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mystery heel pain

Posted by Francis D. on 7/05/02 at 13:21 (089177)

Dear Doctors:
I twisted my left ankle a year ago, and have been on crutches ever since.
At first the crutches were just meant to let the left foot recover, but as
I did P.T. to strengthen the ankle, I found I could not put weight on it
without making it worse. I now have pain in both feet (after favoring the left) but the left is still worse.
Pattern: if I put some weight on the foot (e.g. walk with one crutch for
nine or ten paces) there is no pain at the time, but 12 to 24 hours later
there is considerable pain in the heel. Sometimes the pain will subside
over a few days, sometimes it will then continue to get worse until I find
myself forced to stay off the feet entirely. A bad reaction will include
a dull ache throughout the heel pad, stabbing pain at the plantar fascia
attachment area, and often sharp pricking pain in the heel and across the
back of the ball of the foot.

Tests and procedures:
xrays were normal
bone scan was normal
nerve conduction test was normal
RSD symptoms negative
arthritis blood panel normal
cortisone injection did not help
Medrol dose pack offered slight temporary relief
walking casts offered clear but temporary relief

I am now being told that I MUST get back into water P.T. since continued
time off the feet could cause permanent damage. But at the same time no
specialist I have seen understands this syndrome. I am also starting
Neurontin, but my doctors admit this is a desperate attempt to treat the
symptoms without knowing the causes.

Can you help?!

Re: mystery heel pain

R C on 7/08/02 at 10:48 (089288)

Dear Francis,

I am not a doctor, so I will only reflect on my own experience as a PF patient. I had PF in my right foot only, and it did not respond to conservative treatments for about 2 years. I was put in a hard cast for 4 weeks and used crutches. When the crutches were removed, I was surprised to find that I could not put my weight on my foot -- even the 4 weeks of disuse caused the muscles and tendons to lose some strength and flexibility. So then I proceeded with 4 weeks of physical therapy, during which I continued to use crutches. Gradually I was able to walk again. Even now (4 months after the cast) I tape my foot to protect the plantar fascia during activity.

All of this seems to say that the longer you are on crutches, the more patience and hard work it will take to get back on your feet. Maybe there is no way around that. As for your plantar fascia, I have come to believe in taping as a way to reduce the strain. It takes some trial and error to figure out how to tape your foot so that it is both effective and relatively comfortable. This may be something to discuss with your doctor about adding to the other things you are trying.

Best wishes-
R C

Re: mystery heel pain

paula on 7/08/02 at 17:31 (089314)

i am not a doctor. has a medical professional mentioned disuse osteoporosis to you and possible ways to offset this?

Re: mystery heel pain

R C on 7/08/02 at 10:48 (089288)

Dear Francis,

I am not a doctor, so I will only reflect on my own experience as a PF patient. I had PF in my right foot only, and it did not respond to conservative treatments for about 2 years. I was put in a hard cast for 4 weeks and used crutches. When the crutches were removed, I was surprised to find that I could not put my weight on my foot -- even the 4 weeks of disuse caused the muscles and tendons to lose some strength and flexibility. So then I proceeded with 4 weeks of physical therapy, during which I continued to use crutches. Gradually I was able to walk again. Even now (4 months after the cast) I tape my foot to protect the plantar fascia during activity.

All of this seems to say that the longer you are on crutches, the more patience and hard work it will take to get back on your feet. Maybe there is no way around that. As for your plantar fascia, I have come to believe in taping as a way to reduce the strain. It takes some trial and error to figure out how to tape your foot so that it is both effective and relatively comfortable. This may be something to discuss with your doctor about adding to the other things you are trying.

Best wishes-
R C

Re: mystery heel pain

paula on 7/08/02 at 17:31 (089314)

i am not a doctor. has a medical professional mentioned disuse osteoporosis to you and possible ways to offset this?