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eswt helped heel pain but still arch pain

Posted by Peter F on 1/27/03 at 10:15 (106963)

Dr z -the title of the post speaks for itself-I have had a def improvement over my medial heels but of course the arch tenderness (2.5 yrs) persists-can that simply resolve spontaneously if I continue with orthotics ? Most docs I see say PF always self limits eventually even if it takes 5 yrs but we do see people on this site with 6 yrs or longer.What is your experience of the overall prognosis for patients without other medical conditions complicating the picture

basically will I ever hike again !? (aged 36yrs)

Thanks

Re: eswt helped heel pain but still arch pain

john h on 1/27/03 at 10:25 (106966)

Peter: I have had bi-laterial PF for eight years. We have had people post here who have had it for 20 years. It does not eventually self limit. If you have it treat it early and limit your activities and you have a 90% chance of a complete cure. 10% of patients become chronic. Dr. Gordon who is a guru in this area thinks that 15% of the 10% chronic will find no cure.We have had people on the board who have had PF for 5 years or more who have found almost complete relief through various modes of treatment.

Re: eswt helped heel pain but still arch pain

Peter F on 1/27/03 at 10:50 (106971)

John

thats very clear info-thanks

Have you found that yours has gradually got better over 8 yrs-mine is def better than it was-but even on a good day I know my feet aren't right as if they are ready to sing out after the least over activity.

Re: eswt helped heel pain but still arch pain

dave r on 1/27/03 at 10:53 (106973)

I have had pf for 6 years now. Although it has improved a great deal over the years i can say that my battle with pf is a long time from being finished.

Re: eswt helped heel pain but still arch pain

Peter F on 1/27/03 at 10:57 (106974)

thanks -I hope you finally beat it-I really cant see any people on this board who have had it for more than 2 yrs who seem to get fully active again-maybe I'm just fed up

Re: eswt helped heel pain but still arch pain

dave r on 1/27/03 at 10:59 (106976)

Peter, actually there has been a few. Although i know how easy it is to be very fed up!

Re: eswt helped heel pain but still arch pain

Peter F on 1/27/03 at 11:21 (106980)

well thanks for that any way-can I just ask one more thing from your experience-I have honestly done nothing other than swim for 4 months-this keeps the pain to a low level-more of a fullness than an ache-I have a skiing holiday booked soon-I know it will feel worse if I do ski when I get back but the question really is : does activity genuinely cause more damage or is it just flaring up a static chronic problem ? clearly I wouldnt dream of hiking or cycling but I would like to at least do something on the hols -what do you find with your PF?

Re: eswt helped heel pain but still arch pain

dave r on 1/27/03 at 11:32 (106984)

Peter, i havent done anything since March of last year. I had eswt twice so i have been trying to give my feet some rest. My feet are not any better now then they where a year ago. From my experiances with pf i can honestly say that there came a point where i 'avoided' activities that i knew would cause a flare up. It wasnt worth it to me in the long run. One day of fun and then a flare up that would last a week or sometimes a few months. My time now is spent trying to keep myself happy in other ways. I think that there are activities that should be avoided. Pf is a very tuff to get rid of once you have had it for so long. The longer you have it the longer it is to get rid of. I will be having surgery on my right foot in a week and a half to try to get some quality of like back. I havent been active in many many years. I get up, go to work, come home and go to bed. thats it! The bad part of this is that some of us have lost our jobs, i was fortuante enough to only loose 20% of my pay. Now i can barely make ends meet. I cant see struggling with this like i have for the rest of my life either. It would be so nice to get a job that payed more and just be able to go grocery shopping. Ok i am starting to loose it here.
Good luck!

Re: eswt helped heel pain but still arch pain

Peter F on 1/27/03 at 12:19 (106993)

Dave

I agree - personally I think activities simply flare up the PF and the pain that causes is not worth the activity-but I think the damage was done a long time ago -I'm signing off now to go home-6pm here in uk
best wishes

Re: eswt helped heel pain but still arch pain

Dr. Z on 1/27/03 at 13:25 (107006)

Are we taking about posterior tibial tendonitis.? This is the tendon that inserts into the navicular bone. The answer is maybe and maybe not. The type of foot structure you have is a factor. Orthosis can help to relieve the Post tib problems. Sometimes this tendon is damaged or torn and that needs to be addresed. Sorry tough question to answer without seeing your foot and how your gait functions

Re: eswt helped heel pain but still arch pain

Ed Davis, DPM on 1/27/03 at 14:16 (107018)

Dr. Z:
I second the advise that it needs to be determined exactly where there arch pain is coming from. If the source was plantar fasciitis is the arch arch (non-insertional PF) where do you stand on ESWT use?
Ed

Re: eswt helped heel pain but still arch pain

peter f on 1/27/03 at 14:17 (107019)

Dr Z

Thankyou-I will look that up and let you know if the symptoms are similar

What I do know is that my Ultrasound has shown normal plantar fascia thickness and echo pattern

Re: eswt helped heel pain but still arch pain

peter f on 1/27/03 at 14:18 (107020)

ps -it is generally agreed that i walk a bit like Charlie Chaplin!

Re: eswt helped heel pain but still arch pain

monte on 1/27/03 at 15:04 (107027)

I have the same problem. My heel pain has gotten better over the past 24 months. I think the ESWT helped it alot. i still have arch pain.

my new orthotics have helped some. My fascia inflammation has decrease down to a normal reading at Dr Z's office.

he taped me and it helped a little more.

hang in there...and be diligent in finding answers.

there is hope for all of us.

