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Who should I get to make sure my back is ok?

Posted by Marty on 2/04/03 at 11:55 (107931)

Little background:

Suffered for 7 years
I have seen 3 pod's none of which checked my walking gate? Not sure why, not sure if it matters in my case.
One orthopedic foot and ankle surgeon would not treat me, said I have more going on then pf/tts. Suggested a neurologist.
I've had 3 sets of hard orthodics
Injections
Blood tests
Neurontin
Ice
Stretching
Always wear shoes etc.

FIRST QUESTION:
Next week I go see a neurologist because the burning sometimes moves from traditional pf/tts locations. Top of feet and side of lower legs and I know back problems can cause this. Is the neurologist qualified to rule out back problems or will I need to go somewhere else for this?

SECOND QUESTION:
I had a NCV test done at a neurologist office but not be a neurologist. The girl that did it didn't seem real confident and when the neurologist told her I might have neuropathy I asked her what it meant and she didn't even know. Can I count on this test results? Pod wants to do TTS release. Seems he called the neurologist and the neurologist thinks it might help my neuropathy. How can he make that assumption? Hasn't even seen me.

I want to rule out all possibilities first. Like back problems, b-12 deficiency and pf.

Any suggestions?

Re: Who should I get to make sure my back is ok?

lara t on 2/09/03 at 09:20 (108566)

Don't think I'll be much help, but perhaps a little bit about the NCV. When I saw the first podiatrist (who told me it was the beginning of diabetes, probably - a medical impossibility since the blood test was negative for diabetes) it was because she recognized the symptoms as nerve pain and assumed it was the beginning of peripheral neuropathy. While this wasn't particularly helpful, as she sent me home to wait for the onset of diabetes, it does show that a doctor, not familiar with Tarsal Tunnel Syndrome, may recognize the symptoms of nerve pain without knowing what to do.

I also got nerve pain on the top of my feet (when it was at its worst) and while probably not common, I don't think its counterindicative of TTS.

I don't know if a neurologist is qualified to recognize back problems (probably depends on the cause), but I think you could probably just ask him. If he's the kind that thinks patients shouldn't read and participate, you've learned something valuable. If he's the kind that welcomes working 'WITH' a patient, he'd probably give you a straight answer as to whether it's beyond his ability.

Neuropathy means 'disease of the nerves'. If I remember what my podiatrist told me correctly, 'perhipheral neuropathy' generally refers to something people with diabetes get, and involves many nerves. In a sense TTS is a peripheral (a limb) neuropathy (nerve disease), but it's only one nerve, rather than several, and is generally not referred to as 'peripheral neuropathy'. I could see someone not familiar with TTS (lots of good doctors aren't) referring to it as neuropathy, having recognized nerve pain.

Before going to surgery, I'd try compression hose, PT, and stop stretching (I understand stretching is great for PF - if done correctly - but not for TTS - someone please correct me if I'm wrong). I mention these because they are the things I recognize at first glance as non-invasive things that have helped me. THere is a list available that has LOTS of treatments (for PF or TTS) from non-invasive to meds to surgery, that you might want to review if you haven't already.

Good luck. It can be frustrating finding someone who you feel you can trust.

Re: Who should I get to make sure my back is ok?

Julie on 2/09/03 at 09:45 (108570)

Marty, you've been waiting ages for a response to your post! I didn't see it until just now, when Lara's response came up. You are very patient.

'Peripheral', as in peripheral neuropathy, refers to the peripheral, as distinct from the central, nervous system. The former consists of the nerves radiating out from the spine to all parts of the body, the latter consists of the brain and the spinal cord.

Neuropathy, as Lara says, is a pathological condition of the nerves. Peripheral neuropathy isn't a diagnosis, it's a description of a symptom, which can have different causes, one of which can be spinal problems.

If you want to rule out spinal problems, I think a chiropractor or an osteopath would be the way to go. They know about structure, and should be able to assess whether you have any spinal malfunction - i.e. a vertebra putting pressure on a nerve. A neurologist may also have the necessary expertise to determine if the problem has a structural origin, and Lara has given you good pointers there.

