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Desperately Need Help...

Posted by MichaelM on 6/07/02 at 13:12 (086674)

For the last four years, I've been suffering from plantar fasciitis in both feet and I can't tell you how frustrated I am. When I first started having the problem I saw an othropedic surgeon who prescribed Naproxen as well as stretching my calf muscles and rest. After this didn't work, I wore night splints for a month and I went through iontophoresis in physical therapy. This seemed to help slightly, but as soon as the treatment was over I was back to the same pain. After that I went to a podistrist, and I had orthotics made. Trying to wear these was absolute torture. The pain for me is most severe in the arch of my foot and the orthotics just aggravated the pain. I tried wearing them for a little while and gave up. Has anyone tried pressing through the pain and had orthotics help? I think I have most of the classical symptoms like when I get up in the morning the pain is really bad. As I go on walks the pain will subside (say down to a 1 or 2 on a scale of 10), but if I'm just standing around the pain can climb to a 7 or an 8. Is it normal for the pain to be worse just standing around? Why is that? I live in Salt Lake City, Utah and I'm ready to try shockwave therapy, although I must be honest and say I'm concerned because it's so new. I don't know what to try next though. I'm of a normal weight so weight loss wouldn't really help for me. I could really use some advice. Thank you for any help.

Re: Desperately Need Help...

Pete R on 6/07/02 at 14:19 (086677)

Michael,

I share your frustration. I get pain on standing too, but not morning pain. We are all different. Definitely consider ESWT, there are NO down sides. I've had one treatment 4 weeks ago, time will tell if it works.

With orthotics, I've had 6 pairs and found that the one's that feel totally uncomfortable / painful from the start rarely get any better. If you're foot just aches (as opposed to excrutiating pain) a bit after you've started using them, then stick with them and 'wear' them in.

Wish you luck.

Re: Desperately Need Help...

BrianJ on 6/07/02 at 17:26 (086710)

Yes, standing in one place on a hard surface is the WORST. When I got married two years ago, I had to stand still on a marble floor for about an hour as the photographer got all the pictures of my wife and me with all the attendants. Even though I had taped my feet heavily beforehand, it felt like someone was drilling holes in my heels with a chuck bit.

Re: Desperately Need Help...

Pauline on 6/07/02 at 19:26 (086719)

Michael,
Don't lose faith. Easy to say but hard to do. I certainly would try ESWT before you let anyone talk you into surgery. Personally I'd try it as soon as possible because I think the longer you have P.F. the more difficult it is to eliminate.

I can tell you from my own experience 1 month of night splint use isn't enough to really help. I've actually wore out one pair and purchased new ones for the last round of P.F. that I had. My cases seem to last about 2 1/2 years if I am consistent with all the standard treatments from night splinting for months and months, exercises and physical therapy, ice and lots and lots of time off my feet.

Don't try to push through the pain, because you can win that way. P.F. will always be the winner if you continue your daily routine. I've had it 3 times and each time it went away. From reading stories like yours maybe in my case luck played a role, but I can tell you I still do every exercise I was taught through out the years to keep everything stretched from hip to toe. I hung up my night splints a while back, but their never really out of sight just in case it comes back.

Look for a good physician doing ESWT and try it. Hopefully it will help you. Wishing you the best of luck.

Re: Desperately Need Help...

Dr. Wishnie on 6/08/02 at 15:20 (086783)

Dear Michael:

I definitely understand your pain since I see about 10-15 new cases of this per week. I have also treated over one hundred patients with this problem. The one thing is that the pain is in the arch. ESWT is for insertional plantar fasciitis, that is where the ligament attaches to the heel bone. Do you have any pain there? Let me know. Dr. Wishnie

Re: Desperately Need Help...

john h on 6/10/02 at 10:28 (086930)

Michelle: you are following much the same symptoms and attempts to cure your problems as many of us. Yes, standing around sure is a major cause of pain. I would sure proceed ahead and try ESWT if I were you. You did not mention iceing on a regular basis or trying Birkenstock sandals such as the Airizon. Both of these have been a help to many people. Keep on reading here and do not expect some sort of instant cure. It is going to take time so do not get involved in heavy duty activites which might further aggrevate your condition.

Re: Location of pain...

MichaelM on 6/10/02 at 13:11 (086956)

Dr Wishnie,

The pain is concentrated for me in the arch, not really in the heel. If I flex back my toes, my plantar fascia is quite prominent in the arch, and that's where it hurts. Am I not a good candidate for ESWT because of this? Thank you for your help.

