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scared need info

Posted by Marilu H on 4/14/03 at 16:10 (116107)

Hi, I am new to the message board. I am getting conflicting information from my doctors and am getting nervous. I have very high arches-the orto pedist said only about 2% of people have arches this high. He said I had plantar fascitis even though the pain I was experiencing was on the top of my foot. Originally my primary care Dr. said to get specially made orthotics which I did. At first they seemed to work but then the outside of my feet started to hurt so bad I could barely limp and once when I was feeling good I went for a walk in deep snow and must have twisted weird and had a serious set back. Then it would start to feel better and get worse again. By the time I got to see the orthopedist I am seeing now I was really hurting.-My orignal primary care would not give me a referral to an orthopedist close to me( anyone close to me was outside of this dr.s hospital association) so I ended up changing primary care physicians to be able to get to go to an orthopedist I didn't have to drive 50 minutes to get to. But before I went to my current orthopedist.I had a visit with the one originally recommended. HE examined me and did nothing for the pain told me I had a back problem and would need an MRI and probably would need an appointment with a surgeon. I have no back pain other then caused from limping. I had a car accident 6 years ago that gave me a lot of muscle problems in my neck but I am feeling better then I ever did since that happened. He wanted to insist that that was causing the pain in my foot. To say the least I was shaken up by what he said. I then changed Dr.'s and am seeing this orthopedist since March.He recommended not wearing orthotics getting lambs wool slippers and lots of exercises and Celebrex-which I didn't take-Have a hard time with medicines and wasn't sure I wanted to risk the side effects. So I tried taking salmon oil for inflammation instead. I tried to do the exercises but it made everything worse. Also, unfortunately I was out with our puppy and she raced around me and the hard chain leash wrapped around my foot and wacked hard against it. It took my breath away and I ended up with a hugh black and blue mark behind my ankle and it made the pain worse on the rest of my foot. That happened the beginning of March. My foot was already swollen on the pad of the foot and limping sore and blue. -I have had 11 cortizone/lidocaine liquid with ultrasounds-not shots On the underside of my foot. I thought things were going very well about half way through I was even able to move my foot like normal! and walk like normal. I wasn't thinking and I did some painting over some windows and used a ladder quite a bit with just slippers on plus the Physical therapist tried to strtch my foot because it felt better and between these two things the pain has come back. Also when the pain is bad my foot and only the foot with pain turns blue. The Ortho said I have Raynaud's disease but it only happens in that one foot when pain is bad. So I don't know if his diagnosis is right.I just went back to see him and he put me in a walking cast he took an x-ray and said because I was able to put some weight on it- he didn't think it was fractured but I was allergic to dye so he couldn't give me a bone scan so he decided to just put me in a sft walking cast-(it is very heavy). Can an MRI with out contrast tell what is happening with soft tissue?. I have been in the walking cast for a week and have been using a wheel chair to get around-tried crutches but they started to hurt my neck and shoulder where I had an accident. I hate the wheel chair and cast though I am grateful for some way of getting around. I don't see much improvement but I don't know how soon I should expect improvement I wear the cast sleeping too.- I am feeling very paniced and confused about what to believe and what to hope for a prognosis. Especially after the first ortho's opinion. I am 5'4' and weigh 108 pounds so weight isn't the reason for this. It seems like there is more going on then Plantar fascitis because I have pain by my ankle joint and the outside of my foot that is made worse if I wear orthotics.Some time the pain is sharp and in a definite spot and other times just feels sprained. Can anyone give me some information or advice or direction? I have been trying to read as much as I can on the web but am feeling overwhelmed and confused. Thank you-Marilu

Re: scared need info

Ed Davis, DPM on 4/14/03 at 19:23 (116132)


Orthotics, if not properly made, can transfer too much weight to the outside of your foot and make things worse - especially true with a high arch foot. It can be trickier to make orthotics for a high arched foot.
It is tempting to look for tests to provide the answers but you have simply described a situation in which your orthotic prescription needs modification or change at this point. You may want to consider a second opinion from a podiatrist.