I'm surprised that three podiatrists failed to check out your gait. I would have thought that abnormal gait could have been at least one causative factor, if not the only one, in your problems, whatever they are. These may have gone beyond the stage where they can be treated conservatively and independently from whatever nerve issues may now be involved, but I would think it would still be vital to pinpoint their cause.

I wish you all luck in your search for relief and healing.

Re: Who should I get to make sure my back is ok?

Bev N on 2/09/03 at 09:52 (108571)

Julie, I surely enjoy and learn so much from you on the boards, and I thank you for all of your input. You are a PF cure, is that right? Ehat do you do? Do you have a job that allows you to sit down? Where are you located that you had such good help to find you a cure? Thankyou again, Bev

Re: Who should I get to make sure my back is ok?

Bev N on 2/09/03 at 09:58 (108572)

Lara, My doctor had be take the EMG for possible nerve problems also as I had the tingling and numbness and all those SX., and also due to the diabetes in my family(father, and his family). The tests were all neg., however the neuro. said that they could not check for any small nerves,only the larger nerves. The labs all came back fine also, no systemic diseases at all. Bev

Re: Who should I get to make sure my back is ok?

Julie on 2/09/03 at 11:13 (108579)

Thank you, Bev, that's very nice of you.

Yes, I'm recovered from PF, and have been for well over a year, though I'm careful not to use the word 'cure'! I'm in England, and I had a clever podiatrist, but I also had a great deal of help from this website. I think I was lucky to find it, and to go to a podiatrist, within a couple of weeks of the onset of my PF: the sooner treatment starts, the quicker it goes away, as a general rule.

Things that helped me, not necessarily in any particular order, were:

Relative rest (I cut out all non-essential walking)
Custom orthotics
Re-evaluating my footgear - I always wear either good trainers (outdoors) or my Birkenstock Arizonas (indoors)
Never going barefoot (I've let up on this a little now)
Taping - to support the arch and encourage healing by resting the fascia
Icing - to reduce inflammation

I am a yoga teacher. Idon't work full time, having retired early from a long career in publishing. For the past 15 years I have been teaching yoga, and writing. I do need to stand at times when I teach (and when I practise) which is when I go barefoot (though for the five months my PF took to heal I always wore Birks for teaching.

The main contributory cause of my PF was abnormal pronation, diagnosed by my podiatrist, who watched and videod me walking on a treadmill. This has been corrected by orthoses. I would never go without them now, reckoning that the biomechanics that predisposed me to PF are still there, and will always need correction.

So I stay vigilant - and that's why I don't like to use the word 'cure'. But I've certainly healed to the point where I can do everything I used to do and want to do, without having to worry about my feet. I'm very happy about that, and grateful for all the help I've had.

Re: Who should I get to make sure my back is ok?

lara t on 2/09/03 at 09:20 (108566)

Don't think I'll be much help, but perhaps a little bit about the NCV. When I saw the first podiatrist (who told me it was the beginning of diabetes, probably - a medical impossibility since the blood test was negative for diabetes) it was because she recognized the symptoms as nerve pain and assumed it was the beginning of peripheral neuropathy. While this wasn't particularly helpful, as she sent me home to wait for the onset of diabetes, it does show that a doctor, not familiar with Tarsal Tunnel Syndrome, may recognize the symptoms of nerve pain without knowing what to do.

I also got nerve pain on the top of my feet (when it was at its worst) and while probably not common, I don't think its counterindicative of TTS.

I don't know if a neurologist is qualified to recognize back problems (probably depends on the cause), but I think you could probably just ask him. If he's the kind that thinks patients shouldn't read and participate, you've learned something valuable. If he's the kind that welcomes working 'WITH' a patient, he'd probably give you a straight answer as to whether it's beyond his ability.

Neuropathy means 'disease of the nerves'. If I remember what my podiatrist told me correctly, 'perhipheral neuropathy' generally refers to something people with diabetes get, and involves many nerves. In a sense TTS is a peripheral (a limb) neuropathy (nerve disease), but it's only one nerve, rather than several, and is generally not referred to as 'peripheral neuropathy'. I could see someone not familiar with TTS (lots of good doctors aren't) referring to it as neuropathy, having recognized nerve pain.