Michael

Re: Desperately Need Help...

MichaelM on 6/10/02 at 13:15 (086957)

Thanks for all of the advice. I called my podiatrist on Friday to ask if anyone in Utah does ESWT and unfortunately no one does, so I'll have to research having it done out of state and look into seeing if by some chance my insurance covers it.

Re: Desperately Need Help...

john h on 6/10/02 at 15:07 (086965)

Michael: In your part of the country Dr. Ed seems to know the place to go that is experienced and the price is right.

Re: Location of pain...

Dr. Wishnie on 6/10/02 at 15:56 (086981)

Dear Michael:

I am afraid so. However, let me know all prior treatments and I think I can help you as best as I can through e-mail. Dr. W

Re: Desperately Need Help...

terry h on 6/11/02 at 10:31 (087087)

hi mike, i've had pf for almost 2 years now, for the first year or so i wore orthotics, my doc refitted them 3-4 times and i found that NOT wearing them, using tape, and heel pads helped more than the orthotics.

I had eswt about 7 weeks ago and the pain is worse than before, but a different kind of pain. . . some days it's a 1, or like right now, it's a 5 0r 6

Re: Desperately Need Help...

Patricia R. on 6/12/02 at 07:53 (087249)

Hi...I'm searching for answers myself. I had the procedure done
on 4/23/02 and it apparently hasn't worked. I am in pain 80% of
the time and have had to cut out most activity and walking.
I had a surgeon use the Dornea Machine at 3800 impulses. On my
one month follow up he told me it didn't work and I should expect
things to worsen. I am supposed to wear a walking cast and come
back in two months to start physical therapy. He was reluctant
to answer questions I posed regarding the number of impulses
received, etc. and just cut me off. I had had a heel spur for
years in my right foot and never wanted to undergo surgery as
the recuperation time was long and results weren't guaranteed.
I have had orthotics, shots, taped feet, therapy, etc...and
nothing worked. I use to be able to still get quite a good amount
of exercise and be able to walk a lot from the time I got up until
about 1PM and then the pain would be terrible.

Now, I have had to cut back on everything and the pain is constant
unless I am off of it and taking Vioxx with an iced foot.

Please let me hear from you....I need help too.

Re: Asking Doctor Z

dave on 6/12/02 at 08:12 (087256)

Im curious to ask why your doctor said to expect things to worsen. What are your comments on this doctor Z

Re: Desperately Need Help...

john h on 6/12/02 at 10:01 (087282)

Patricia you need to give yourself more time to heal. Usually the minimum amount of time is 12 weeks for improvement. I am not familiar with the Dornea maching. Do you mean Dornier? For the doctor to tell you it did not work after 1 month and to expect it to get worse sounds crazy. Something sounds very wrong here.

Re: Asking Doctor Z

Dr. Zuckerman on 6/12/02 at 10:18 (087287)

Hi

This is very strange. If the pain has increased a re-evaluation as to why needs to be done. The reason for the pain must be discussed with you. Yes you can get increased pain sometime but this should go away.and is very very rare The impact of ESWT really starts between week six and week twelve. Feel free to discuss this with any doctors on this board. We are always here to help, IF you are having of pain this must be evaluated

Re: Desperately Need Help...

Ed Davis, DPM on 6/12/02 at 14:58 (087333)

Patricia:

Please describe the symptoms your are experiencing now and before. We need to be sure that this is definitely PF. When a problem does not respond to conventional treatment or responds in unusual ways we always have to question if we are treating the right thing.
Ed

Re: Asking Doctor Z

Patricia R. on 7/08/02 at 18:20 (089318)

Hi Dr. Z.

Thanks for your response. I did ask him on my one month visit if I should
have another procedure. He said NO..he also wouldn't give me a cortizone
shot..or start therapy. He gave me that orthotic boot to wear I told you
about that doesn't help.
My 12 week visit is July 18th I think...I have stopped in his office..
I have written him letters...I called again today and the nurses advise
he will not speak to any patients without an appointment. I have United
Health Care who agreed to pay for this but won't support my going elsewhere/
I believe my procedure with Dr. Lee cost around $4,000 and I received a
bill for $670.00 which wasn't covered. In speaking with United Health
Care they told me that they had an 'agreed upon price' for the procedure
which was paid to him. You know, if this would have worked or he would
even talk to me I would have gladly paid this already. He charged them
$500.00 for this boot of which I have to pay another $100.00 for something
I can't even wear. I'm sorry if you feel I'm putting you in a position
against another physician, it just seems that my treatment is a lot
different from most others I've seen or read about on these websites.

