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searching for real diagnosis with foot pain

Posted by caryn z. on 10/15/02 at 13:51 (097547)

Dear Doctor:

I am coming up to the 2 yr mark with pain in my left foot which began with pain only in the heel area after being on my feet for an extended period of time ie, walking, rollerblading, standing in one spot to do something. Upon consultation with family doctor an xray was taken because he figured I had either fractured the bone or I had a heel spur. The xray showed a rather large calcium deposit on the heel as well as a hook spur obviously causing my pain. The xray also showed several toe deformities named as hammertoes although I do not suffer with any toe pain to this day. I was put on a 2 week dose of NSAIDS (can't remember which one first but I think it was Celebrex) which did absolutely nothing for pain or relief so he gave me another one, Vioxx which made me hallucinate when I took the pill so I stopped those right away. I then tried a third NSAID and again nothing for relief so I continued on with Ibuprofen 3 tablets 3x daily and although this provided some relaxation when resting, it did nothing to alleviate the pain itself. When I explained this to the doctor, he suggested staying off the foot as much as possible and to stop all activity requiring any direct pressure on the heel. I told him the pain was becoming more intense and that I had a tingling feeling as well as numbness so it was getting extremely hard to stand after lying down or sitting for a period of time. In January of this year, I suffered a very emotional traumatic incident at my place of employment and a result I have found that the pain in my left foot is now much worse and to the point where to stand or walk at all is most excruiating. At a visit in January, I mentioned that my mother suffers with chronic polyneuropathy which was diagnosed 2 yrs ago after a series of nerve conduction tests and loss of feeling in her feet. My doctor found this quite interesting and admitted he did not know a lot on neuropathy or nerve damage but suggested an appt with a neurologist would be the best thing. Off I went to the neurologist in July and had a series of in office tests done such as pin pricks, walking, putting my finger to my nose etc.. He then sent me for an EMR at the hospital. When I arrived for this nerve test, I was told that I would not be having any needle probe testing and they just did a few pressure points along my ankle and calf and knee area. This was strictly electrical stimulation on the nerve area. Apparently this report came back normal and no sensory damage was found but the neurologist said I could possibly have some nerve damage to the tibial nerve itself which is causing the tingling and numbness in the foot itself. He stated probable plantar fasciitis and I should see an orthopaedic doctor to see if surgery was an option. After a lengthy wait and with my medical benefits running out shortly (I have not been able to work since January/02) I finally had the appt with the ortho doctor last Friday, Oct. 11th and he was quite confused with the information received from the neurologist. He said he did not think a fasciotomy was in order because he did not know what he would be looking for once he got inside the foot. He looked at the xrays (I have since had a 2nd xray done that indicates no changes from the first one last year)and then did a couple of quick checks for strength of ankle and said possibly I have tarsal tunnel syndrome which means I could have nerve entrapment and that could give a negative reading on an EMR test. I am frustrated that no one really seems to know what the real diagnosis is and after trying anti inflammatory pills and orthotics which made it feel a lot worse, I find myself without a job, and soon to be without an income and not knowing where to turn next. Any suggestions you are able to offer would be greatly appreciated. I have stumbled across this website by accident and am astounded by the number of people who suffer daily like myself. I appreciate reading your comments for various heel pain sufferers.
Thank you so much for your time. I do hope I've not rambled on too much here but as you can tell I'm extremely frustrated at this time.

Sincerely,
Caryn Z. British Columbia Canada

Re: searching for real diagnosis with foot pain

AmyM on 10/16/02 at 12:41 (097635)

Dear Caryn

I'm not a doctor, but from your history that sounds like TTS, tarsal tunnel syndrome. It is entirely possible that you have both PF (Plantar fasciitis) and TTS (Tarsal Tunnel Syndrome) at the same time.
The symptoms you describe do seem to indicate a nerve problem (tingling and numbness) and you can have TTS and a negative nerve test. So it does sound like you (finally) have a correct diagnosis.

As you've just found this site, I'll guess you have a lot of reading to do! I suggest you start with the heelpain book (the link is at the top, don't worry its free!) Also check out the TTS message board. There are loads of people who live with this sort of pain daily and threre are loads of treatments that can help.

A combination of several treatments over a long time seems to bring relief for many people, so don't panic your not alone and there are things that can be done.

Please don't take offence, but a couple of paragraphs in your message will make it a bit easier to read and you might find more people respond. There are lots of people here who can help you so don't despair.

