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PF but no heel pain

Posted by Theresa F on 10/17/03 at 13:24 (134347)

I have had arch pain in left foot for a little over a year and in both feet for the last six months. The initial diagnoses was PF so I did all the typical treatments, stretching, custom orthotic,PT (two rounds), taping, injection (1 shot)but have not experienced any signicant improvement. Doctors then thought it might be TTS so I had a Nerve Conduction test (twice) and an EMG test(once) and confirmed it wasn't TTS.
I also had a bone scan to confirm it wasn't a stress fracture.

Now the doctors are back to thinking it is PF but I don't have the typical symptoms. No real pain in the heel and usually my first step in the morning is the best. The stabbing pain in the center of my feet just gets worse as the day goes on. My other big primary symptom is that the balls of my feet always feel bruised. It kills to stand on hard surfaces and is particularly painful when driving a car.I was wondering if other PF sufferers have similar symptoms. If so do you do anything different from the usual heel pain treatments.

Re: PF but no heel pain

Steve G on 10/17/03 at 13:30 (134348)

Theresa - It could be PF, but if you don't have discomfort in your heel, that is unusual. Many of us don't have first step pain, and we have pain in the arch, but most of the pain (at least for me) is in the heel. You might want to post this to the 'Ask the Doctors' section of the board to see what they say.

Re: PF but no heel pain

DR PEPPER on 10/17/03 at 15:00 (134382)

P.F.? Hey clown are you a Docter? then stop giving everybody advise, advise that you are not sure of. I,am sure you have foot pain, I think the biggest problem most of you have is a bad case of the nerve sydrome. It only takes a few steps to get to the clinic and have a complete check up. It looks to me like most of you spend hours in foot pain and take the advise from other,s. They don,t call me dr.pepper for nothing.

Re: PF but no heel pain

Richard, C.Ped on 10/17/03 at 16:00 (134405)

Post deleted due to inappropriate comments.

Re: PF but no heel pain

Rick R on 10/17/03 at 17:15 (134421)

Nice shot for a dart gun, thanks.


Re: PF but no heel pain

Ellen J. on 10/17/03 at 20:15 (134456)

Hi Theresa,
I've really never had pain in the heel with my P.F. symptoms and all the docs over the last 4 yrs have said I have Plantar Fasciitis. However, it's a good idea to keep pursuing it to make sure the pain isn't caused by something else like a pinched nerve or something. Anyway, although my feet are pain-free at this time (as long as I don't do too much), my previous pain was mostly in the arch area and moved around to different spots in the arch.

Re: PF but no heel pain

SteveG on 10/17/03 at 20:29 (134459)

Ellen - I am glad to here your feet are so much better - it was your advice that helped me solve the problem I was having with my knees

Re: PF but no heel pain

monte on 10/17/03 at 21:31 (134475)


Hi...you arch pain sounds like mine. Plus you had the pain spots that seemed to move around...like me. How long did it last for you until you were pain free....I like hearing about people with similar symptoms as me getting better

Please let me know

Re: PF but no heel pain

Kathy G on 10/18/03 at 10:31 (134532)


I had no heel pain for a long time with my PF. In fact, until I went for PT, I had no heel pain at all. And even now, the best my feet feel is in the morning. My pain has always been worst in my arch. Actually, it's like my arches are on fire; they just burn all the time and get much worse as the day progresses. I also get that bruised feeling in the balls of my feet. Now, I do get the pain in my heels but I didn't for a couple of years.

All the doctors I've seen say it's PF. My Pod said that it can take on many forms and mine is atypical but still PF.

I hope you can find some relief. I have good days and bad days. On a good day, I have pain but it isn't anything like it is on bad days which usually follow the times when I overdo it. My good days outnumber my bad days so hopefully, that will happen for you, too.

In the meantime, read the Heel Pain Book, do your gentle Yoga stretches and we'll all hope for the best!

Re: PF but no heel pain

John H on 10/18/03 at 13:33 (134572)

Tehersa: In 8 years I have never actually had 'heel' pain. My pain has always been just forward of the heel where the fascia attaches to the heel towards the inside of the foot. That would be the band of fascia from the great toe. From what I have read this is the most commom area for pain.

Re: PF but no heel pain

Ellen J. on 10/18/03 at 13:41 (134576)

Hi Steve,
I'm glad your knees are better! I slacked off the exercises all summer so now I'm back at the fitness ctr getting those muscles back in shape. Also, I finally found an exercise I can do to work the thigh muscles to try and get back in shape, without hurting the feet. I'm doing leg presses but with a very light weight for now (50 lbs.) and doing about 100 reps to start with. 100 sounds like alot, but iwth such a light weight it's easy, and doesn't put the pressure on the arches that a heavier weight would do. The plan is to slowly increase the amount of weight and/or the number of reps through the winter. The rowing machines seem OK too, but don't target the thighs as much as the upper body.
So glad the exercises helped!

