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Recurring pain in both feet; right more than left

Posted by John Lane on 12/24/02 at 16:54 (103934)

Hi: I am a relatively active and healthy 40 yr old man. 6'2', 200 lbs. I have recently begun experiencing pain in both feet, but more in right than left. Pain is centered in back (heel)area and/or the outside edges of feet. My foot can be so tender, I feel it can barely support any weight. It is usually worse in morning or when getting up out of bed at night. The pain recurs, but does not generally last all day. I have not seen any specialist for this because in a week or so, it usually goes away. Finally, I have an identical twin brother who has a similar, but not as acute, experience, so I have ruled out physical injury.

Two questions:

1) Any idea what I may be experiencing? Are these symptoms typical of the 'heel spurs' (plantar fasciitis )affliction or something else?
2) What kind of Dr. should I see? (I have been to a podiatrist before, but all they seem to want to do is sell me insole supports).

Thanks,

John

Re: Recurring pain in both feet; right more than left

john h on 12/24/02 at 17:35 (103935)

See a Podiatrist or MD Foot and Ankle Surgeon. Your symptoms do sound similar to those with Plantar Fasciaitis. Read the Scotts book on this board and post up what your Doctor recommends. Diagnois it early and treat it conservatively and you have a 90% chance of a quick and full recovery.

Re: Recurring pain in both feet; right more than left

Mar on 12/24/02 at 17:39 (103938)

Listen to John H and get it taken care of. If inserts are recommended, then try them. You DO NOT want this to go on, believe me! Mar

Re: Recurring pain in both feet; right more than left

Julie on 12/25/02 at 01:16 (103956)

John

This does sound like typical plantar fasciitis (the first-step-in-the-morning pain is the giveaway. Read the heel pain book (click on this link). You'll learn a great deal about PF and the conservative treatments for it. However, you should look around quickly for another podiatrist. There are podiatrists and podiatrists, just as there are good and not-so-good doctors in any field of medicine. You need one who will give you a full examination and evaluation of your gait to determine the cause of your pain so that it can be addressed appropriately. Inserts may well be needed, but if your biomechanics are faulty they will need to be prescribed and made for your feet, not purchased otc.

There is a wide range of conservative treatments, but each case of PF needs the right ones applied in the right combination. While it's important to be involved in your treatment, self-treatment can be a hit-and-miss business, so you do need to see a clued-up podiatrist.

You may need to wait until after the holidays to get a response from one of the doctors here. Meanwhile here are a few ideas:

Don't go barefoot: your arches need support all the time.

Evaluate your footgear and make sure they are getting the support they need. Shoes need to be stable (no bending at the arch, only at the metatarsal) and frequently replaced so they don't get excessively worn down. And though it sounds obvious, they need to be the right size. (Feet spread as we grow older - not that you're old, but have you been measured for size since your adolescence?)

Stay off your feet as much as your work and life style allow. This is important: PF is an injury (the fascia is tearing at its insertion point in the calcaneus) and like all injuries this one needs rest in order to heal.

Your 'first'step' pain is typical of PF, as I said. The feet are plantarflexed overnight, which contracts the achilles tendon and the calf muscles. Some gentle foot exercises before getting out of bed will help: see my post of a few days ago on the Treatments board titled Yoga Foot Exercises, or use the search facility to find it.

If there is inflammation icing will relieve it.

Taping will often relieve the pain: there are instructions and illustrations in the heel pain book. But because taping supports the arch, it also 'rests' the fascia and contributes to healing.

I hope this helps. Happy Christmas!

Re: Recurring pain in both feet; right more than left

Lara T on 12/25/02 at 07:07 (103959)

Following up on what Julie said about getting another podiatrist/orthopod if you aren't satisfied. I went through several doctors, all competent and recommended by good people, including other doctors. HOwever after initial treatments didn't work, I was either sent on, sent home, or told it was in my head (or my favorite - it was the first sign of diabetes - something that would be impossible since I had been tested for diabetes - negative- and the symptoms I had that were similar to problems caused by diabetes are caused by the excess sugar, so it couldn't be a sign of impending diabetes). I finally hit pay dirt when I went to a doctor that 'specialized' (unofficially) in sports podiatry. If you can find the doctor that treats the local basketball team (if there is one in your area) that would probably be a gold mine. My impression is that most podiatrists see a lot of issues related to diabetes and aging - neither of which was really my problem. We all know much better those things we deal with regularly. This podiatrist had at least one Olympian, and many week-end athletes at various competetive levels. My issues weren't exactly those of an athlete, but more common to that than diabetes or aging issues.

