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Plantar Fasciitis

Posted by Leonie M on 9/10/02 at 06:45 (094877)

COuld you please advise me what I should do regarding the fact that I have just developed Plantar Fasciitis and I went to see an Orthopedic Surgeon here in London who wants to give me various seriod injections into both of my feet at the same time on Saturday morning and will therefore have to give me a general anaesthetic which I am not too happy about because I cannot take time off work and don't like the idea of GA nor the idea of steriods.
I am desperate to cancel the operation.
Please help!
Thank you in anticipation.

Re: Plantar Fasciitis

Julie on 9/10/02 at 08:03 (094889)

Hello Leonie

Welcome. As a fellow-Londoner I'd like to give my sympathies and also my views.

You should see a podiatrist. Orthopaedists, unless they have specialised in foot and ankle surgeries, may not know a great deal about plantar fasciitis. From what you say - steroid injections being offered as a first line of treatment - it sounds to me as though this man is one of the less knowledgeable. Steroid injections will give only temporary relief at best, sometimes no relief, and can make matters worse. And too many steroid injections can weaken the tissues. I wouldn't go down that road, certainly not so soon.

I think it would be extremely unwise to have both feet injected at the same time. And I have never heard of a general anaesthetic being administered for steroid injections.

I would be very suspicious. I would not go any further with this doctor. That is just my opinion.

There are many conservative treatments for PF: taping to support the arch, icing to reduce inflammation, proper footgear, possibly custom orthotics if you have biomechanical faults, are only a few. Read the heel pain book on this site (click on the link right here or at the top of the page).

And see a podiatrist for a full evaluation of your walking to ascertain the CAUSE of your PF, and to get a sensible, well-balanced treatment plan started. As you are in London, I will recommend my podiatrist, with whose help my PF resolved within months (I did not have steroid injections). He is qualified to do surgery,but like all the doctors here, he believes that conservative measures should be followed for at least six months and that surgery is a last resort. (And if all conservative treatments fail, which they probably won't - most people do get better with them - there is ESWT to consider before surgery.

My pod is Ron McCulloch. He practices in Lewisham, and in Harley Street. He is head of Podiatric Medicine at Guys, and looks after two football teams (Charlton is one, I forget the other!) You can have a look at his website if you like: http://www.londonpodiatry.com/

Please keep posting here and let us know how you fare.

Re: Plantar Fasciitis

Pauline on 9/10/02 at 08:09 (094890)

Leonie,
First of all and formost remember YOU are in control of any and all of your treatment. Unless you've give up this responsibility in a legal document YOUR STILL IN CONTROL of what treatment you will or will not have.

Sometimes patients are so caught up in the moment that they forget who is in charge of their body.

No need to be desperate to cancel an operation, you simply call the doctors office and tell them you need more time to make your decision about the type of treatment you desire.

Your posting doesn't really mention a surgery but rather steroid injections. Are you quite sure the doctor said you would get a 'general' anesthetic? Usually a local anesthetic is delivered in combination with a steroid injection to lessen the pain, but not a 'general'.

This in inself is reason enough to cancel your scheduled treatment until you are completely clear on what he is telling you.

If you are uncomfortable with this doctor or any of his treatment get a second opinion.

As far as steroid injections go there are several opinions on whether they should be given for P.F. The concern is, of course, the steroid causing the P.F. to rupture. We warn people a lot about this possibility and maybe toooo much so, because I don't know if we've seen all the studies and documentation on the frequency of this occurance.

So before you get to excited over the offer of a steroid injection do some homework and check out the medical journals to see for yourself what has been reported in these studies.

In the past, I've had them and they provided only temporary relief from the actual pain, but they did remove a good deal of local inflammation. I was given only 1 in each foot and sustained no injury from it.

Although you will get various opinions on the use of steroid injections I think most of us would agree they definately should be used sparingly and certainly not more than 3.

My suggestion to you is to clarify the treatment being offered, then decide for yourself whether you want it or not. If your at all unsure or uncomfortable seek a second opinion. Remember your in charge and never give up that right until you can no longer care for yourself.

P.F. treatment choices are not life and death decisions so don't put that kind of pressure on yourself. Go with your gut feeling, do your homework and then select your choice treatment.

Good luck.