Re: PF but no heel pain

Ellen J. on 10/18/03 at 13:52 (134582)

Hi Monte,
It took me a long time to become pain free because I kept doing the wrong things, which kept aggravating my feet. Every time I felt a little bit better I would try to do more, which would then set me back. Or I would try wearing a new pair of shoes, or the wrong old shoes and that would set me back. Once I started wearing only one pair of shoes that were super comfortable and wearing no other shoes, my feet began to steadily improve. I also quit trying to do any bike riding or any other exercise that made my feet sore. Now I am back at the fitness center, carefully working my way back to exercising, and as I told Steve, I'm doing leg presses with very light weights and also using other machines such as leg curl machines, leg extension machine and upper body weights. All of those are OK for my feet.
Anyway, my point is that I think a person will recover once they figure out all the things that aggravate the feet and stay away from those things. The problem is, it sometimes takes a long time to figure out what those things are, whether they are shoes, exercises or what. Another big discovery for me was that I cannot wear all those arch supports that help others. If I try to wear those, it inflames my arches. Right now I'm wearing Teva Circuit sandals, which have very little arch support but are nicely cushioned. I don't know what I'll wear when it starts to snow!
I hope this helps a bit. I know I'm forgetting to mention other things but I woudn't want to ramble on and bore you too much!

Re: PF but no heel pain

Ed Davis, DPM on 10/18/03 at 13:55 (134585)

Your feet don't really hurt. You are experiencing pain associated with memories of an unhappy childhood.

Re: PF but no heel pain

Scott R on 10/18/03 at 15:11 (134598)

Ed, after challenging the ladies to show me something wrong you've posted, they came up with this one that you've posted today....even in jest telling a patient their feet don't hurt and it's in their mind is as close as you can get to an automatic permanent block from visiting let alone posting to heelspurs.com. i can only hope kathy and you have a relationship where you know that she would not be offended by that. One of the more important aspects of the website and the message board is to let people know that they are not alone and that it is not in their head as incompetent, frustrated, and lazy doctors of all disciplines are apt to do when their ignorance of what's wrong with a patient exceeds their ability to effect a cure.

Re: PF but no heel pain

Ed Davis, DPM on 10/18/03 at 15:25 (134599)

After two weeks of being lambasted with insults and derogatory remarks by the gadflies who are constantly emailing you to complain about everything and everyone they don't like, I think I deserve a bit of latitude in this area. Did you read Kathy's remarks about my childhood today, it came as close to libel as one can imagine -- they obviously were deleted in your latest revision of the site?

Re: congratulations to the axis of evil on this site

Phil C.. on 10/18/03 at 16:17 (134607)

Well Ed, they finally got your goat and egged you on to say something nasty on the site. Obviously, the site's axis of evil, nancy s, kathy and Judy were just waiting for you to say something mean as they went to Scott as fast as they could as soon as they got a response from you. Then Scott threatens you. Looks like a set up if I ever have seen one.
Your best bet is to leave the site alone and let these people find someone else to complain about.
Phil C.

Re: PF but no heel pain

BGCPed on 10/18/03 at 16:32 (134612)

Sounded like tit for tat Dr Ed but you must remember, you are a DR and you cant have an opinion or feelings. Just shut up and keep posting the free , great medical advice. I think I am gone again also. I wish my previous prediction was wrong but they even went a step further thsan complaining about it, they got the board nuked.

Re: PF but no heel pain

Ed Davis, DPM on 10/18/03 at 16:38 (134615)


I apologize for inviting you back. I really thought that things would work out -- I am sort of the perennial foolish optimist. Scott fails to realize that he is letting four people ruin the board for everyone else. I really thought that he understood that but I was wrong again. Best wishes my friend and keep in touch.

Re: PF but no heel pain

BGCPed on 10/18/03 at 16:46 (134620)

No problem Dr Ed, I was not sure until I got some strong encouragement in a post on the social board

Re: PF but no heel pain

BGCPed on 10/18/03 at 16:47 (134622)

p.s. you gotaa admit, that one about the santa dolls made from ivory snow bottles was a hoot

Re: PF but no heel pain

Scott R on 10/18/03 at 19:20 (134633)

i didn't know kathy was 'one of them' but responding to her like that with new comers (like me) not knowing what's going on does not make the message board appear inviting. posting private emaill correspondence is a serious violation of netiquette if not against the law in many circumstances

Re: PF but no heel pain

Andrue on 10/21/03 at 10:10 (134802)

I'm in a similar boat. I have only had pain under the heel once or twice.