Turns out I didn't have PF (as initially thought), I have TTS, which makes things more difficult as TTS is only recently recognized so many good doctors aren't familiar with it, and to the best of my knowledge, there isn't a recognized protocol even among those familiar with TTS, so you get significantly differing treatments/opinions about what to do. However, given your youth and description, and the statements of many on this board, it seemed it might be helpful to see if you can find someone with an interest/background in treating athletes/sports injuries.

Re: Recurring pain in both feet; right more than left

john h on 12/24/02 at 17:35 (103935)

See a Podiatrist or MD Foot and Ankle Surgeon. Your symptoms do sound similar to those with Plantar Fasciaitis. Read the Scotts book on this board and post up what your Doctor recommends. Diagnois it early and treat it conservatively and you have a 90% chance of a quick and full recovery.

Re: Recurring pain in both feet; right more than left

Mar on 12/24/02 at 17:39 (103938)

Listen to John H and get it taken care of. If inserts are recommended, then try them. You DO NOT want this to go on, believe me! Mar

Re: Recurring pain in both feet; right more than left

Julie on 12/25/02 at 01:16 (103956)

John

This does sound like typical plantar fasciitis (the first-step-in-the-morning pain is the giveaway. Read the heel pain book (click on this link). You'll learn a great deal about PF and the conservative treatments for it. However, you should look around quickly for another podiatrist. There are podiatrists and podiatrists, just as there are good and not-so-good doctors in any field of medicine. You need one who will give you a full examination and evaluation of your gait to determine the cause of your pain so that it can be addressed appropriately. Inserts may well be needed, but if your biomechanics are faulty they will need to be prescribed and made for your feet, not purchased otc.

There is a wide range of conservative treatments, but each case of PF needs the right ones applied in the right combination. While it's important to be involved in your treatment, self-treatment can be a hit-and-miss business, so you do need to see a clued-up podiatrist.

You may need to wait until after the holidays to get a response from one of the doctors here. Meanwhile here are a few ideas:

Don't go barefoot: your arches need support all the time.

Evaluate your footgear and make sure they are getting the support they need. Shoes need to be stable (no bending at the arch, only at the metatarsal) and frequently replaced so they don't get excessively worn down. And though it sounds obvious, they need to be the right size. (Feet spread as we grow older - not that you're old, but have you been measured for size since your adolescence?)

Stay off your feet as much as your work and life style allow. This is important: PF is an injury (the fascia is tearing at its insertion point in the calcaneus) and like all injuries this one needs rest in order to heal.

Your 'first'step' pain is typical of PF, as I said. The feet are plantarflexed overnight, which contracts the achilles tendon and the calf muscles. Some gentle foot exercises before getting out of bed will help: see my post of a few days ago on the Treatments board titled Yoga Foot Exercises, or use the search facility to find it.

If there is inflammation icing will relieve it.

Taping will often relieve the pain: there are instructions and illustrations in the heel pain book. But because taping supports the arch, it also 'rests' the fascia and contributes to healing.

I hope this helps. Happy Christmas!

Re: Recurring pain in both feet; right more than left

Lara T on 12/25/02 at 07:07 (103959)

Following up on what Julie said about getting another podiatrist/orthopod if you aren't satisfied. I went through several doctors, all competent and recommended by good people, including other doctors. HOwever after initial treatments didn't work, I was either sent on, sent home, or told it was in my head (or my favorite - it was the first sign of diabetes - something that would be impossible since I had been tested for diabetes - negative- and the symptoms I had that were similar to problems caused by diabetes are caused by the excess sugar, so it couldn't be a sign of impending diabetes). I finally hit pay dirt when I went to a doctor that 'specialized' (unofficially) in sports podiatry. If you can find the doctor that treats the local basketball team (if there is one in your area) that would probably be a gold mine. My impression is that most podiatrists see a lot of issues related to diabetes and aging - neither of which was really my problem. We all know much better those things we deal with regularly. This podiatrist had at least one Olympian, and many week-end athletes at various competetive levels. My issues weren't exactly those of an athlete, but more common to that than diabetes or aging issues.

Turns out I didn't have PF (as initially thought), I have TTS, which makes things more difficult as TTS is only recently recognized so many good doctors aren't familiar with it, and to the best of my knowledge, there isn't a recognized protocol even among those familiar with TTS, so you get significantly differing treatments/opinions about what to do. However, given your youth and description, and the statements of many on this board, it seemed it might be helpful to see if you can find someone with an interest/background in treating athletes/sports injuries.