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Does this sound like TTS ?

Posted by Theresa F on 9/19/03 at 19:45 (130566)

I used to be a very active person. About a year ago I started getting sharp pain in the center of my left arch. I went to a podiatrist who specialized in runners and he diagnosed me with PF. Got the custom orthotics, 6 weeks PT and I did get a little better for awhile. Started running and rock climbing again but in March it came back, this time in both feet. I never had the classic PT symptoms, for me the first step out of bed is the best. The longer I am on my feet the worse it gets. The balls of my feet feel bruised all the time and I frequently get pins and needles in the bottom of my feet. It is especially bad when I drive a car, feels like the accelorator is a knife blade stabbing me in the foot.
Do these symptoms sound familiar?

I have a new doctor who had me get an EMG? (nerve conduction test) and a pressure sensitivity test both indicated some minor nerve problems but nothing conclusive. Basically he thinks it is early TTS. Any opinions?

Re: Does this sound like TTS ?

marie on 9/19/03 at 22:08 (130578)

I hope for your sake it isn't but you seem to have some of the symptoms. I have TTS and PF. When I walked it felt like I had no padding on the bottoms of my feet. It felt like I was walking on my bones or walking on broken glass. My meta tarsals were numb. The pain got worse as the day went on. Sometimes my right leg would stiffin up so I often dragged it by the end of the day. I would come home and go to the sofa until morning as I couldn't make it up the stairs. I had electric shocks that went from behind my knees to my calves and thighs. My thighs eventually became numb and could barely stand. I began jerking and twitching...my calves and thighs mostly. sometimes my hands shook violently and my fingers jerked uncontollably. It was all i could do to make it through each day.

I am doing well now. So hang in there.

Re: Does this sound like TTS ?

Ed Davis, DPM on 9/23/03 at 11:02 (130797)

Theresa:

TTS in the early stages can be VERY difficult to diagnose.
First, I would do some testing to try to rule out other potential causes such as peripheral neuropathy. Second, if I had suspicion of early TTS, I would try some conservative empirical treatment such as using iontophoresis over the tarsal tunnel or an injection of a local anesthetic plus cortisone into the tarsal tunnel. Often, the manner in which one responds to treatment helps make the diagnosis.
Ed

Re: Does this sound like TTS ?

Chad H on 9/24/03 at 20:48 (130951)

Dr. Davis,

Early on in my TTS a doctor did an injection of Marcaine and Kenalog and I got substaintial relief for about 6 weeks before the pain came back. For the benefit of discussion, what type of diagnosis (if any) would you make with this type of response?

Re: Does this sound like TTS ?

Theresa F on 9/25/03 at 12:35 (130989)

The doctor who first suggested this might be TTS gave me an injection of novacaine. The numbing effect of the novacaine lasted about 24 hours but within a few hours after the feeling came back I had the pins and needle feeling worse than I ever experienced. I would say it took about two weeks before my foot calmed down to where it was before the injection.

Numerous doctors have given me the Tinsel test. I don't generally get an intense shooting pain but the area is very tender.

I am scheduled to have a bone scan (stress fracture?) and then maybe another EMG.

Re: Does this sound like TTS ?

lara on 9/25/03 at 12:59 (130991)

It sounds similar to my experience (which was later diagnosed as TTS with a definitive NCV test). Another non-invasive and sometimes very effective treatment is compression socks. THey are the same socks that many people with varicose veins wear and can be found in drugs stores in some regions (as I discovered when on vacation), and in medical supply stores (and may require a Rx) in other regions.

Re: Does this sound like TTS ?

angelasi on 9/27/03 at 21:05 (131351)

Hi Lara,
I know you have suggested compression socks and explained details about them which is greatly appreciated.
My question is if socks hurt my feet how could I stand compression socks?
I now need the baggiest, softess, lightess socks or none at all which is going to be a real prblem this winter since they are like ice when they are not burning :P
In fact at night in bed I have my feet up against a flannel blanket rolled up. The softness just feels so soothing.
Take Care,
Angela

Re: Does this sound like TTS ?

lara on 9/30/03 at 08:45 (131727)

I was afraid I've been repeating myself too much about compression socks. I know they don't work for everyone. I believe there are some physical conditions in which light touch is painful, but strong, firm touch isn't (although I can't remember what I'm thinking of right now). I don't know if that would be the case here or not - you'd know better than anyone. Wish I knew something else.