Please tell me what to do now.....I'm just at a loss all the way around.
Patricia

Re: Asking Doctor Z

Dr. Zuckerman on 7/08/02 at 18:59 (089320)

I would start physical therapy, possible steriod injection. and possible 2nd treatment . I can only tell you what I would do . I am at a lost for words to help you.

Re: Desperately Need Help...

Pete R on 6/07/02 at 14:19 (086677)

Michael,

I share your frustration. I get pain on standing too, but not morning pain. We are all different. Definitely consider ESWT, there are NO down sides. I've had one treatment 4 weeks ago, time will tell if it works.

With orthotics, I've had 6 pairs and found that the one's that feel totally uncomfortable / painful from the start rarely get any better. If you're foot just aches (as opposed to excrutiating pain) a bit after you've started using them, then stick with them and 'wear' them in.

Wish you luck.

Re: Desperately Need Help...

BrianJ on 6/07/02 at 17:26 (086710)

Yes, standing in one place on a hard surface is the WORST. When I got married two years ago, I had to stand still on a marble floor for about an hour as the photographer got all the pictures of my wife and me with all the attendants. Even though I had taped my feet heavily beforehand, it felt like someone was drilling holes in my heels with a chuck bit.

Re: Desperately Need Help...

Pauline on 6/07/02 at 19:26 (086719)

Michael,
Don't lose faith. Easy to say but hard to do. I certainly would try ESWT before you let anyone talk you into surgery. Personally I'd try it as soon as possible because I think the longer you have P.F. the more difficult it is to eliminate.

I can tell you from my own experience 1 month of night splint use isn't enough to really help. I've actually wore out one pair and purchased new ones for the last round of P.F. that I had. My cases seem to last about 2 1/2 years if I am consistent with all the standard treatments from night splinting for months and months, exercises and physical therapy, ice and lots and lots of time off my feet.

Don't try to push through the pain, because you can win that way. P.F. will always be the winner if you continue your daily routine. I've had it 3 times and each time it went away. From reading stories like yours maybe in my case luck played a role, but I can tell you I still do every exercise I was taught through out the years to keep everything stretched from hip to toe. I hung up my night splints a while back, but their never really out of sight just in case it comes back.

Look for a good physician doing ESWT and try it. Hopefully it will help you. Wishing you the best of luck.

Re: Desperately Need Help...

Dr. Wishnie on 6/08/02 at 15:20 (086783)

Dear Michael:

I definitely understand your pain since I see about 10-15 new cases of this per week. I have also treated over one hundred patients with this problem. The one thing is that the pain is in the arch. ESWT is for insertional plantar fasciitis, that is where the ligament attaches to the heel bone. Do you have any pain there? Let me know. Dr. Wishnie

Re: Desperately Need Help...

john h on 6/10/02 at 10:28 (086930)

Michelle: you are following much the same symptoms and attempts to cure your problems as many of us. Yes, standing around sure is a major cause of pain. I would sure proceed ahead and try ESWT if I were you. You did not mention iceing on a regular basis or trying Birkenstock sandals such as the Airizon. Both of these have been a help to many people. Keep on reading here and do not expect some sort of instant cure. It is going to take time so do not get involved in heavy duty activites which might further aggrevate your condition.

Re: Location of pain...

MichaelM on 6/10/02 at 13:11 (086956)

Dr Wishnie,

The pain is concentrated for me in the arch, not really in the heel. If I flex back my toes, my plantar fascia is quite prominent in the arch, and that's where it hurts. Am I not a good candidate for ESWT because of this? Thank you for your help.

Michael

Re: Desperately Need Help...

MichaelM on 6/10/02 at 13:15 (086957)

Thanks for all of the advice. I called my podiatrist on Friday to ask if anyone in Utah does ESWT and unfortunately no one does, so I'll have to research having it done out of state and look into seeing if by some chance my insurance covers it.

Re: Desperately Need Help...

john h on 6/10/02 at 15:07 (086965)

Michael: In your part of the country Dr. Ed seems to know the place to go that is experienced and the price is right.

Re: Location of pain...

