that I am giving you is the common thinking in the Seattle area. Generally speaking, EPF has a decent chance of working BUT it has a poor chance of success with a tight achilles tendon. We generally favor a plantar fascial release (few use EPF in my area) coupled with either a gastrocnemius recession or tendo achilles lengthenening.
Ed

Re: another opinion

Dr. J Cione on 5/01/02 at 10:22 (081955)

Doing an EPF in my opinion will do nothing for the tight achilles tendon. With your tight achilles there is a very good chance following the EPF you can have a return of the pain. Stretching is very important in resolving PF. I assumed you have exhausted all conservative care over the 8 years. You may want to consider alternative procedures before surgery.

Re: another opinion

Dr. Zuckerman on 5/02/02 at 14:24 (082156)

Why is your calf tendons tight. Do you have a problem with your ankle. Is there any arthrosis in the ankle. How is the entire lower extremity biomechanics.

Re: another opinion

Lisa G on 5/02/02 at 21:11 (082222)

dr z,
i do not know why my calf muscles are tight...i was in the army...and in basic training we did not stretch enough...i have fibromyalgia...which could be another reason...

i have medium-high arches...and i know that the lack of shoe/boot support in basic training is the initial cause of my feet pain...at my first duty station after basic...i developed severe tendonitis in my right achilles tendon...which was only treated with motrin...no stretching...after that...my pain symptoms increased...first in the right foot then in the left foot...

i have some ankle pain...more severe in my right ankle...

lisa

Re: another opinion

Dr. Cozzarelli on 4/29/02 at 19:49 (081656)

Hi Lisa:

Surgery is not your only option. Do you know about ESWT? This is a non-invassive treatment that has very high success rates. I have personally stopped doing EPF'S. We have the endoscope in our office and it has been collecting dust for the last year. ESWT far out weighs the downsides to EPF'S. If you would like information on this treatment please go to my website and e-mail me. I will be happy to send inforamtion about the treatment.

Dr. John Cozzarelli

Re: another opinion

Dr. David S. Wander on 4/29/02 at 20:32 (081672)

Lisa, although ESWT is an excellent alternative to surgery/EPF for chronic plantar fasciitis/heel pain, it appears that you may have something else contributing to your pain. I perform ESWT and this will not help a tight tendon and some of the other calf pain you describe. My suggestion is to understand that ESWT can have a very high success rate when dealing with plantar fasciitis and/or insertional Achilles tendinitis. But realize that the pains in your calf and tightness may still persist. Get everything checked out prior to any procedure. I would highly recommend ESWT over EPF. Good luck.

Re: another opinion

Lisa G on 4/29/02 at 23:57 (081704)

thank you for your responses...i have heard of the technique...have a friend who had it done...and is very pleased with the results...unfortunately i do not think it is an option for me at this time...i will look into it more before i go under the knife ;) i will try just about anything to find relief at this point though...

lisa

Re: another opinion

Daniel C. on 4/30/02 at 04:03 (081714)

Lisa,

Have you tried physical therapy? If you did, did you find it helpful at all? Just wanted to know. I did not find pt to be helpful for plantar fasciitis.

Re: another opinion

Lisa G on 4/30/02 at 08:01 (081735)

hi daniel...yes! physical therapy which included: ultrasound, electric stim, stretching (which i know i am doing correctly), exercises, deep tissue work, and a program called flexible feet...night splints, injections, and orthotics...if i don't wear my orthotics...i can't walk...but i still have TERRIBLE pain with them...ok...that's all i've done so far...

lisa

Re: another opinion

Ed Davis, DPM on 4/30/02 at 14:19 (081802)

Lisa:

The opinion that I am giving you is the common thinking in the Seattle area. Generally speaking, EPF has a decent chance of working BUT it has a poor chance of success with a tight achilles tendon. We generally favor a plantar fascial release (few use EPF in my area) coupled with either a gastrocnemius recession or tendo achilles lengthenening.
Ed

Re: another opinion

Dr. J Cione on 5/01/02 at 10:22 (081955)

Doing an EPF in my opinion will do nothing for the tight achilles tendon. With your tight achilles there is a very good chance following the EPF you can have a return of the pain. Stretching is very important in resolving PF. I assumed you have exhausted all conservative care over the 8 years. You may want to consider alternative procedures before surgery.

Re: another opinion

Dr. Zuckerman on 5/02/02 at 14:24 (082156)

Why is your calf tendons tight. Do you have a problem with your ankle. Is there any arthrosis in the ankle. How is the entire lower extremity biomechanics.

Re: another opinion

Lisa G on 5/02/02 at 21:11 (082222)

dr z,
i do not know why my calf muscles are tight...i was in the army...and in basic training we did not stretch enough...i have fibromyalgia...which could be another reason...

i have medium-high arches...and i know that the lack of shoe/boot support in basic training is the initial cause of my feet pain...at my first duty station after basic...i developed severe tendonitis in my right achilles tendon...which was only treated with motrin...no stretching...after that...my pain symptoms increased...first in the right foot then in the left foot...

i have some ankle pain...more severe in my right ankle...

lisa