Re: Plantar Fasciitis

Leonie M on 9/11/02 at 03:48 (094984)

>> Dear Julie
>>
>> Thank you so much for your advice - everything I wanted to hear and more!
>> The thing with NHS is that they haven't the time or money to 'pussy foot'
>> around (excuse the pun!) and just want people out of the way to move on to
>> the next person. I am on PPP as well but that doesn't seem to help
> either.
>> The specialist is Mr Hashemi and he works at both Mayday NHS(apparently he
>> started up the A&E unit there????) and Shirley Oaks (private). I have
> seen
>> him before re a broken baby finger which he couldn't do anything about so
> he
>> does not specialise in feet.
>> A friend of mine has a doctor friend who is a member of royal something of
>> medical professionals or something or the other (something very
> prestigious)
>> and he phoned me last night to say that I should stay well away from
> steroid
>> injections. He has invited me for a free consultation and deals more with
>> homeopathic medicines. I will see what he has to say and report back to
> you
>> with the facts. He mentioned something about injections (NOT steroids)
> into
>> the calf at the pressure point ...
>> I do feel so much better having had your advice. You have saved my bacon!
>> Thank you so much again.
>> Regards
>> Leonie

Re: Leonie

Pete R on 9/11/02 at 06:54 (094986)

Also a Brit. I fully endorse everything Julie says. I've had 2 lots of injections which were very painful and didn't work. Some of the conservative treatments in Scotts Heel Book on this site are best. I'm with PPP and they don't like paying out for feet unless its surgery and you definitely want to avoid this. Get it treated early and I'm sure it will clear up, Julie is a great example of this.

As for the injection in the calf, this is probably 'trigger point treatment' which is effectively putting a needle in the pressure point of your calf in order to relief the muscle 'tightness' which may be contributing to your pf. I've had this and although it didn't work for me it may help you. No side effects as far as I'm aware and it doesn't hurt too much.

Good luck

Re: Plantar Fasciitis

Ed Davis, DPM on 9/11/02 at 15:19 (095034)

Sounds like you have obtained good advice from our posters. I would be leary of seeking further treatment from Dr. Hashemi based on the information you have provided. If you see him again, ask him if he went deer hunting would he use a rifle or a hand grenade.
Ed

Re: Plantar Fasciitis

Julie on 9/11/02 at 16:29 (095044)

Hi Leonie

I'm very glad my post was useful, and glad too to learn from your email earlier today that you've cancelled the injections. There are many other things you can do to help yourself.

I was interested to hear that you're looking into homeopathy. Nancy S, also a regular here, had a very good experience with homeopathic treatment. If she sees this thread, she may be able to tell you about it.

I do think, though, that you ought to consult a podiatrist as well. It's important to address the cause of your PF, whatever it is. Have you any idea what it might be?

Keep in touch. There are lots of knowledgeable people here, and the doctors are extremely helpful.

Re: Plantar Fasciitis

Leonie M on 9/12/02 at 02:45 (095104)

Hi Julie
Everyone has been so helpful and if it weren't for all of you, I probably would have been none the wiser and gone ahead with the GA and steriod injections. The problem came about gradually starting with the fact that I have put on 5 stone of weight over the past couple of years and starting doing vigorous exercise in the form of both aqua and kickboxing 6 to 7 days per week. The crunch came when I recently ran the 5km Flora Light Challenge for Women in aid of cancer - I could not walk the following day. I will definitely take your advice Julie to see your or a Podiatrist.
Thank you again.

Re: Plantar Fasciitis

Julie on 9/10/02 at 08:03 (094889)

Hello Leonie

Welcome. As a fellow-Londoner I'd like to give my sympathies and also my views.

You should see a podiatrist. Orthopaedists, unless they have specialised in foot and ankle surgeries, may not know a great deal about plantar fasciitis. From what you say - steroid injections being offered as a first line of treatment - it sounds to me as though this man is one of the less knowledgeable. Steroid injections will give only temporary relief at best, sometimes no relief, and can make matters worse. And too many steroid injections can weaken the tissues. I wouldn't go down that road, certainly not so soon.

I think it would be extremely unwise to have both feet injected at the same time. And I have never heard of a general anaesthetic being administered for steroid injections.

I would be very suspicious. I would not go any further with this doctor. That is just my opinion.

There are many conservative treatments for PF: taping to support the arch, icing to reduce inflammation, proper footgear, possibly custom orthotics if you have biomechanical faults, are only a few. Read the heel pain book on this site (click on the link right here or at the top of the page).

And see a podiatrist for a full evaluation of your walking to ascertain the CAUSE of your PF, and to get a sensible, well-balanced treatment plan started. As you are in London, I will recommend my podiatrist, with whose help my PF resolved within months (I did not have steroid injections). He is qualified to do surgery,but like all the doctors here, he believes that conservative measures should be followed for at least six months and that surgery is a last resort. (And if all conservative treatments fail, which they probably won't - most people do get better with them - there is ESWT to consider before surgery.

My pod is Ron McCulloch. He practices in Lewisham, and in Harley Street. He is head of Podiatric Medicine at Guys, and looks after two football teams (Charlton is one, I forget the other!) You can have a look at his website if you like: http://www.londonpodiatry.com/

Please keep posting here and let us know how you fare.

Re: Plantar Fasciitis

Pauline on 9/10/02 at 08:09 (094890)

Leonie,
First of all and formost remember YOU are in control of any and all of your treatment. Unless you've give up this responsibility in a legal document YOUR STILL IN CONTROL of what treatment you will or will not have.

Sometimes patients are so caught up in the moment that they forget who is in charge of their body.

