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Is the cast I have on causing me more problems?

Posted by Michael K on 9/21/02 at 06:38 (095883)

About a month and ahalf ago (first week in August), I started to experience a dull pain in my right heel only upon first walking after a long stretch of sitting.

About 3 days later, I saw a podiatrist. He did an ultrasound on the right foot showing that the heel tendon was larger than normal. He said I had PF and prescribed Naproxen. I started applying ice to reduce the inflammation. Orthodics were discussed as the next step in my treatment.

The following week, a cast was made of my feet.

After another week, the pain in my right heel occured as before only when I first started walking but it was more intense. Also, I started to experience a similar pain in my left foot. I received one shot of cortisone in my right heel which did nothing to alleviate the pain. I started to do stretching exercises on that day. I did 50-60 stair raisers and a few stretches using a belt to flex the foot inward. Immediately after this, I experienced a tingling sensation and a sharp pain in my arch upon flexing. The doctor suggested I get commercially available arch supports from a drugstore while I waited for my orthodics. I wore these for a period of three days, wearing them for increasing amounts of time: 1 hours the first day, 2 hours the next day, and 3 hours the final day. I did not experience any discomfort until the third day. After ~ 2 hours, the pain in my arch upon flexing returned.

On September 11, about a month after my condition started, I received my custom made orthodics. These I tried to wear for ~ 2 hours the first and second days but the pain in my arches was constant so I went immediately to my doctor. He said that the pain I felt was caused by a pinched nerve due to inflammation but he did not examine my foot in any way in making this diagnoses. His solution was to put my right foot in a hard cast. The cast was supposed to be on for 3 weeks. I was informed that I was to keep the foot elevated and not move the toes at all.

Three days after the cast was put on, the pain in my arches had not subsided at all. The pain is a constant throbbing and becomes a sharp pain whenever I inadvertently twich my toes. The doctor prescribed Vicoden for the arch pain. (I take 2-3 tablets a day.) At this time, the heel pain seemed to be subsiding (or at least not getting worse).

Today, one week after I got this cast on, the arch pain I feel is unrelenting. I am worried that the cast is doing my feet more harm than good. Friends have suggested that I get the cast off or at least get both feet reevaluated by another doctor. I feel overwhelmed by all that's happened to me in such a short period of time and can't seem to make sense of all the conflicting information. I wouldn't mind the pain if I knew in the long term i was doing the right thing.

Can anyone help me decide what to do next???

Re: Is the cast I have on causing me more problems?

wendyn on 9/21/02 at 07:15 (095885)

Michael, I am not a doctor (just a fellow patient).

I think your friends are right, get a second opinion. (Those stair stretches can be really dangerous, they're difficult to control and seem to be a good way to injure yourself further.)

Re: Is the cast I have on causing me more problems?

Ed Davis, DPM on 9/21/02 at 10:33 (095902)

Casting is a reasonable treatment for short time periods (ie. 2 to 3 weeks).
It sounds like further investigation of the problem is in order sconsidering the amount of symptoms you still have though.
Ed

Re: Is the cast I have on causing me more problems?

Julie on 9/22/02 at 02:28 (095938)

Michael

I have two suggestions:

1. Inform yourself. Read the heel pain book. CLick on the blue link right here. Print it out and read and re-read it. It is the best source of information about plantar fasciitis and related foot conditions.

2. The wall stretch and the stair stretch clearly made matters worse. I know you were probably advised to do them, but they really are not appropriate for PF. I don't suppose you're still doing them with your cast on (!) but I counsel caution for the cast-free future. Don't go back to them. Non-weightbearing exercise is best, and the night splint (see Dr Wander's post to Maxine further up this board) is probably the most effective way of stretching the calf muscles.

Re: Is the cast I have on causing me more problems?

