Home The Book Dr Articles Products Message Boards Journal Articles Search Our Surveys Surgery ESWT Dr Messages Find Good Drs video

To Dr. Z - A question about non-tradtional PF

Posted by Kathy G on 5/27/03 at 09:30 (120012)

First of all, I guess that all cases of PF are 'non-traditonal', aren't they? The doctors I've seen, for the last eight years, all seem to think my PF is related to something else but no one can come up with a viable cause. It's bi-lateral and seems to be concentrated more in the arch area although I have days when my heels kill me. I have achilles tendonitis and calf pain. I have pain in the area underneath my toes but it doesn't act like a typical Morton's Neuroma, so it's considered an 'atypical' Morton's Neuroma. Although I sure had those shooting pains in my big toe. After cortisone shots stopped relieving that pain, I got custom orthotics and now pain in that area is rare. My foot pain is not bad on rising but gets worse as the day goes on.

A rheumatologist has ordered tests to rule out Spondylitis. If it comes out negative and I firmly believe it will, then he says I have Fibromyalgia and the 'worst case of PF he's ever seen.' I also have osteoarhritis that is suddenly appearing in my cm joints, shoulder and elbows.

I live in southern NH and go to the man who is considered to be the best podiatrist in the area. He and I have never discussed ESWT but I think one of the reasons might be that he has always believed I have RA. Another podiatrist in the area is advertising that he now offers ESWT. I have not heard many good things about this guy prior to this but maybe I just met a few of his dissatisfied patients.

This weekend someone else kind implied that I am not exercising all my options because she heard that ESWT will completely cure PF. I don't know as anyone has ever claimed it will 'completely cure' PF, but maybe now that this other doctor is offering it, I should see him. Without having examined me, I know it's impossible for you to do anything but cautiously advise me, but based on what little you know, do you think I should explore ESWT? Is there an actual success ratio availble?

Thanks so much!

Re: To Dr. Z - A question about non-tradtional PF

john h on 5/27/03 at 09:51 (120015)

Kathy for years I looked for reasons other than PF that might be causing my PF like pain which is very much localized in the instep just forward of the heel. I think sometimes if it looks like a duck, quacks like a duck it just might be a duck. I have sort of stopped looking for something more exotic than just plain old PF.

Re: To Dr. Z - A question about non-tradtional PF

Kris C on 5/27/03 at 13:57 (120044)

Hi Kathy. I have been suffering from pf for about 4 years. Within the last 2 years, i have had shots, ice, splints, anti-inflamatorys, orthodics, i would say it is only about 50% better. I have seriuos ankle pain along with the CONSTANT heel pain. I too have been trying to find out more about eswt. I too live in southern NH, I know the advertisement you're talking about. I've been tossing calling him up. I've been to so many foot dr's. Would you mind telling me who your podiatrist is? Surgery seems the only way to get rid of this. BUT is it?? Thank you for any info.

Re: To Dr. Z - A question about non-tradtional PF

Archir B on 5/27/03 at 14:19 (120046)

In Concord NH you can consult with Dr's T. Detwiller, J, Davis, or W.McCann@603-225-5281. I found that they use ESWT for PF while surfing the net

Re: To Dr. Z - A question about non-tradtional PF

Dr. Z on 5/27/03 at 18:31 (120062)


If you don't have insertional pf and pain when you sit for a time and then get up then ESWT isn't going to create the mircle you are seeking. Sorry but it only works well in the right patient. There are some patients that improve with insertional pf that get painful with increased walking but in my experience the sucess is less then with first morning step type of pain.

Re: To Dr. Z

Kathy G on 5/28/03 at 08:42 (120119)

Thanks, Dr. Z. That's the most definitive information I've received to date. I have never thought that my PF was the kind that would respond to ESWT despite my great hopes.

You hear it all the time but I really appreciate the time and effort you put into answering all our questions on these boards. Thanks!

Re: Kris C

Kathy G on 5/28/03 at 08:56 (120122)

Hi Kris,

I go to David Kosofsky in Nashua. He's in partnership with Howard Wagenburg who I've never seen but with whom Dr. K has discussed my case. I find Dr. K to be very knowledgeable and while up on the current trends, he is somewhat conservative. He has never promised me a 'quick fix' and he is extremely compassionate and kind. His treatment plan has followed much of what I've learned, from this website, to be the appropriate approach. He came highly recommended and those who know podiatrists seem to have great respect for him. Along with that, he's just a nice guy!

Dr. Harold Bonenburger is the Pod who's advertising ESWT. He, too, has an office in Nashua. I've heard that there's a guy up in the Peterborough area that some people swear by but I don't know his name.

At a certain point, I just decided not to go for other opinions. I truly don't think my feet will get any better but for me, this is do-able. I mean, I can survive under these circumstances even if I don't like it. I am able to do far more than I could two years ago, so who knows? Maybe two years from now, I'll be even better than I am now.

Now that a Rheumatologist has totally ruled out RA (or as totally as anyone can rule out any disease), and is doing tests to rule out Spondylitis (which I don't think I have at all), I will feel that I have left no stone unturned.

I live in Milford. Where are you? Who do you see? If you switch over to the Social/Support Board, that would be a more appropriate place to answer all my nosey questions!

I hope to 'hear' from you!

Re: To Dr. Z - A question about non-tradtional PF

Mary M on 5/30/03 at 00:24 (120337)

Kathy G--

I live in Southern NH too and am scheduled to undergo ESWT soon. I'm desperate for some relief after a lengthy battle with PF. I recently switched doctors (my previous pod. didn't offer ESWT) and I'd like to make sure the new one isn't the guy with the dissatisfied patients you mentioned in your post. Maybe you could hint at his initials or office location if you aren't comfortable revealing his full name? Thanks--

Re: To Dr. Z - A question about non-tradtional PF - Mary M

Kathy G on 5/30/03 at 09:52 (120365)

Oh, I don't mind. I don't feel as though I'm slandering the man as I have heard a couple of good things about him. I think all of us know that people who haven't recovered from an ailment the way they think they should have a tendency to blame the doctor. That may well be the case here. My chiropractor, who I respect, and my Primary Care Physician both like him. His name is Howard Bonenberger. He's the one who is now advertising that he does ESWT. He also has a new partner, I see from his ad.

The problem, in our area anyway, seems to be that there are just very few podiatrists. I believe Dr. Bonenberger has the largest practice and the more people you see, the more people there are to be displeased. When I was looking for a podiatrist, I just happened to hear more good stories about the doctor I see.

Good luck to you, Mary! May the ESWT work out for you.

Re: To Dr. Z - A question about non-tradtional PF

Mary M on 5/31/03 at 00:59 (120485)

Kathy, thanks so much for your reply. I'm relieved to see that my new podiatrist isn't the one you mention. I'm eagerly counting the days until my ESWT-- I've had no relief whatever from the traditional arsenal of cortisone shots, stretching, NSAIDS, icing, orthotics (admittedly, not the expensive custom jobs, just over-the-counter cheapies)-- only taping gave any kind of positive result, albeit minimal and temporary, but the PF has been getting steadily worse. Although I'm trying to keep my expectations about ESWT realistic, I feel as if I have some hope at last. After my treatment, I'll come back here to report on my experience and results-- hopefully, I'll be able to proclaim major improvement! Thank you again, and best of luck to you in your search for relief.