No need to be desperate to cancel an operation, you simply call the doctors office and tell them you need more time to make your decision about the type of treatment you desire.

Your posting doesn't really mention a surgery but rather steroid injections. Are you quite sure the doctor said you would get a 'general' anesthetic? Usually a local anesthetic is delivered in combination with a steroid injection to lessen the pain, but not a 'general'.

This in inself is reason enough to cancel your scheduled treatment until you are completely clear on what he is telling you.

If you are uncomfortable with this doctor or any of his treatment get a second opinion.

As far as steroid injections go there are several opinions on whether they should be given for P.F. The concern is, of course, the steroid causing the P.F. to rupture. We warn people a lot about this possibility and maybe toooo much so, because I don't know if we've seen all the studies and documentation on the frequency of this occurance.

So before you get to excited over the offer of a steroid injection do some homework and check out the medical journals to see for yourself what has been reported in these studies.

In the past, I've had them and they provided only temporary relief from the actual pain, but they did remove a good deal of local inflammation. I was given only 1 in each foot and sustained no injury from it.

Although you will get various opinions on the use of steroid injections I think most of us would agree they definately should be used sparingly and certainly not more than 3.

My suggestion to you is to clarify the treatment being offered, then decide for yourself whether you want it or not. If your at all unsure or uncomfortable seek a second opinion. Remember your in charge and never give up that right until you can no longer care for yourself.

P.F. treatment choices are not life and death decisions so don't put that kind of pressure on yourself. Go with your gut feeling, do your homework and then select your choice treatment.

Good luck.

Re: Plantar Fasciitis

Leonie M on 9/11/02 at 03:48 (094984)

>> Dear Julie
>>
>> Thank you so much for your advice - everything I wanted to hear and more!
>> The thing with NHS is that they haven't the time or money to 'pussy foot'
>> around (excuse the pun!) and just want people out of the way to move on to
>> the next person. I am on PPP as well but that doesn't seem to help
> either.
>> The specialist is Mr Hashemi and he works at both Mayday NHS(apparently he
>> started up the A&E unit there????) and Shirley Oaks (private). I have
> seen
>> him before re a broken baby finger which he couldn't do anything about so
> he
>> does not specialise in feet.
>> A friend of mine has a doctor friend who is a member of royal something of
>> medical professionals or something or the other (something very
> prestigious)
>> and he phoned me last night to say that I should stay well away from
> steroid
>> injections. He has invited me for a free consultation and deals more with
>> homeopathic medicines. I will see what he has to say and report back to
> you
>> with the facts. He mentioned something about injections (NOT steroids)
> into
>> the calf at the pressure point ...
>> I do feel so much better having had your advice. You have saved my bacon!
>> Thank you so much again.
>> Regards
>> Leonie

Re: Leonie

Pete R on 9/11/02 at 06:54 (094986)

Also a Brit. I fully endorse everything Julie says. I've had 2 lots of injections which were very painful and didn't work. Some of the conservative treatments in Scotts Heel Book on this site are best. I'm with PPP and they don't like paying out for feet unless its surgery and you definitely want to avoid this. Get it treated early and I'm sure it will clear up, Julie is a great example of this.

As for the injection in the calf, this is probably 'trigger point treatment' which is effectively putting a needle in the pressure point of your calf in order to relief the muscle 'tightness' which may be contributing to your pf. I've had this and although it didn't work for me it may help you. No side effects as far as I'm aware and it doesn't hurt too much.

Good luck

Re: Plantar Fasciitis

Ed Davis, DPM on 9/11/02 at 15:19 (095034)

Sounds like you have obtained good advice from our posters. I would be leary of seeking further treatment from Dr. Hashemi based on the information you have provided. If you see him again, ask him if he went deer hunting would he use a rifle or a hand grenade.
Ed

Re: Plantar Fasciitis

Julie on 9/11/02 at 16:29 (095044)

Hi Leonie

I'm very glad my post was useful, and glad too to learn from your email earlier today that you've cancelled the injections. There are many other things you can do to help yourself.

I was interested to hear that you're looking into homeopathy. Nancy S, also a regular here, had a very good experience with homeopathic treatment. If she sees this thread, she may be able to tell you about it.

I do think, though, that you ought to consult a podiatrist as well. It's important to address the cause of your PF, whatever it is. Have you any idea what it might be?

Keep in touch. There are lots of knowledgeable people here, and the doctors are extremely helpful.

Re: Plantar Fasciitis

Leonie M on 9/12/02 at 02:45 (095104)

Hi Julie
Everyone has been so helpful and if it weren't for all of you, I probably would have been none the wiser and gone ahead with the GA and steriod injections. The problem came about gradually starting with the fact that I have put on 5 stone of weight over the past couple of years and starting doing vigorous exercise in the form of both aqua and kickboxing 6 to 7 days per week. The crunch came when I recently ran the 5km Flora Light Challenge for Women in aid of cancer - I could not walk the following day. I will definitely take your advice Julie to see your or a Podiatrist.
Thank you again.