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Where do I go from here?

Posted by debbi a. on 9/22/03 at 21:12 (130744)

I am at a standstill in my treatment and wondering where to go or what to do next...any thoughts or advice would be greatly appreciated.

I was diagnosed w/ PF (in my right foot) in 2000 by my family doctor. I was having pain upon rising in the a.m. and after being on my foot for long periods of time. Naprosyn, stretching and ice were prescribed, as well as being told to get 'better' shoes. I got PG w/ my 2nd child in January 2001 and stangely enough, during pregnancy, I had no pain in my foot. I honestly thought I was healed after doing the above things recommended from my doctor. About 6 months after my son was born, the pain returned...much worse this time. I went back to the family doctor, who in turn referred me to a podiatrist. He recommended more stretching, even 'better' shoes and Birkenstock inserts for my shoes. When this didn't help, he did put me in a walking cast for 4 weeks. When that didn't improve the pain, he did one cortisone shot, which seemed like a miracle at the time. The pain of the shot wasn't bad at all, but the 3 days following were very bad. On day four and for about 5 weeks after, I was totally pain free. Slowly, but surely, the pain returned. At my last visit to the pod., he said I needed to be in permanent, custom orthotics, which isn't covered by insurance. This history brings me to my current situation -- do I try the orthotics? My fear is that I have spent money on shoes, doctors visits, walking cast, OTC shoe inserts and Rx shots and meds, do I want to spend the $400 for orthotics that is something that may or may not work? It is frustrating, because really nothing has worked up to this point. What would you do?

Re: Where do I go from here?

BrianJ on 9/22/03 at 21:42 (130755)

Debbi --

If you are looking for an inexpensive treatment that will bring some relief, you should try taping. It takes a little practice, and it can be a hassle, but it should give you temporary relief so you can consider your next move with a clear head.

Re: Where do I go from here?

R C on 9/22/03 at 23:37 (130772)

I second the recommendation to try taping, which worked in my case. It takes some trial and error to get the tension just right, but it was really the only thing that worked for me in the long run.

Orthotics might work, too, but I would try an off-the-shelf variety first (they are much cheaper), rather than a custom-fitted orthotic (which is only as good as your podiatrist's judgment anyway).

If you are in a job that requires you to be on your feet a lot, see if you can get a stool to sit on, or transfer to a desk job. It is so hard to make progress when your feet take a beating from standing and walking a lot.

If you have excess body fat, it might help to lose some of it. I found that even a 25 pound loss made a big difference in my case (even in the pain level). One way to test this is to pick up a 20 pound bag of potatoes at the greocery store, and see if your pain level goes up noticeably.

Please write back and tell us how you're doing. If need be, we'll try to think of some other things.

Re: Where do I go from here?

AnnaO on 9/23/03 at 09:19 (130791)

I would also recommend taping and definitely pass on the orthotics. I went to the 'best podiatrist' in the state and was given orthotics. Not only did they not help after the prescribed breakin period, they ended up making my knees and calves hurt. I turned to a Dr. Scholls product for $7/pr and it seems to help better. I still have PF and will be making another appointment with another podiatrist soon.

Good luck!

Re: Where do I go from here?

john h on 9/23/03 at 10:23 (130794)

debbi: if orthics would work I would spend $4000. I do in fact wear $400 orthics and they have not cured me but probably have helped me get better. I always wear them or birk sandals which is an orthotic in itself.

Re: Where do I go from here?

Jen L on 9/23/03 at 16:04 (130823)

When my podiatrist told me I should have custom othotics ($420.00 last year) he also said my insurance does not cover it. But he could offer some kind of installment pay schedule to ease the 'pain'. I got the orthotics following his advice. Then later on I found out my insurance covers othotics by 80% of the cost if it's prescribed by doctor as a necessay treatment for the foot problem. By filing a claim, I finally got the some money back. While, since the pod. is in my network, the refund money was sent to him by the insurance procedure, it took some effort on my part to get my refund from the doctor's office.
So check with your insurance to make sure. We are so dependant on doctors now, but the truth is that they are not supposed to know everything!
Wearing custom othotics seems to be one of the popular treatments for heel pains. Worth it or not, I think you have to give it a try. Besides, you can ask your pod., in case the othotics does not help, can you get a refund? One of our heelspurs.com doctors posting last week mentioned he would do it.
Good luck!

Re: Where do I go from here?

Kathy G on 9/23/03 at 16:06 (130824)


I have had wonderful luck with my orthotics and yes, they were $400 and they weren't covered by my insurance. There's no guarantee, however, and you will probably hear a different story from everyone who answers you! Each case of PF is so different.

Some people swear by C.Peds for orthotics. I, in fact, after getting my orthotics and not getting better beyond a certain point, went to a C.Ped for a second opinion. I have some complications and am termed as having 'atypical PF.' She concurred with what my Pod had suggested but a second opinion never hurts!

Of course, with a baby, you don't exactly have time to go running from doctor to doctor! But it is an option.

Good luck. Having PF is the pits; it's doubly hard for someone who has no option but to be on their feet! Keep us posted!

Re: Where do I go from here?

debbi a. on 9/24/03 at 17:07 (130921)

Thanks to everyone for their input. I am going to make an appt. w/ my pod. to see about doing the molds for the orthotics. I guess I won't know if it will help until I try. As many have said, it is a frustrating process, because there isn't a #1, #2, #3 protocol that one can follow to be healed -- it is different for each person. Thanks Again and I'll keep you posted.

Re: Where do I go from here?

Marty on 9/25/03 at 09:42 (130974)

I had a pair of rigid's made that my insurance covered but they didn't help me, in fact made it worse. A year later I had a new pair made with specific materials that I got from BC in the Orthodics board. I have been wearing them now everyday and I can't say weather they are helping or not. I think a bit but not that much. (I have never gone without them, I even kneel while showering). Allot depends on your foot type and how bad your condition has become.


Re: Where do I go from here?

Sher A on 9/27/03 at 18:54 (131323)

I too am battling 3 years now with PF and heelspurs. I'm at desperation's edge because I don't believe there really is a good cure for PF. I've had all kinds of store bought orthotics, but finally got a custom pair from my pod. Yes, they helped tremendously with the heelspurs. But I can't stand having my feet in shoes for hours on end. PF is totally different than heelspurs and has its own separate agony. The thing I found that honestly does work is taping. You should try that! It takes some practice to master the technique so that it isn't too tight. The heel pain book here is especially helpful. The taping technique that works well for me is simply 3 strips on the bottom of the foot. I was surprised at how well this helps! ESWT is prohibitively expensive for me and since insurance doesn't help, it's just out of the question. Applying heat, which is discussed in another thread also helps! I don't think this ever really goes away. I'd love to lose weight but I eat so little as it is and I'm not sure as to what is causing it. Maybe it's age related since I am going through the big 'M' now. I'll tell you this, this website has been more helpful than my pod or any other website. Good luck to you!

Re: Where do I go from here?

Ed Davis, DPM on 9/27/03 at 19:02 (131324)

If you feel better when the custom orthotics are in place but don't like the confinement of a shoe, consider the following:
1)wearing the orthotics in a sandal designed to take orthotics
2)either obtaining a standard Birkenstock sandal or better yet, having your orhtotic design built into a Birkenstock type sandal (Langer Biomechanics lab).

Make sure you have checked to make sure you have adequate dorsiflexion (backward movement of your foot on your leg). An ankle dorsiflexion night splint can help with that.

ESWT fees are 'all over the place' so it can be very affordable. For many, getting the ESWT treatment in Canada is an option. Where do you live?