Before going to surgery, I'd try compression hose, PT, and stop stretching (I understand stretching is great for PF - if done correctly - but not for TTS - someone please correct me if I'm wrong). I mention these because they are the things I recognize at first glance as non-invasive things that have helped me. THere is a list available that has LOTS of treatments (for PF or TTS) from non-invasive to meds to surgery, that you might want to review if you haven't already.

Good luck. It can be frustrating finding someone who you feel you can trust.

Re: Who should I get to make sure my back is ok?

Julie on 2/09/03 at 09:45 (108570)

Marty, you've been waiting ages for a response to your post! I didn't see it until just now, when Lara's response came up. You are very patient.

'Peripheral', as in peripheral neuropathy, refers to the peripheral, as distinct from the central, nervous system. The former consists of the nerves radiating out from the spine to all parts of the body, the latter consists of the brain and the spinal cord.

Neuropathy, as Lara says, is a pathological condition of the nerves. Peripheral neuropathy isn't a diagnosis, it's a description of a symptom, which can have different causes, one of which can be spinal problems.

If you want to rule out spinal problems, I think a chiropractor or an osteopath would be the way to go. They know about structure, and should be able to assess whether you have any spinal malfunction - i.e. a vertebra putting pressure on a nerve. A neurologist may also have the necessary expertise to determine if the problem has a structural origin, and Lara has given you good pointers there.

I'm surprised that three podiatrists failed to check out your gait. I would have thought that abnormal gait could have been at least one causative factor, if not the only one, in your problems, whatever they are. These may have gone beyond the stage where they can be treated conservatively and independently from whatever nerve issues may now be involved, but I would think it would still be vital to pinpoint their cause.

I wish you all luck in your search for relief and healing.

Re: Who should I get to make sure my back is ok?

Bev N on 2/09/03 at 09:52 (108571)

Julie, I surely enjoy and learn so much from you on the boards, and I thank you for all of your input. You are a PF cure, is that right? Ehat do you do? Do you have a job that allows you to sit down? Where are you located that you had such good help to find you a cure? Thankyou again, Bev

Re: Who should I get to make sure my back is ok?

Bev N on 2/09/03 at 09:58 (108572)

Lara, My doctor had be take the EMG for possible nerve problems also as I had the tingling and numbness and all those SX., and also due to the diabetes in my family(father, and his family). The tests were all neg., however the neuro. said that they could not check for any small nerves,only the larger nerves. The labs all came back fine also, no systemic diseases at all. Bev

Re: Who should I get to make sure my back is ok?

Julie on 2/09/03 at 11:13 (108579)

Thank you, Bev, that's very nice of you.

Yes, I'm recovered from PF, and have been for well over a year, though I'm careful not to use the word 'cure'! I'm in England, and I had a clever podiatrist, but I also had a great deal of help from this website. I think I was lucky to find it, and to go to a podiatrist, within a couple of weeks of the onset of my PF: the sooner treatment starts, the quicker it goes away, as a general rule.

Things that helped me, not necessarily in any particular order, were:

Relative rest (I cut out all non-essential walking)
Custom orthotics
Re-evaluating my footgear - I always wear either good trainers (outdoors) or my Birkenstock Arizonas (indoors)
Never going barefoot (I've let up on this a little now)
Taping - to support the arch and encourage healing by resting the fascia
Icing - to reduce inflammation

I am a yoga teacher. Idon't work full time, having retired early from a long career in publishing. For the past 15 years I have been teaching yoga, and writing. I do need to stand at times when I teach (and when I practise) which is when I go barefoot (though for the five months my PF took to heal I always wore Birks for teaching.

The main contributory cause of my PF was abnormal pronation, diagnosed by my podiatrist, who watched and videod me walking on a treadmill. This has been corrected by orthoses. I would never go without them now, reckoning that the biomechanics that predisposed me to PF are still there, and will always need correction.

So I stay vigilant - and that's why I don't like to use the word 'cure'. But I've certainly healed to the point where I can do everything I used to do and want to do, without having to worry about my feet. I'm very happy about that, and grateful for all the help I've had.