Dr. Wishnie on 6/10/02 at 15:56 (086981)

Dear Michael:

I am afraid so. However, let me know all prior treatments and I think I can help you as best as I can through e-mail. Dr. W

Re: Desperately Need Help...

terry h on 6/11/02 at 10:31 (087087)

hi mike, i've had pf for almost 2 years now, for the first year or so i wore orthotics, my doc refitted them 3-4 times and i found that NOT wearing them, using tape, and heel pads helped more than the orthotics.

I had eswt about 7 weeks ago and the pain is worse than before, but a different kind of pain. . . some days it's a 1, or like right now, it's a 5 0r 6

Re: Desperately Need Help...

Patricia R. on 6/12/02 at 07:53 (087249)

Hi...I'm searching for answers myself. I had the procedure done
on 4/23/02 and it apparently hasn't worked. I am in pain 80% of
the time and have had to cut out most activity and walking.
I had a surgeon use the Dornea Machine at 3800 impulses. On my
one month follow up he told me it didn't work and I should expect
things to worsen. I am supposed to wear a walking cast and come
back in two months to start physical therapy. He was reluctant
to answer questions I posed regarding the number of impulses
received, etc. and just cut me off. I had had a heel spur for
years in my right foot and never wanted to undergo surgery as
the recuperation time was long and results weren't guaranteed.
I have had orthotics, shots, taped feet, therapy, etc...and
nothing worked. I use to be able to still get quite a good amount
of exercise and be able to walk a lot from the time I got up until
about 1PM and then the pain would be terrible.

Now, I have had to cut back on everything and the pain is constant
unless I am off of it and taking Vioxx with an iced foot.

Please let me hear from you....I need help too.

Re: Asking Doctor Z

dave on 6/12/02 at 08:12 (087256)

Im curious to ask why your doctor said to expect things to worsen. What are your comments on this doctor Z

Re: Desperately Need Help...

john h on 6/12/02 at 10:01 (087282)

Patricia you need to give yourself more time to heal. Usually the minimum amount of time is 12 weeks for improvement. I am not familiar with the Dornea maching. Do you mean Dornier? For the doctor to tell you it did not work after 1 month and to expect it to get worse sounds crazy. Something sounds very wrong here.

Re: Asking Doctor Z

Dr. Zuckerman on 6/12/02 at 10:18 (087287)

Hi

This is very strange. If the pain has increased a re-evaluation as to why needs to be done. The reason for the pain must be discussed with you. Yes you can get increased pain sometime but this should go away.and is very very rare The impact of ESWT really starts between week six and week twelve. Feel free to discuss this with any doctors on this board. We are always here to help, IF you are having of pain this must be evaluated

Re: Desperately Need Help...

Ed Davis, DPM on 6/12/02 at 14:58 (087333)

Patricia:

Please describe the symptoms your are experiencing now and before. We need to be sure that this is definitely PF. When a problem does not respond to conventional treatment or responds in unusual ways we always have to question if we are treating the right thing.
Ed

Re: Asking Doctor Z

Patricia R. on 7/08/02 at 18:20 (089318)

Hi Dr. Z.

Thanks for your response. I did ask him on my one month visit if I should
have another procedure. He said NO..he also wouldn't give me a cortizone
shot..or start therapy. He gave me that orthotic boot to wear I told you
about that doesn't help.
My 12 week visit is July 18th I think...I have stopped in his office..
I have written him letters...I called again today and the nurses advise
he will not speak to any patients without an appointment. I have United
Health Care who agreed to pay for this but won't support my going elsewhere/
I believe my procedure with Dr. Lee cost around $4,000 and I received a
bill for $670.00 which wasn't covered. In speaking with United Health
Care they told me that they had an 'agreed upon price' for the procedure
which was paid to him. You know, if this would have worked or he would
even talk to me I would have gladly paid this already. He charged them
$500.00 for this boot of which I have to pay another $100.00 for something
I can't even wear. I'm sorry if you feel I'm putting you in a position
against another physician, it just seems that my treatment is a lot
different from most others I've seen or read about on these websites.

Please tell me what to do now.....I'm just at a loss all the way around.
Patricia

Re: Asking Doctor Z

Dr. Zuckerman on 7/08/02 at 18:59 (089320)

I would start physical therapy, possible steriod injection. and possible 2nd treatment . I can only tell you what I would do . I am at a lost for words to help you.