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MD vs PT

Posted by Linda R on 6/20/02 at 13:49 (088141)

I have had intermittent severe heel pain in my left foot for almost three months. It NEVER hurts in the morning, but the more I walk as the day progresses, the more it hurts. I've been on a crutch full time for over a month as well as religiously icing, rest, heel cups, and stretches. No better. An x ray revealed a small bone spur at exactly the point of pain. The orthopedist insists it is PF and that there is no cure; he now suggests a night splint. Two PTs who have been treating me for six weeks say it does not present as PF, that the splint will do no good, and that the pain is probably the heel spur pressing into the soft tissue, or a hairline fracture. The PTs recommend an MRI, which the MD refuses to do for at least another month. Who do I believe and what should I do now?

Thanks,
Linda R.

Re: MD vs PT

Sharon W on 6/20/02 at 19:23 (088165)

Linda,

I am not a doctor and they will probably say something different. But an MRI with contrast would stand a good chance of proving your ortho right or wrong. If it's PF the MRI may show thickening of the plantar facia, or inflammation around it. An MRI might also show other abnormalities. Has the Dr. ordered just the ONE x-ray???

Is your orthopedist a specialist in foot and ankle?

-- Sharon

Re: MD vs PT

Dr. John Cozzarelli on 6/21/02 at 04:56 (088183)

Hi Linda:

Get the MRI or diagnostic ultrasound of the plantar fascia. Insist that you would like this non-invassive test performed.

Dr. John Cozzarelli

Re: Linda: PS

Sharon W on 6/21/02 at 16:06 (088227)

Linda,

By the way, while it is certainly true that there is no one 'cure' for PF that works for almost everyone, the vast majority of people (about 90%) will be able RECOVER from PF using appropriate 'conservative' methods. It takes time -- sometimes 6 months, maybe more -- and you would need a comprehensive treatment plan that involves stretching, good shoes and/or orthotics, icing your foot, physical therapy (which it sounds like you're already doing). But it is NOT true that all cases of PF are 'chronic' -- actually, only about 10% of them are -- and even chronic cases AREN'T 'hopeless'!!! IF your problem does turn out to be PF, there ARE many things that can be done. And I DON'T think you should just take your orthopedic doctor's word that it's PF, in fact I really think you need a second opinion.

If you want to know more about treatments for PF, you should check out the Heel Pain Book, on this site -- and read what the doctors here have to say, they give great advice!

-- Sharon

Re: MD vs PT

Sharon W on 6/20/02 at 19:23 (088165)

Linda,

I am not a doctor and they will probably say something different. But an MRI with contrast would stand a good chance of proving your ortho right or wrong. If it's PF the MRI may show thickening of the plantar facia, or inflammation around it. An MRI might also show other abnormalities. Has the Dr. ordered just the ONE x-ray???

Is your orthopedist a specialist in foot and ankle?

-- Sharon

Re: MD vs PT

Dr. John Cozzarelli on 6/21/02 at 04:56 (088183)

Hi Linda:

Get the MRI or diagnostic ultrasound of the plantar fascia. Insist that you would like this non-invassive test performed.

Dr. John Cozzarelli

Re: Linda: PS

Sharon W on 6/21/02 at 16:06 (088227)

Linda,

By the way, while it is certainly true that there is no one 'cure' for PF that works for almost everyone, the vast majority of people (about 90%) will be able RECOVER from PF using appropriate 'conservative' methods. It takes time -- sometimes 6 months, maybe more -- and you would need a comprehensive treatment plan that involves stretching, good shoes and/or orthotics, icing your foot, physical therapy (which it sounds like you're already doing). But it is NOT true that all cases of PF are 'chronic' -- actually, only about 10% of them are -- and even chronic cases AREN'T 'hopeless'!!! IF your problem does turn out to be PF, there ARE many things that can be done. And I DON'T think you should just take your orthopedic doctor's word that it's PF, in fact I really think you need a second opinion.

If you want to know more about treatments for PF, you should check out the Heel Pain Book, on this site -- and read what the doctors here have to say, they give great advice!

-- Sharon