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Help with chronic (2 years and counting) bi-lateral plantar faciitis

Posted by Mike B. on 6/11/03 at 08:59 (121524)

I am (was) a runner for over 13 years and started experiencing heel pain in October of 2001. I put off a marathon I was training for and sought help from my family Doc and then a Dr. of Podiatric medicine. To make a very long story short(er): I have had 3 cortisone injections in the left foot and 2 in the right; been through 3 months of physical therapy (continued all the stretching exercises for over a year) had ultrasound, iontphoresis, etc; done yoga; spent $450 on custom orthodics (now collecting dust as they increased the pain 5 fold); and now am under the care of an orthopedic specialist who has had me in a Cam walker for 4 weeks (moderate relief in the pain -- left foot is in Cam walker as it is much worse than the right). With having gone through all the above, my doc is now suggesting Lithotripsy (ESWT) and if that is not successful surgery. Every article I have read about ESWT involves treatment in patients with short-term (less than a year) plantar faciitis, how successful is ESWT in treating long-term plantar faciitis?

Re: Help with chronic (2 years and counting) bi-lateral plantar faciitis

SteveG on 6/11/03 at 09:13 (121525)

Mike - Many people are successfully treated that have had it for years. In fact, it is often claimed that it works best for chronic cases.

Re: Help with chronic (2 years and counting) bi-lateral plantar faciitis

elliott on 6/11/03 at 09:22 (121526)

Mike:

I feel your pain. I am (was) a runner who got done in (bilaterally) by tarsal tunnel syndrome and complications from one of the surgeries. Last real run: Oct 10, 2000.

You may like to know that there was an ESWT study done exclusively on runners with PF for at least a year by Jan Rompe, a respected researcher who has occasionally appeared on these boards. Below is an abstract of his article as well as his comments as to how many runners returned to their previous 'occupation':

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12642264&dopt=Abstract

bbt.cgi?n=119725

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Re: PS-Mike

elliott on 6/11/03 at 09:24 (121527)

The device used in Rompe's study on runners was a Siemens Sonocur Plus (low-energy).

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Re: Help with chronic (2 years and counting) bi-lateral plantar faciitis

Pauline on 6/11/03 at 11:33 (121538)

If Brian sees your post I'm sure he will respond. His story goes something like this. He's told us he has had P.F. for about 9 years if I remember correctly.

He's had two rounds of treatments with the Dornier Espos and I know from earlier posts he has not had any relief. I'm sure he will probably up date us shortly on this last round of treatment.

Brian if you read Mikes post could you please us date us.

Re: Help with chronic (2 years and counting) bi-lateral plantar faciitis

BrianG on 6/11/03 at 17:59 (121589)

Hi Mike B / Pauline,

Yes, I have had chronic PF pain for about 9 years now. I had my 1st High power ESWT (Dornier) a little more than a year ago. It was no help. About 5 weeks ago, I went for my second Dornier treatment. So far no help. It may still happen though, as healing can take up to 3 months, or even a year for that matter.

Two years of PF is not that extreme. By doing all the right things, I think you may be able to cure it with conventional methods; rest, ice, taping, rest, anti-inflamatories, rest, and some more REST !!! If I had rested earlier, instead of trying to work through the PF, I'm quite sure I would have been able to cure myself.

Personally, I think the longer you have had PF, the harder it will be to cure it with ESWT. I'm not saying it won't happen, just that it's more difficult. I posted something not to long ago, about having ESWT after surgical procedures. I had one, an EPF about 3.5 years ago.

I'll repost that same abstract, from the ISMST convention held earlier this year in Orlando. This is from Dr Gordon, a well know Orthopedist from Canada:

Cut and pasted:
PS: The moral is, try ESWT before surgery !!

Previous Plantar Fascia Surgery and ESWT Treatment of Plantar Fasciitis
Author: Robert G. Gordon
PURPOSE:
To determine whether ESWT is effective in patent with failed plantar fascial surgery.
INTRO:
The success of ESWT on plantar fasciitis has been demonstrated. Numerous other treatments have been tried . Patients who had attempted mini open or endoscopic releases, and who failed after a minimum of one year were treated.
MATERIALS AND METHODS:
15 patients who previously had surgery on their PF were treated with ESWT 18KV, 1500 shocks. They were reevaluated at 3 months post treatment. VAS was used.
RESULTS:
There was a trend to lowering the VAS scores in these patients. Greater than 50% reduction in pain was not seen.
CONCLUSION:
ESWT does not seen as effective in reducing the patients pain in patients with previous surgery