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chronic heel pain

Posted by Anne G on 1/02/03 at 11:53 (104559)

I have had chronic heel pain in both feet, right worse than left, for about 7 years. Most dr.'s think it is plantar fascitis. I have tried just about everything except injections, casting, or surgery. I recently developed a nerve problem in the toes of my right foot which seemed to come from an ill fitting orthotic. I am thinking of trying shockwave therapy. Anybody doing it that is really good within driving distance of San Diego? I am scared because so many of the treatments haven't worked or made me worse but I am also tired of worrying constantly about my feet and having them run my life.

Re: chronic heel pain

Carole C in NOLA on 1/04/03 at 07:54 (104781)

Anne, I'm not a foot doctor but thought I'd answer anyway.

By shockwave therapy, do you mean ESWT?

We have an ESWT message board on this site and it might be worth inquiring there about a good ESWT facility near San Diego. Several of the foot doctors read that message board too. They can also direct you to some lists of ESWT facilities or may perhaps know ESWT doctors in the San Diego area.

I'm sure there must be several ESWT facilities in your area since they are becoming more and more common and easy to find these days. Don't be scared... from what I understand, the scariest part of ESWT is paying for it or trying to get your insurance to pay for it, since it can be pretty expensive.

Carole C

Re: chronic heel pain

Anne G on 1/05/03 at 09:40 (104886)

Thanks for answering. I did post a message on the ESWT message board and am awaiting a response. How can I be sure that I have plantar fascitis and not some other heel problem like fat pad atrophy or bursitis? I get different answers from different practicioners?

Re: chronic heel pain

Carole C in NOLA on 1/05/03 at 14:27 (104896)

From what my doctor said, a lot of times these things go together and people have plantar fasciitis along with bursitis and so on. My doctor told me that I had plantar fasciitis (PF) along with bursitis and achilles tendonitis, for example. But generally the treatments for PF seemed to help everything pretty much, for me.

It's sure confusing when different foot doctors give you different diagnoses! Probably the doctor who does your ESWT will want to examine your feet and will give you his opinion too, and help you to decide if ESWT is a wise course of action or not. Of course if he does ESWT he may think it's a smart thing for most PF sufferers to do.

I've never had ESWT, but from reading on the message board it seems to me that generally the outcome after ESWT is more favorable if your pain is in a particular spot on your foot, and not the 'all over the bottom of the foot' pain with no one place any worse. If it's in one spot, you can have them zap your foot right there... but if it's all over the foot, it can't really get to every single spot.

After having foot pain for a while, many of us feel that doing something, anything, is better than just having to live our lives with foot pain. I'm glad that you have the good sense to be thinking about these things. It's a lot of money to spend.

I have to admit that if my PF had persisted beyond six months I would have got ESWT despite the cost and even if I wasn't sure it would work, simply out of desperation. I figured they wouldn't take me until I had had PF for six months, so I was waiting for the six months before looking into it. It turned out that I was one of the lucky ones whose PF responded to the usual treatments (as described in the heel pain book on this website) and started getting a lot better after about five months.

Carole C

Re: chronic heel pain

Dr. Z on 1/05/03 at 16:50 (104901)

The diagnosis of plantar fasciitis is done via a phyiscal examination,history and ruling out other causes. Most heel pain is typical plantar fasciitis. Fat atrophy is a physical examination and the type of pain is different. You have have a little of both but classic plantar fasciitis is easy to determine but sometimes very hard to get rid of with just conservative treatment

Re: chronic heel pain

Carole C in NOLA on 1/04/03 at 07:54 (104781)

Anne, I'm not a foot doctor but thought I'd answer anyway.

By shockwave therapy, do you mean ESWT?

We have an ESWT message board on this site and it might be worth inquiring there about a good ESWT facility near San Diego. Several of the foot doctors read that message board too. They can also direct you to some lists of ESWT facilities or may perhaps know ESWT doctors in the San Diego area.

I'm sure there must be several ESWT facilities in your area since they are becoming more and more common and easy to find these days. Don't be scared... from what I understand, the scariest part of ESWT is paying for it or trying to get your insurance to pay for it, since it can be pretty expensive.

Carole C

Re: chronic heel pain

Anne G on 1/05/03 at 09:40 (104886)

Thanks for answering. I did post a message on the ESWT message board and am awaiting a response. How can I be sure that I have plantar fascitis and not some other heel problem like fat pad atrophy or bursitis? I get different answers from different practicioners?

Re: chronic heel pain

Carole C in NOLA on 1/05/03 at 14:27 (104896)

From what my doctor said, a lot of times these things go together and people have plantar fasciitis along with bursitis and so on. My doctor told me that I had plantar fasciitis (PF) along with bursitis and achilles tendonitis, for example. But generally the treatments for PF seemed to help everything pretty much, for me.

It's sure confusing when different foot doctors give you different diagnoses! Probably the doctor who does your ESWT will want to examine your feet and will give you his opinion too, and help you to decide if ESWT is a wise course of action or not. Of course if he does ESWT he may think it's a smart thing for most PF sufferers to do.

I've never had ESWT, but from reading on the message board it seems to me that generally the outcome after ESWT is more favorable if your pain is in a particular spot on your foot, and not the 'all over the bottom of the foot' pain with no one place any worse. If it's in one spot, you can have them zap your foot right there... but if it's all over the foot, it can't really get to every single spot.

After having foot pain for a while, many of us feel that doing something, anything, is better than just having to live our lives with foot pain. I'm glad that you have the good sense to be thinking about these things. It's a lot of money to spend.

I have to admit that if my PF had persisted beyond six months I would have got ESWT despite the cost and even if I wasn't sure it would work, simply out of desperation. I figured they wouldn't take me until I had had PF for six months, so I was waiting for the six months before looking into it. It turned out that I was one of the lucky ones whose PF responded to the usual treatments (as described in the heel pain book on this website) and started getting a lot better after about five months.

Carole C

Re: chronic heel pain

Dr. Z on 1/05/03 at 16:50 (104901)

The diagnosis of plantar fasciitis is done via a phyiscal examination,history and ruling out other causes. Most heel pain is typical plantar fasciitis. Fat atrophy is a physical examination and the type of pain is different. You have have a little of both but classic plantar fasciitis is easy to determine but sometimes very hard to get rid of with just conservative treatment