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chronic plantar fasciitis

Posted by debbie c on 3/31/03 at 07:51 (114960)

Two yrs ago noticed that I would 'hobble' in the morning and had heel pain that felt as if a stone was in my shoe. An xray diagnosed bilateral heel spurs. The left foot was the most troublesome. I started vigorous strecthing excercises taping,ice, better shoes and orthotics. Finally progressed to coritsone injections. The fourth one ruptured the fascia.
Seven weeks in a fiberglass cast followed by three months of physical therapy and then one month after casting an MRI. The MRI determined full thickness tear of plantar fascia. Shortly after I noticed burning and tingling sensation. This would radiate from insertion point on heel to outer aspect of foot up towards the ankle and accross the bottom of foot to the opposite ankle. After seven months of trying to ignore pain I went for three evaluations. Number one Ortho. stated perhaps ESWT (not available where I live) Number two refered me to Pain management clinic and another pair of orthtoics ( I have at least seven different types) Number three recommended invasive surgery for plantar fascia including gastro, release and nerve entrapment. He was the first to suggest TTS. I have not had any tests to support the diagnosis of TTS. The MRI I had last month is normal(after 3 weeks in boot)Ortho number three suggests it is inconsistant with previus MRI one year ago.
I am frustrated and confused where do I go for treatment? Iwould like to try ESWT but I have been led to believe that it may not be appropriate if I also have TTS. Can you guide me? I am at my wits end. This foot problem has changed my life so much. After two plus years it is starting to wear on me emotionally and the toll that of constant pain and my revamped lifestyle is a little depressing. I have tried Vioxx and Celebrex for pain with no relief. I take three advil only if I am unable to sleep due to pain.Any suggestions? Debbie C

Re: chronic plantar fasciitis

dave r on 3/31/03 at 11:26 (114989)

wow, you sound like alot of us here. I have had a ruptured fascia from two cortizone shots. That took me two years to get over along with the loss of my job. i have had eswt twice. I finally have had the open plantar release and it has helped.I am not a doctor just a sufferer. I know your pain very well. I have had pf for 6 years and have learned to live with it like it or not.. I am doing well after my pf surgery. Although it was only 7 weeks ago.Lots of things can still happen. If i were to have another pf sugery on my right foot i would personally look into the gastroc slide option along with pf surgery. But thats just my opinion. Surgery has helped alot of people but there is always a chance that you can be left in more pain from invasive surgery. With eswt there really isnt any complications.

Re: chronic plantar fasciitis

Mar on 3/31/03 at 13:22 (114999)

Debbie -

The doctors can answer your questions better than I can as you seem to have a lot going on, but I do recommend going to Pain Management for Biofeedback and Pain Counseling. Being in pain for a prolonged period of time with an impact on your daily lifestyle can be very difficult and depressing. It has helped me tremendously to handle the pain and the lifestyle change until something comes along that works to take away my pain. Good luck -- Mar

Re: question-Mar

SteveG on 3/31/03 at 14:00 (115012)

Mar - did you ever try neurotonin - if so, how did it work for you?

Re: question-Mar

Mar on 3/31/03 at 16:24 (115041)

Steve -

No I haven't tried neurontin. A year ago when I suggested it, none of my doctors wanted me to take it. Now they are suggesting it as a possibility, and I don;t know if I want to take it. I have such a time with medication -- IBS -- which has been acting up for a month since I took large doses of Vit C for a cold. the cold went anyway in 2 days, but not the iBS!! Many on the board have taken it with good results. Try a search. Mar

Re: chronic plantar fasciitis

Ed Davis, DPM on 3/31/03 at 18:18 (115051)

ESWT can be performed even if tarsal tunnel syndrome is present. It can only be used to treat PF at this time. It is a good idea to consider a nerve conduction velocity test to rule out TTS.

ESWT is becoming widely available and you may consider traveling if necessary. Where do you live?

Please take some time to read Scott's Heel Pain Book to understand the gamut of treatment. There probably is information that you have left out in your post but there is a lot that should be looked at and done before considering surgery.

Re: chronic plantar fasciitis

debbie c on 4/12/03 at 23:14 (116024)

Dr. Davis
I am scheduled for an EMG first week of May until then I have started Neurontin and Lidocaine patch. Checking insurance to see if ESWT is covered. debbie