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entrapment neuropathy and PF

Posted by chrisb on 6/23/03 at 10:49 (122674)

My doc suspects that I may have both an entrapment neuropathy and plantar fascitis. He plans to inject a temporary freeze of the calcaneal nerve area to determine how this affects my pain, and we will make further decisions from there. Anyone had this experience? If the freeze does significantly drop my pain (suggesting nerve involvement) would a cortisone shot be likely to help? (I have had this quite badly for 2+ years but haven't had a cortisone shot yet)

Re: entrapment neuropathy and PF

Aly R. on 6/23/03 at 11:53 (122683)

Hi Chris,

What were your symptoms that suggested entrapment neuropathy?

Re: entrapment neuropathy and PF

chrisb on 6/23/03 at 14:24 (122706)

Well, I developed PF 2.5 years ago and in the beginning had typical symptoms. Later it began to be atypical, i.e. less or no pain with 1st steps in the morning and after sitting. The pain developed only after I walked 10, 20 or 50 yards. Its been this way now for nearly 2 years, up and down. Its pretty severe, and getting worse.

I'm not overweight, pronate slightly, and have tried all the usual things, orthotics, physio etc but not cortisone shots. Ultrasound puts my fascia thickness at 5.8, which suggests PF. Nerve-wise I don't show Tinel's sign and my nerve conduction study doesn't point to TTS, although I'm told a conduction test doesn't rule out entrapment. Because I'm now atypical for PF, and because I haven't recovered by now, the docs suspect entrapment may be present along with PF. I gather the problem is there doesn't seem to be a very good diagnostic test for entrapment. Hence the plan to try to temporarily freeze the nerve area and see what results.

If the freeze does not point to nerve involvement, I'm thinking ESWT. If it does, then I guess my options are more scary. I would love to know if anyone has been helped by cortisone for entrapment with PF.

Re: entrapment neuropathy and PF

Zane U on 6/23/03 at 14:38 (122709)

Two rounds of cortisone shots here with no improvments. Needle scares the hell of of you, then heel feels good from the anesthesia for just 10 minutes. After that its back to nagging heel pain.

Like you, I have absolutely no pain upon first awakening. But try to shave or brush teeth for 2 minutes and its back. I'm considering eswt too. I've had all the nerve conduction tests with negative results. Had tarsel tunnel release with zero percent improvement. If I were you I'd skip it and do eswt. Good luck with whatever you decide.

Zane Ullman
PF 13 years, will eswt preclude 14 !

Re: entrapment neuropathy and PF

Mar on 6/24/03 at 05:15 (122781)

Chris -

I'll be interested in how the freeze works out. I too have atypical PF with no help from any treatments. I like your use of the word 'suggests' PF, as I'm not sure that PF is what is causing all this pain. Keep us posted and good luck. Even though I tried ESWT twice with no help, I would still suggest you try it and hope for the best. Mar

Re: entrapment neuropathy and PF

chrisb on 6/24/03 at 09:47 (122800)

Thanks all -
I'll be seeing my doc tomorrow so can probably give you the info about the shot after that.

Re: entrapment neuropathy and PF

Kathy R. on 6/25/03 at 09:34 (122888)

Do the Drs. suspect that your entrapment is from the imflammation compressing or entrapment of a nerve? Or do they think it is from your walking gait or something else? Good Luck!

Re: entrapment neuropathy and PF

chrisb on 6/25/03 at 10:23 (122893)

Kathy they think inflammation is compressing it. My gait is not bad, and the foot & fascia are pretty flexible now. BTW I just got the diagnostic shot and posted it.