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Chronic Pain and Rest

Posted by Nigel on 11/30/03 at 17:00 (139064)

I have just had my MRI results back after four months of foot pain. They confirm PF in both feet. I only have bad pain in one foot.

When my pain was at it worst, about 8 weeks ago I could not even put my heel on the ground. I would walk on my toes and the further I walked the worse it got. I did not try and walk through the pain.

I have tried nearly complete rest for 6 weeks, crawling around the house to do the basics and working from home. The intense pain has reduced to almost nothing.

I am gradually walking more and more as each week goes by. I'm now up to 6 * 20 meter walks every day, increasing by one each few days. They are almost pain free, as soon as the pain starts I stop walking.

At this rate, it will talk a while before I can walk around the block, however it appears to be working.

Has anyone else tried this method longer term? Has it worked?

Re: Chronic Pain and Rest

Bob G. on 11/30/03 at 20:25 (139072)

I think you can make it, Nigel. If I were you (which I'm not) I would become friends with the Nightsplint. I believe you are on the right track by resting it and keeping off your feet. Do some research on what your feet do when you sleep and get used to sleeping with a Nightsplint on. Do a search under my name for many posts I've made on this subject over the past few years. I am pain-free now. Good luck.

If you want to respond to me, find me on the social support side.

Re: Chronic Pain and Rest

Carole C in NOLA on 11/30/03 at 21:03 (139074)

Yes, several of us here have treated our PF with rest (along with other treatments). I found it did not take very long at all to get back to my prior level of mobility. It sounds like you are being careful that you increase your mobility very gradually, so that you don't overdo and strain anything. That's very smart and I found that it is surprisingly easy to overdo so patience (such as yours) is the key.

It worked for me, though for me rest was not the only treatment. Also I didn't try complete rest, but did try to rest as much as possible... not doing any errands or housework or cooking, and only walking a few feet to my car to go to work (at a desk job). I also combined rest with gentle non-weightbearing stretching. I think this helped because it kept my tissues from contracting due to all the rest. I also a number of other treatments such as icing, custom orthotics, Birkenstocks, shower shoes, never going barefoot, and so on.

Carole C

Re: Chronic Pain and Rest

Julie on 12/01/03 at 05:05 (139077)

I'm sure you're on the right track, Nigel, and are wise to make rest the mainstay of your treatment. Do investigate the night splint if you haven't already, and I would also suggest you do gentle, non-weight bearing exercises to maintain muscular strength, e.g. the yoga foot exercises, while you're still being very careful.

Keep persevering - there is light at the end of the tunnel.

Re: Chronic Pain and Rest

Nigel on 12/01/03 at 17:11 (139106)

Thanks for your replies, great to hear that I'm doing the correct thing. It is great to get advise from those that have been through this before. The orthopaedic surgeon that I saw said that I should just ignore the pain and keep walking. That just feels so wrong to me. The further I walk the more painful it gets. At it's worse it felt like someone had taken to my heel with a baseball bat. He explained that PF it like a sore tooth, it hurts but drinking cold water is not going to damage your tooth any more, it just hurts. Has anyone else heard of an explanation like that before? I think of my foot as a dislocated shoulder. I would not do push ups on that so why would I walk on my foot.
Thanks for the other advise, I have two Nice Stretch night splints (as well as two S/SOcks and some other device that hurts my ankle) as well as two pairs of orthotics, stretching stuff, etc.
I'll try those Yoga stretches, they look great

Re: Chronic Pain and Rest

Nigel on 12/01/03 at 17:16 (139107)

thanks for your advise on the night splint. I found some of your old posts on the subject. I'll try the S/sock with the splints and see if that also works for me.
I wear mine quite loose. Maybe I need to tighten them up some more. I'm probably not quite at 90 degrees. I find that if I put them on too tight my heel goes numb.
Should it feel as though the PF is being stretch or the calves are being stretched?

Re: Chronic Pain and Rest

Bob G. on 12/01/03 at 22:19 (139122)

No, don't want to feel stretched. That would become uncomfortable. Keep it loose, you're doing the right thing. And the S/Sock with just the slightest bit of tension will keep the pressure off the stress, more comfortable and doable. Better to sleep.

If you can learn to sleep with the nightsplint you can win.

If you can do that, you can figure out the rest of it.

Patience and persistence wins.

