EPF -Posted by Lynn S on 7/10/03 at 00:56 (123932)
Dr. Z: I've had PF bilaterally for 2-1/2years. I have had ESWT treatment (ossatron) twice (last treatment 12/02). My left foot, while there is improvement, there is still pain. My dr. (podiatrist) feels encouraged that there has been some improvement. I most recently was in a walking boot for 6 weeks(May & June) with more improvement. My dr. is conservative and for the next 5 weeks has me stretching and wearing a night splint. If this doesn't relieve the pain then he feels the next step is EPF. (I've been thru all the other treatments).
Can I be overdoing it with the stretching? It seems to me that when I do weightbearing stretching that it seems to aggrevate my pain, yet my dr. has instructed me to do this type of stretching.
My dr. recently sent me for 2nd opinion and I recently had a MRI - confirmed PF (no rupture). I don't understand why the ESWT didn't work? I'm concerned about the surgery as well. If the ESWT was not successful for me, will the EPF be of concern?
If I have seen some improvement, does that mean there is still a chance that the PF will subside? Thanks, Lynn
Re: EPF -john K on 7/10/03 at 08:35 (123939)
You are right to be concerned with the EPF. Any surgery includes risk. There is a risk that the condition my get worse. I think the recovery period is longer than many doctors tell there paitients. There are people on this board who can't walk at all after botched surgeries. Get as much information as you can before making any decision about surgery. It is good that your doctor is conservative.
Re: EPF -Ed Davis, DPM on 7/10/03 at 17:05 (123975)
No treatment is 100% successful. Our limitation to two high energy treatments can be somewhat arbitrary so consideration fo a third ESWT is not out of the question.
Re: EPF -Dr. Z on 7/10/03 at 17:35 (123986)
I agree with Dr. Ed. A third ESWT isn't out of the question. Your weight bearing stretching could be one of the problem with your heel pain. Take a look at the foot trainers. They are not weight bearing. In addition I find the post on stretching for plantar fascia very interesting. Take a look at that thread
Re: EPF -BrianG on 7/10/03 at 20:41 (124013)
As someone who has had both, I'd suggest you go with another ESWT treatment, before considering surgry. I had a failed EPF surgery before my ESWT treatments. I feel lucky that although it took quite a long time to heal, I didn't seem to be worse off after the EPF. Unlike some others here, who ended up in much worse shape then before the surgery.
If your doctor keeps insisting on the EPF, ask him a couple of questions. Find out if the cannula (blade) will cut enough of the fascia with one slice. I have read that some of the earlier 'kits' that went in from each side (2 incisions) could NOT cut enough of the fascia. The doctor had to go back in, and cut some more, by hand!!!!! Mine was extremely painfull, and took almost 4 months to heal. I had the earlier style kit, which I'd bet you $20, that Pod is still using!!
And don't forget, if you go back to your same job, and it's hard on your heels, there is a good chance that the surgery will fail. I hate to be the bearer of so much negative news, but I call them like I see them. and I've seen this surgery close up. Personally I think it should be eliminated.
Good luck with your decisions,
Re: EPF -Dr. Z on 7/10/03 at 21:29 (124017)
I have one question which I don't believe I ever asked. Before your EPF surgery did you have classic plantar fasciitis. This is the first step pain usually in the am after sitting for any length of time .
Re: EPF -Lynn S on 7/10/03 at 21:54 (124023)
Hi Dr. Z:, yes I had classic plantar fasciitis - pain first step in the a.m. and then after sitting for a period of time. Currently, the pain seems to occur when I am active such as walking or standing for longer periods of time. I wear orthotics. My dr. is not recommending a 3rd treatment of ESWT - he indicated that there was no medical information/studies(?) indicating that a 3rd treatment of ESWT would have positive results. Do you have any data regarding this? If so, I would like to share this with my Dr. Thank you for your expertise!! Lynn
Re: EPF -Dr. Z on 7/10/03 at 22:08 (124026)
There is some information in the first text book for the international society for shockwave therapy. I can fax it to you if you first e-mail me at (email removed) with your fax number. Not a large study but it was about 2nd and 3rd eswt treatment with high energy eswt.
Re: EPF -Ed Davis, DPM on 7/11/03 at 00:25 (124047)
I am surprised to see a number of posts recently where patients are mentioning that they had 1/3 of the fascia cut. The only advantage to doing such a thing is avoidance of the disability and complications that would go with a complete cut. I have to wonder about the effectiveness about such a procedure. One must wonder that if the patients where such a procedure worked had PF of sufficient intensity to warrant surgery in the first place.
Re: EPF - BrianDr. Z on 7/11/03 at 08:22 (124062)
Did you have classic plantar fasciitis before your EPF? I don't remember if you did
Re: EPF - BrianBrianG on 7/11/03 at 21:30 (124172)
Yes, I did have all the classic PF symptoms before the EPF. Pain upon getting up in the morning, pain after sitting for an hour, or so. Pain while driving, etc.
I had all the classic symptoms for at least 5 years before I had the EPF surgery. Unfortunatly I had the surgery just before I found this message board.