Re: eswt helped heel pain but still arch pain

peter f on 1/28/03 at 03:34 (107102)

thanks monte

Re: eswt helped heel pain but still arch pain

john h on 1/27/03 at 10:25 (106966)

Peter: I have had bi-laterial PF for eight years. We have had people post here who have had it for 20 years. It does not eventually self limit. If you have it treat it early and limit your activities and you have a 90% chance of a complete cure. 10% of patients become chronic. Dr. Gordon who is a guru in this area thinks that 15% of the 10% chronic will find no cure.We have had people on the board who have had PF for 5 years or more who have found almost complete relief through various modes of treatment.

Re: eswt helped heel pain but still arch pain

Peter F on 1/27/03 at 10:50 (106971)

John

thats very clear info-thanks

Have you found that yours has gradually got better over 8 yrs-mine is def better than it was-but even on a good day I know my feet aren't right as if they are ready to sing out after the least over activity.

Re: eswt helped heel pain but still arch pain

dave r on 1/27/03 at 10:53 (106973)

I have had pf for 6 years now. Although it has improved a great deal over the years i can say that my battle with pf is a long time from being finished.

Re: eswt helped heel pain but still arch pain

Peter F on 1/27/03 at 10:57 (106974)

thanks -I hope you finally beat it-I really cant see any people on this board who have had it for more than 2 yrs who seem to get fully active again-maybe I'm just fed up

Re: eswt helped heel pain but still arch pain

dave r on 1/27/03 at 10:59 (106976)

Peter, actually there has been a few. Although i know how easy it is to be very fed up!

Re: eswt helped heel pain but still arch pain

Peter F on 1/27/03 at 11:21 (106980)

well thanks for that any way-can I just ask one more thing from your experience-I have honestly done nothing other than swim for 4 months-this keeps the pain to a low level-more of a fullness than an ache-I have a skiing holiday booked soon-I know it will feel worse if I do ski when I get back but the question really is : does activity genuinely cause more damage or is it just flaring up a static chronic problem ? clearly I wouldnt dream of hiking or cycling but I would like to at least do something on the hols -what do you find with your PF?

Re: eswt helped heel pain but still arch pain

dave r on 1/27/03 at 11:32 (106984)

Peter, i havent done anything since March of last year. I had eswt twice so i have been trying to give my feet some rest. My feet are not any better now then they where a year ago. From my experiances with pf i can honestly say that there came a point where i 'avoided' activities that i knew would cause a flare up. It wasnt worth it to me in the long run. One day of fun and then a flare up that would last a week or sometimes a few months. My time now is spent trying to keep myself happy in other ways. I think that there are activities that should be avoided. Pf is a very tuff to get rid of once you have had it for so long. The longer you have it the longer it is to get rid of. I will be having surgery on my right foot in a week and a half to try to get some quality of like back. I havent been active in many many years. I get up, go to work, come home and go to bed. thats it! The bad part of this is that some of us have lost our jobs, i was fortuante enough to only loose 20% of my pay. Now i can barely make ends meet. I cant see struggling with this like i have for the rest of my life either. It would be so nice to get a job that payed more and just be able to go grocery shopping. Ok i am starting to loose it here.
Good luck!

Re: eswt helped heel pain but still arch pain

Peter F on 1/27/03 at 12:19 (106993)

Dave

I agree - personally I think activities simply flare up the PF and the pain that causes is not worth the activity-but I think the damage was done a long time ago -I'm signing off now to go home-6pm here in uk
best wishes

Re: eswt helped heel pain but still arch pain

Dr. Z on 1/27/03 at 13:25 (107006)

Are we taking about posterior tibial tendonitis.? This is the tendon that inserts into the navicular bone. The answer is maybe and maybe not. The type of foot structure you have is a factor. Orthosis can help to relieve the Post tib problems. Sometimes this tendon is damaged or torn and that needs to be addresed. Sorry tough question to answer without seeing your foot and how your gait functions

Re: eswt helped heel pain but still arch pain

Ed Davis, DPM on 1/27/03 at 14:16 (107018)

Dr. Z:
I second the advise that it needs to be determined exactly where there arch pain is coming from. If the source was plantar fasciitis is the arch arch (non-insertional PF) where do you stand on ESWT use?
Ed

Re: eswt helped heel pain but still arch pain

peter f on 1/27/03 at 14:17 (107019)

Dr Z

Thankyou-I will look that up and let you know if the symptoms are similar

What I do know is that my Ultrasound has shown normal plantar fascia thickness and echo pattern

Re: eswt helped heel pain but still arch pain

peter f on 1/27/03 at 14:18 (107020)

ps -it is generally agreed that i walk a bit like Charlie Chaplin!

Re: eswt helped heel pain but still arch pain

monte on 1/27/03 at 15:04 (107027)

I have the same problem. My heel pain has gotten better over the past 24 months. I think the ESWT helped it alot. i still have arch pain.

my new orthotics have helped some. My fascia inflammation has decrease down to a normal reading at Dr Z's office.

he taped me and it helped a little more.

hang in there...and be diligent in finding answers.

there is hope for all of us.

Re: eswt helped heel pain but still arch pain

peter f on 1/28/03 at 03:34 (107102)

thanks monte