Re: scared need info

BGCPed on 4/14/03 at 23:27 (116150)

i would bet your orthotics are very high arch, no cut out for the first ray and probably posted medial. That can flare up peroneal tendon and or pain on base of fifth met. Dr Ed is correct find somebody that has a clue about orthotics. where are you located?

The guy that said 2% should not be making orthotics for that foot type. If you have a digital cam and can take a few pics of your foot and the orthotic top and bottom we may be able to help

Re: scared need info

Marilu H on 4/15/03 at 14:10 (116196)

Hi Thank you.Yes,I will send photos it will take a day. It does seem that a tendon is involved.I am in York Maine. Please let me know if you know someone in this area that can help. I have a rigid orthotic- my current podiatrist(third one) told my husband to play around with grinding it down till it feels right-I don't feel right about that and it hasn't worked. This soft cast seemed to help first few days but now isn't and I have been taking my foot out to get relief. He said I will need a hard cast if this doesn't work. My Physical therapist said he thought that the right orthotic would help me though he felt stumped at some of the symptoms. He thought maybe another injury caused a stress and might need immobilization.It does seem that a tendon is part of the problem it just keeps getting more sore (worse with orthotic)-in a couple different places on the outside of my foot and right at the place the tendon joins to the ankle it feels and right on the pad under my foot and under arch area it is stinging and inflammed feeling-plantar fascitis. Thank you for any help or advice.

Re: scared need info

BGCPed on 4/15/03 at 21:49 (116242)

I dont know anyone in the Maine area. No offense but why is he telling your husband to grind them himself? he may be handy but if he doesnt have the background I cant see why he would tell your hubby to do it. If they are causing that much pain I would not wear them at all and if he is letting your hubby grind them I would go someplace else.
Reading this may help, it is a bit boring for the layperson. One interesting point, if you search on cavus diagnosis at that website you will find only 1 hit. THAT is the problem. 99% of practitioners treat cavus (high arch) feet the same way they treat flat feet.

That site has very good peer reviewed articles that tend to be more to the point than many journal papers. I sometimes make this offer, if you can fly to s.e. Michigan I would make you a proper pair free of charge. They are done in one visit that takes about an hour. It may seem like a trip but some airline tickets are cheaper than a pair of orthotics. Also your quality of life is worth it.

Let me know if you have any questions. I am not trying to stir a conflict with your orthotic provider but if he is telling your husband to adjust them, imho you need to go elsewhere.

Re: scared need info

Marilu H on 4/16/03 at 20:12 (116356)

Hi Thank you for your very kind offer!That is so nice. :-) It is a little far though but you sure are right that plane tickets can cost less then orthotics! I read the article you recommended with my husband. It was a little over my head tecnically but it made a lot of sense and I can see why just a semi-rigid tight fit to my arch orthotic is not working and can cause problems. It gives me an idea of what to ask for. Is the type of orthotic the CFO orthotic that they discuss in the article the type you make? I can't find anyone around here yet who is familiar with it. Can I ask you what you think of the Dr. Kipper SDO silicone dynamic orthotic in terms of addressing the type of foot I have? Thanks for any information-Marilu

Re: scared need info

BGCPed on 4/18/03 at 07:18 (116493)

I make a custom version of it, the one mentioned is still patent pending so it is not available yet. It will serve as a good device for subtle cases but higher degree will still do better with custom. There are a few tricks that need to be done with your foot type and some are not done by most fo providers. I have never seen a sdo so I cant speak to that. I do know that if you have that high degree cavus you prob have a ff valgus and a plantarflexed 1st met. I know that is techie but that is one of the main issues that gets incorrectly done in cavus ortotic, that and the false notion that the arch needs to be pushed and help up firmly.