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plantar faciitis and pernicious enemia

Posted by Sylvia on 5/04/03 at 20:20 (117810)

Is there any relation to plantar faciiatis and pernicious anemia? I have neroapathy on my left foot and left hand due to pernicious anemia. Recently I was experiencing heel pain in my right foot. My podiatrist said I had plantar faciiatis. It is going on now for over 6 months and walking on a cain to keep the weight off my right heel. She has given me the inserts and meds, no cortizone shots or stretching exercises, and she wants to due surgery.
Should I get a second opinion? Reading on this topic via the internet, I see that everyone talks about therapy and shots. Which I have had none. Is it because of my pernicious anemia that may be related causing my plantar faciiatis that she thinks may be causing my plantar faciiatis and her wanting to do surgery? Thanks Sylvia

Re: plantar faciitis and pernicious enemia

Sharon W on 5/04/03 at 22:53 (117814)

Syvia,

Get a second opinion, and a third one if need be. You have NOT exhausted all the other treatments for plantar facaetis (PF).

Even assuming that PF was the correct diagnosis in the first place (and it might not be) -- this doctor seems too eager to cut. Have you had nerve conduction tests (both NCV and EMG can be useful) done on your right foot within the past year? Have you had an MRI or diagnostic ultrasound done of that foot?

Knowing that you have peripheral neuropathy from your pernicious anemia, I would be concerned that a doctor might discount not associate nerve conduction findings that showed problems with the posterior tibial nerve with tarsal tunnel syndrome (TTS). In TTS, the posterior tibial nerve is squeezed or compressed in tarsal tunnel area, causing symptoms that are no doubt already familiar to you -- burning, tingling, etc. in your arch and the bottom of your foot and sometimes the toes and heel. It can also cause 'zapping' electrical type pain that shoots up your calf. TTS can often mimic the symtpoms of PF; I've had TWO neurologists tell me that TTS and peripheral neuropathy are LINKED -- in fact, one actually said that peripheral neuropathy 'contributes to' the development of TTS.

Just a thought. I'm not a doctor or anything, but I've had TTS and I also have both PF and peripheral neuropathy, so your post caught my eye.

Sharon
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Re: plantar faciitis and pernicious enemia

Ed Davis, DPM on 5/05/03 at 20:34 (117860)

Sylvia:

Surgery for plantar fasciitis is a last resort, after all reasonable conservative modalities have been tried. Unless your doc has a compelling reason for surgery (occasionally that does exist) I would be curious as to why you are not getting more aggressive conservative treatment -- physical therapy, ESWT, night splints, etc. -- please take time to read Scott's Heel Pain Book in order to understand the various treatments for plantar fasciitis.

Pernicious anemia causes peripheral neuropathy and that is not related to plantar fasciitis. There are scenarios in which such neuropathies can mimick symptoms of plantar fascia so one must be meticulous about the workup. Your type of neuropathy should respond well to treatment -- hopefully that is being done currently.
Ed