The whole thing started for me when I got discomfort on the inside of my ankle at the base of the arch just below the bone that sticks out. As with PF the discomfort (more of a strong twinge than actual pain) only occured when I first got up.

At some point it stopped hurting there and became a swelling. At least I think it did. I don't think I've always had a swelling but I don't inspect my feet every day so who knows :)

I also remember going through several months of random twinges all over my feet. For my left foot this happened after I triggered problems by lifting a bookcase barefoot.

For a while my left foot also hurt at 'The Site' (shown as most common site of pain on this site) when my ankle was lying across my knee and the foot was hanging down but that has stopped now.

I am sensitive to pressure at that point on both feet but 99.9% of the time it doesn't get pressure so doesn't hurt.

I also got a lot of pain along the course of the tendon to the big toe twice but that has gone.

Right now my feet just continuously feel a bit put upon. Various tendons/muscles/what-have-you seem to take it turn to have a bad day. I am currently putting this down to my feet adapting as they heal but who knows?

FWIW I currently seem to have a problem in this respect in other part of my body. I seem able to pull muscles/strain tendons spontaneously. Not enough to hurt but it's a rare day when I don't have a twinge or two somewhere.

I'm only 36 although at the top of the BMI for my height am probably not quite overwheight :)

Re: PF but no heel pain

john h on 10/21/03 at 13:07 (134810)

We all use the word 'pain' in our discussions. It is always of interest to note what kind of pain you are experiencing. Is it burning,aching,throbbing,etc. When I first developed PF and for perhaps a year afterwards I would always describe it as a burning pain (usually nerve related), I would often go to bed and place the bottom of my feet on ice. At some point about a year or more later the nature of the pain changed. I would now describe it more as a aching pain. Yesterday I was having a massage. I had the thearapist press on the area that my pain generally is located. The pain on my right foot could clearly be reproduced by pressing hard on the area I normally experience daily pain. This pain felt almost like the pain you have with a pulled muscle. This was on my right foot which has had ESWT but no surgery.

On my left foot on which I have had ESWT and Baxter Procedure the thearapist could not produce nearly as much pain and the thearapist notes the bottom of the foot felt mose loose.

Re: PF but no heel pain

AndrueC on 10/21/03 at 16:54 (134843)

I agree about the type of pain being important. Twice (not recently) I have felt what I describe as a cold, piercing pain. I associate this as being a warning of major injury. Aside from those two occasions all I've mostly felt is a bruised feeling. Like you though if something presses hard on a slightly bruised area it starts to hurt. It will also often trigger throbbing and pain that continues long after the initial pressure.

This has nearly always been the case for my feet right from the start. As long as nothing pressed in those places I was okay. Only a couple of times did I get genuine pain and in all cases it went away after a week or so.

No one has ever said that I definitely have PF. In fact given my wheight, age, general fitness and the fact that I used to walk everywhere (20 minutes most evenings just for the pleasure of it) most Drs have said that PF seems highly unlikely.

What seems more likely is a cummulative overuse situation.

I don't worry about it too much now because the treatments for PF seem much the same as the treatments for any foot problem.

Re: PF but no heel pain

Dr Kiper on 10/21/03 at 19:44 (134864)

Hi Andrue,
I want to remind you that you are still healing, in fact you've 'only' been wearing your orthotics since March of this year. I have found that it takes 1-2 years to get the most out of the first Rx. During that time your pain is getting less and you're need for a Rx change is getting greater. Also, remember that every step you take while you're getting better antagonizes the healing. It's kind of like two steps forward and one back. It is my opinon that when any biomechanical pain comes to the surface, it's from a lifetime of walking/running etc, hundreds and thousands of steps/day.
In addition I have found that your Rx changes can amount to 2-3 changes over 6-10 years. This does not mean still having pain during this time, it simply means restoring the health of the tissues back to the level where they were say between 10-30 years ago.
I don't know how my colleagues explain this, but I feel that every patient I've ever spoken to and the ones I occaisionally see posted expect
evrything to go much faster.
The key to all this is understanding that the 'criteria' of a proper fit is being met. If that is the case then the orthotics are working and only time will tell.

Re: PF but no heel pain

AndrueC on 10/23/03 at 16:33 (135185)

Well my feet are improving. Sometimes I have bad days but I'm finding that they aren't very bad any longer and rarely last more than a day.

I'm even building up a level of resilience. I can be a bit naughty to my feet once and get away with it. Last Tuesday I spent nearly an hour on my feet including ten minutes spent standing at the Post Office. I had no ill effects from that.