Re: searching for real diagnosis with foot pain

caryn z. on 10/16/02 at 19:39 (097674)

Dear Amy:

Thank you so much for your informative reply today. Yes, I must try and remember to make paragraphs!! I got kind of carried away writing yesterday and was quite thrilled to find there are others out there with the same symptoms it seems and yes I'll read the information y ou mentioned.

Hope all is well and thanks again, your reply is really appreciated.

Cheers,
Caryn Z

Re: Amy M - confirmed nerve damage

carynz on 11/04/02 at 14:16 (099298)

hi Amy

you posted a reply to my msg last month and i was just scrolling through the message board so thought I'd update you.

Yes, I have now received a confirmed TTS diagnosis and have undergone a peripheal nerve block injection whice froze the nerve area so the doctor could determine if it is the posterial tibial nerve affected. It does seem now that the decompression surgery will be the route I take and the doctor has explained that it is still guarded with a 30% chance of reoccurrence.

It seems there are quite a few who write here that they have had surgery and results differ with each patient so it's obviously a 50/50 split and you decide to either have it or not.

Since the injection I have had a few side effects like cramping in the ankle/calf and very cold on underside (more than usually have) of my foot even with socks on 24/7. Doctor says this is normal to experience other effects from anasthetic still in system. It really is so frustrating. Hopefully a letter to my family doctor will help to expedite a surgery date now.

Hope you're doing okay. Did you count the number of paragraphs here (ha ha). It is now 12:15pm on the west coast and a gorgeous sunny day, blue sky and about 10deg celcius (52F) so I am going to attempt a little walk with the dog who is currently lying in front of the fireplace which is his favourite spot. It's funny that he doesn't do it during the warm weather when the fireplace is not turned on as if he knows it's too hot to do that!

My kids will be home from school in 2 1/2 hours so will toodle on my way.

Take care
Caryn

Re: searching for real diagnosis with foot pain

AmyM on 10/16/02 at 12:41 (097635)

Dear Caryn

I'm not a doctor, but from your history that sounds like TTS, tarsal tunnel syndrome. It is entirely possible that you have both PF (Plantar fasciitis) and TTS (Tarsal Tunnel Syndrome) at the same time.
The symptoms you describe do seem to indicate a nerve problem (tingling and numbness) and you can have TTS and a negative nerve test. So it does sound like you (finally) have a correct diagnosis.

As you've just found this site, I'll guess you have a lot of reading to do! I suggest you start with the heelpain book (the link is at the top, don't worry its free!) Also check out the TTS message board. There are loads of people who live with this sort of pain daily and threre are loads of treatments that can help.

A combination of several treatments over a long time seems to bring relief for many people, so don't panic your not alone and there are things that can be done.

Please don't take offence, but a couple of paragraphs in your message will make it a bit easier to read and you might find more people respond. There are lots of people here who can help you so don't despair.

Re: searching for real diagnosis with foot pain

caryn z. on 10/16/02 at 19:39 (097674)

Dear Amy:

Thank you so much for your informative reply today. Yes, I must try and remember to make paragraphs!! I got kind of carried away writing yesterday and was quite thrilled to find there are others out there with the same symptoms it seems and yes I'll read the information y ou mentioned.

Hope all is well and thanks again, your reply is really appreciated.

Cheers,
Caryn Z

Re: Amy M - confirmed nerve damage

carynz on 11/04/02 at 14:16 (099298)

hi Amy

you posted a reply to my msg last month and i was just scrolling through the message board so thought I'd update you.

Yes, I have now received a confirmed TTS diagnosis and have undergone a peripheal nerve block injection whice froze the nerve area so the doctor could determine if it is the posterial tibial nerve affected. It does seem now that the decompression surgery will be the route I take and the doctor has explained that it is still guarded with a 30% chance of reoccurrence.

It seems there are quite a few who write here that they have had surgery and results differ with each patient so it's obviously a 50/50 split and you decide to either have it or not.

Since the injection I have had a few side effects like cramping in the ankle/calf and very cold on underside (more than usually have) of my foot even with socks on 24/7. Doctor says this is normal to experience other effects from anasthetic still in system. It really is so frustrating. Hopefully a letter to my family doctor will help to expedite a surgery date now.

Hope you're doing okay. Did you count the number of paragraphs here (ha ha). It is now 12:15pm on the west coast and a gorgeous sunny day, blue sky and about 10deg celcius (52F) so I am going to attempt a little walk with the dog who is currently lying in front of the fireplace which is his favourite spot. It's funny that he doesn't do it during the warm weather when the fireplace is not turned on as if he knows it's too hot to do that!

My kids will be home from school in 2 1/2 hours so will toodle on my way.

Take care
Caryn