Laurie R on 9/23/02 at 06:11 (095997)

Hi Michael, Frist I am really sorry you are in pain .... I am not a doctor either , just a patient .I have had many hard casts put on my foot to help control pain and just to give my foot and tendons a rest.....They helped me a lot .
I agree with the others I would get a second opinion if your pain is that bad .....
Also I would read Scott's pain book ...Their is so much info in the book ..It is great ....
Please keep us posted ...My very best to you , Laurie R

Re: Is the cast I have on causing me more problems?

Necee on 9/25/02 at 11:25 (096192)

Hi Michael,
If I were you...I'd get another opinion. I was seeing a Pod, and really didn't feel comfortable with him...all he wanted to do was talk about surgery, which for me at that time wasn't an option. I feel like after all other treatments have been tried without success, then maybe surgery should be considered.

Staying frustrated and overwhelmed all the time has a great bearing on how a person recovers. I was getting that way....and the pain was getting worse, so I switched Dr.s in fact I went to two different Ortho Surgeons. They both gave the same advice to me.....rest, take anti-inflammatory medication, ice my foot, wear good support shoes, and above all, give it time. After seeing those two Dr.s, I had the peace of mind that I was doing the right thing. I have followed their advice, and I'm glad to say that I have improved, I'm not 100% yet, but slowly getting there.
So...Michael, please seek another opinion, and let us know how it goes.

Happy trails...

Necee

Re: Is the cast I have on causing me more problems?

wendyn on 9/21/02 at 07:15 (095885)

Michael, I am not a doctor (just a fellow patient).

I think your friends are right, get a second opinion. (Those stair stretches can be really dangerous, they're difficult to control and seem to be a good way to injure yourself further.)

Re: Is the cast I have on causing me more problems?

Ed Davis, DPM on 9/21/02 at 10:33 (095902)

Casting is a reasonable treatment for short time periods (ie. 2 to 3 weeks).
It sounds like further investigation of the problem is in order sconsidering the amount of symptoms you still have though.
Ed

Re: Is the cast I have on causing me more problems?

Julie on 9/22/02 at 02:28 (095938)

Michael

I have two suggestions:

1. Inform yourself. Read the heel pain book. CLick on the blue link right here. Print it out and read and re-read it. It is the best source of information about plantar fasciitis and related foot conditions.

2. The wall stretch and the stair stretch clearly made matters worse. I know you were probably advised to do them, but they really are not appropriate for PF. I don't suppose you're still doing them with your cast on (!) but I counsel caution for the cast-free future. Don't go back to them. Non-weightbearing exercise is best, and the night splint (see Dr Wander's post to Maxine further up this board) is probably the most effective way of stretching the calf muscles.

Re: Is the cast I have on causing me more problems?

Laurie R on 9/23/02 at 06:11 (095997)

Hi Michael, Frist I am really sorry you are in pain .... I am not a doctor either , just a patient .I have had many hard casts put on my foot to help control pain and just to give my foot and tendons a rest.....They helped me a lot .
I agree with the others I would get a second opinion if your pain is that bad .....
Also I would read Scott's pain book ...Their is so much info in the book ..It is great ....
Please keep us posted ...My very best to you , Laurie R

Re: Is the cast I have on causing me more problems?

Necee on 9/25/02 at 11:25 (096192)

Hi Michael,
If I were you...I'd get another opinion. I was seeing a Pod, and really didn't feel comfortable with him...all he wanted to do was talk about surgery, which for me at that time wasn't an option. I feel like after all other treatments have been tried without success, then maybe surgery should be considered.

Staying frustrated and overwhelmed all the time has a great bearing on how a person recovers. I was getting that way....and the pain was getting worse, so I switched Dr.s in fact I went to two different Ortho Surgeons. They both gave the same advice to me.....rest, take anti-inflammatory medication, ice my foot, wear good support shoes, and above all, give it time. After seeing those two Dr.s, I had the peace of mind that I was doing the right thing. I have followed their advice, and I'm glad to say that I have improved, I'm not 100% yet, but slowly getting there.
So...Michael, please seek another opinion, and let us know how it goes.

Happy trails...

Necee