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

Orthotics as a Cause?

Posted by PatsyC on 5/16/02 at 10:15 (084138)

A seven year puzzle--I was diagnosed with peripheral neuropathy, prescribed neurontin, and then sent to a podiatrist to make sure there were not also musculoskeletal issues. The podiatrist diagnosed plantar fasciitis and metatarsalgia and prescribed custom orthotics, which I wore as directed while the pain intensified. Six months of physical therapy and a year later, I was redirected to an orthopedic surgeon who did a bone scan and then prescribed different orthotics. I wore those as directed and was referred to a different physical therapist. Six more months of therapy later, the pt recommended, casted for and ordered different orthotics. The pain just got worse all of that time until I was off work. I hobbled, rested, tried different pain relief techniques, and then was prescribed ultram for the neuropathy, which brought some relief. My question is,with certain foot structures, have orthotics ever exacerbated pf?

Re: Orthotics as a Cause?

Ed Davis, DPM on 5/16/02 at 15:51 (084182)

It is possible for orthotics to exaccerbate PF if they are not made properly. Considering that you had 3 different pairs of orthotics while the pain was getting worse suggests that the orthotics may have had little to do with the progession. I would be curious to know what portion of your pain comes from peripheral neuropathy and what portion from PF.
Have you been checked for tarsal tunnel syndrome?
Ed

Re: Orthotics as a Cause?

Ellen J. on 5/17/02 at 20:13 (084388)

Hi Patsy,
The orthotics that someone made for me ended up making my feet worse, but because I stopped wearing them, my feet then started to get better. Is the pain in your arch? Have you tried a little less arch support or softer orthotics? Don't go by what I say, as I'm not a doctor, but I'm just telling you that I ended up wearing soft orthotics with less of an arch and then my feet thanked me. The arch on the custom orthos stuck up too much and and aggravated my arches.
Hope you can find the solutiion soon,
Ellen

Re: Orthotics as a Cause?

PatsyC on 5/22/02 at 11:57 (084867)

I've been wondering about what part is neurological and what part is mechanical for ages! Tarsal tunnel was suspected, but the neurologists who did the EMG said there was no sign of entrapment. I have some Tinel's sign, shooting and piercing pain, burning over the whole foot, a deep ache and soreness especially just under the big toe, along the inside of the foot, and in the middle arch area. (I also had a negative bone scan.) But when everything started, the only pain was in the metatarsal region. The neurologists call what I have Myofascial Pain Syndrome, or Cryptogenic polysensory neuropathy. And yet the pain behaves like plantar fasciitis and metatarsalgia. Although I've spent the last four years in the custom orthotics, it feels better now to go around in socks. Any arch support irritates the spot in the inner/mid arch. Sorry to go on so long. . .Any thoughts, Dr. Davis?
PC

Re: Orthotics as a Cause?

Ed Davis, DPM on 5/16/02 at 15:51 (084182)

It is possible for orthotics to exaccerbate PF if they are not made properly. Considering that you had 3 different pairs of orthotics while the pain was getting worse suggests that the orthotics may have had little to do with the progession. I would be curious to know what portion of your pain comes from peripheral neuropathy and what portion from PF.
Have you been checked for tarsal tunnel syndrome?
Ed

Re: Orthotics as a Cause?

Ellen J. on 5/17/02 at 20:13 (084388)

Hi Patsy,
The orthotics that someone made for me ended up making my feet worse, but because I stopped wearing them, my feet then started to get better. Is the pain in your arch? Have you tried a little less arch support or softer orthotics? Don't go by what I say, as I'm not a doctor, but I'm just telling you that I ended up wearing soft orthotics with less of an arch and then my feet thanked me. The arch on the custom orthos stuck up too much and and aggravated my arches.
Hope you can find the solutiion soon,
Ellen

Re: Orthotics as a Cause?

PatsyC on 5/22/02 at 11:57 (084867)

I've been wondering about what part is neurological and what part is mechanical for ages! Tarsal tunnel was suspected, but the neurologists who did the EMG said there was no sign of entrapment. I have some Tinel's sign, shooting and piercing pain, burning over the whole foot, a deep ache and soreness especially just under the big toe, along the inside of the foot, and in the middle arch area. (I also had a negative bone scan.) But when everything started, the only pain was in the metatarsal region. The neurologists call what I have Myofascial Pain Syndrome, or Cryptogenic polysensory neuropathy. And yet the pain behaves like plantar fasciitis and metatarsalgia. Although I've spent the last four years in the custom orthotics, it feels better now to go around in socks. Any arch support irritates the spot in the inner/mid arch. Sorry to go on so long. . .Any thoughts, Dr. Davis?
PC