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treatments for TTS

Posted by Manda C. on 9/29/03 at 23:59 (131702)


I've had TTS for approx 8 months now. My podiatrist has suggested few treatments for my condition, which includes injection of some kind of fluid (not sure exactly what it's called). I've tried neurontin, that didn't work, and currently going to pt twice a week, doesn't seems to be helping too. My podiatrist did suggest surgery as my last option. So I figure, ok…worst comes to worst, I'll get the surgery, and be back at work within a week…(since my doctor did say that it'll only take a week of rest). But now that I'm reading the message board, this doesn't seem to be the case. Everybody that went through the surgery seems to take months to recover. I was unaware of that, so now I'm thinking twice about the surgery

Are there any other retreatments out there for recovery?

Surprisingly my TTS condition is not as painful. Besides the fact that I feel discomfort from half of my feet because of the numbness, and when I tap the bottom of my ankle, I do get a great tingling feeling, my daily activities are not interrupted in most cases, I still walk normal, I can do normal activities, I can even run. I just don't know if it's worth all the trouble that comes after the surgery. My other concern is, from the website…it seems like that TTS worsens through the years, is this true also?


Re: treatments for TTS

stella on 9/30/03 at 00:02 (131703)

Well everyone here knows what im going through. I had tts since last july which started from a stress fracture of my right heel. Then i got tts had surgery in may of this year and still can not walk. I have tried everything. I recently got an MRI and now im back in a plaster cast for 3 weeks. I am trying to help the swelling and that in my tendons. The compression sock and ace bandage didnt help me. I am so stressed i havent worked since feb and my bills just keep piling up. No one will help me and believe me i have tried. I hope you choose well surgery was my last choice but i couldnt stand even at work it was so bad. So if it isnt that bad i would choose against the surgery since u can run and walk. I havent been able to walk since may!!! take care and good luck

Re: treatments for TTS

chris on 9/30/03 at 07:52 (131716)

Have you tried the ESWT or the walking boot cast? Those were 2 things I also treid without success. I did have the option of having my foot casted for some ungodly amount of time (I did not do that).

I also was able to do most activities with my tts, but I was in pain and suffered greatly in the evenings - however I was not running - I'm talking normal activities. I am not the type of person to remain still and I believe I have a pretty high threshhold for pain tolerance.

I would be skeptical of your doctor saying that you will be back to work in a week. I was in a half cast and on crutches for at least 2 -3 weeks. I took about 3 1/2 weeks off of work, but could have easily taken more, but I had a desk job and only lived 2 minutes from my work so it was easy to get rides. There was no way I would have been able to drive.

Also, I thought a recommended treatment for tts was rest of the foot. Just a thought.

Welcome to the board, you will find lots of helpful information here!

Re: treatments for TTS

lara on 9/30/03 at 08:39 (131724)

My understanding is that untreated, TTS does get worse. That was certainly true for me. It took months to go from discomfort to crawling around on the floor, but it got worse - sort of 3 steps down, 1 step back as life made occasions along the way for rest that I didn't know I needed.

I somtimes think I've said what I'm about to say too often and people are getting bored/tired of it and I should stop. But then I wonder if someone new will have read the past posts, so I'm going to go ahead again. My treatment doesn't work for everyone, but it works for a lot of people (according to my podiatrist - not according to this board, which represents the hardest cases). I was crawling around on the floor to avoid walking on my feet and fantasized about amputation when my podiatrist 'gave' me compression socks (available by Rx and also in some drug stores, in three different strengths to the best of my knowledge.) I don't think the strongest compression socks are available OTC - they are also VERY expensive. But the moderates & milds are very affordable. I found the the moderates were best to begin, and milds for maintenance, which is what I do now.

I also recently started a diuretic as I noticed that when I had high salt/sodium foods my feet got worse. I think that has helped with no side effects (including no weight loss : ( )

Re: treatments for TTS

Sharon W on 9/30/03 at 09:03 (131730)


If your lifestyle really hasn't been affected that much, I would definitely say hold off on the surgery.

I think you should give the injections into the tarsal tunnel a try. What they do is inject 'cortisone' type steroids (usually combined with lidocaine and/or marcaine, which help with pain) close to the nerve. The purpose of this is to reduce swelling in the area and therefore, hopefully, reduce the pressure on the nerve. Those injections are painful -- I won't lie about that -- but they don't take very long to do and afterward, most people get least a few days to several weeks of improvement. For a lucky FEW, they can actually stop the cycle of inflammation and allow the TTS to heal. (Actually, I think that is true for all of these treatments -- you never know which treatment will be the one that really works wonders for YOU.)

Other treatments you didn't mention, and may not have tried, include compression hose (as I believe Lara mentioned), orthotics and/or taping (those will only help if there is an underlying problem with the way you walk, but that is often the case with TTS sufferers), iontophoresis, resting it in a cast for a few weeks, ART (a special type of massage - there is some disagreement about the merits of this but some people swear it was the thing that made the difference for them).

I would not have ESWT done anywhere around an inflamed nerve; that is generally not recommended.

Sometimes people even find that a treatment they have tried before, works for them the second time around.

Good luck!


Re: treatments for TTS

chris on 9/30/03 at 09:54 (131732)

? for you Sharon - I think you are the first person I ever heard say that ESWT is not recommended for tts - where did you get that info?? Just really curious because I thought I recalled lots of people recommend it. I know I had it and it did not help me at all.

Just for the record, I'm trying to start a debat eor anything - just trying to keep up on all current info as when I had my surgery my doc said that there is always a possiblity I will develop symptoms again and I want to be certain that I am fully informed :)

Re: treatments for TTS

Sharon W on 9/30/03 at 10:14 (131736)

Chris, if you want to verify that info please post to Dr. Z on the 'Ask the Foot Doctors' board. Ask him, 'Should ESWT be used to treat TTS?'

He is one who has said repeatedly that ESWT should not be used for TTS -- and he is certainly an expert on ESWT.


Re: treatments for TTS

chris on 9/30/03 at 11:32 (131741)

Thanks I did a search and found the info. I must have been confusing it with PF. Before I was dx with tts, they suspected pf and that was when I had ESWT - no wonder it didn't work!

See, I said I needed to be more informed. I consider myself very lucky that I had good doctors and a good surgeon., because I had my surgery prior to finding this board.

Thank you!

Re: treatments for TTS

lara on 9/30/03 at 12:14 (131746)

I asked once on the Ask the Doctors board and they said ESWT was counterindicated for TTS. Don't know any words to help you with a search.

Re: treatments for TTS

Ed Davis, DPM on 9/30/03 at 14:19 (131759)

ESWT cannot be applied over any nerve trunk and as such cannot be used for TTS.

Re: treatments for TTS

chris on 9/30/03 at 14:19 (131760)

Thanks I had found what I was looking for. As I wrote previously, I had confused having the ESWT for pf and not tts.

Re: treatments for TTS

Ed Davis, DPM on 9/30/03 at 14:22 (131761)

You stated that your podiatrist mentioned doing injections but did not actually perform the injections? Please clarify.

The downside to use of injections, properly performed, is small and definitely may be worth a try.

Re: treatments for TTS

Manda C on 9/30/03 at 14:44 (131763)

The podiatrist did inject something below my ankle, it is this white liquid. But that didn't seem to help.

Re: treatments for TTS

wendyn on 9/30/03 at 20:05 (131794)

ESWT has never been recommended for TTS. (At least not in the 4 years that I've been here)

Re: treatments for TTS

chris on 10/01/03 at 07:55 (131825)

Thank you. Again, I say that I had made a mistake and confused it with my treatment of pf!