Re: Chronic Pain and Rest

Bob G. on 12/01/03 at 22:30 (139123)

Fortunately you're not a sucker for bad advise. Making it hurt, or hurt more, is the worst thing. In fact, after much rest, the temptation will be to test it (see if/where it hurts). Instead, bring it back slowly until you are recovered. Then punch it...yes!!!

Most don't have the patience it will take; they want a quick fix.

I ran on the beach this morning, not the stamina I used to have, but I am loving every minute of it. Patience and persistence. Took over a year of rest.

Re: Chronic Pain and Rest

Julie on 12/02/03 at 02:19 (139126)


No: I have never heard of an explanation like that. Either this orthopaedic surgeon is a sadist (some surgeons are - maybe that's why they're attracted to surgery?) or he is simply wrong and shouldn't be allowed near anyone with PF.

PF isn't like a toothache. It's an injury. Whether one's particular case is a repetitive motion injury due to faulty biomechanics or some other cause, or the result of a traumatic injury, it is an injury. There are microtears. When anything is done that causes pain to the injured fascia, it is being re-injured (more microtears). So the answer is usually rest, which allows the injury to heal. The healing can be helped along by other treatments, but rest is important.

The downside of rest is that if you're resting so much that your feet are getting no exercise at all, you risk muscle wastage, so yes, do have a look at the yoga foot exercises. The rest of you will sieze up too, so try to keep all your joints moving. The foot exercises are a part of an entire yoga sequence that works through all the joints, and they can all be done sitting in a chair. I described them in my book, Office Yoga, now out of print but still available second hand on the web.

In a nutshell, if you can't find the book or don't want it, the sequence consists of stretching and fisting the fingers, bending and circling the wrists, bending and straightening the elbows, rotating the shoulders, curling and stretching the toes, bending and circling the ankles, bending and straightening the knees, rotating the hips. The book contains a full range of other exercises - side stretches, forward and backward bends, spinal twists, and exercises for the neck and shoulders, that can also be done sitting in a chair.

The night splint, as Bob says, isn't meant to stretch the calf muscles, but to prevent them, the tendons, and the fascia, from shortening overnight. These structures shorten and tighten up when the feet are in a plantarflexed position, and the night splint keeps them gently dorsiflexed. Over time, the effect is to lengthen them; the immediate effect is the avoidance of first-step pain.

I wish you all the best for your healing.

Re: Chronic Pain and Rest

Sandy H. on 12/02/03 at 02:45 (139130)

In a sense it is like having a dislocated shoulder in that you should avoid doing anything that puts it at risk of another dislocation and everything you can to strengthen the muscles around it without making it worse. I avoided doing anything with my disclocating shoulder and had to have an operation in the end cos it came out so many times. The problem with foot pain is that it's very hard to avoid trauma's like having to rush to stop a kid doing something or whatever so you really need to try to strengthen the muscles around it. Find your own balance and let pain be your guide.

Re: Chronic Pain and Rest

Kathy G on 12/02/03 at 09:24 (139141)

Good Grief, Nigel! Thank goodness you didn't believe that doctor. I'd find a new one! When my foot problems began, I just tried changing my exercise regime. I went from Sweatin' to the Oldies, to the Nordic Track, to the Healthrider, to just taking walks outside. Then I bought a treadmill. When I asked my Pod if I could take a pain pill and then use the treadmill, he just commented, in a rather disgusted tone of voice, that I knew the answer to that question because I wasn't stupid!

Now, many years later and with many complications which I don't think you have, I have good days and bad days but my bad days are nothing like they used to be and I rebound much quicker. I even go for short walks! Last month I walked four times for about fifteen minutes. That's not much compared to what I used to do but it's sixty minutes more than I walked a few months ago! And that was besides my usual daily activities.

So rest; find what works for you; and you will begin to see a gradual improvement. The one positive thing that PF does is to teach us all the art of patience!

Re: Chronic Pain and Rest

Nigel on 12/02/03 at 15:42 (139171)

Thanks again for your comments.. much appreciated..
One of the classic signes of PF is that the pain is worst in the morning and then gets better….. my experience started like that, for a few weeks, however it soon moved into constant pain that gets worst as I walk further.. I therefore assume that this is causing more damage to the PF and therefore I just walk a very short distance everyday. After four months I now am almost pain free in the morning however after walking about 50 meters the pain returns. Most of what I read, mainly on the web, does not describe this situation.. has anyone else experienced these symptoms as well???

Re: Chronic Pain and Rest

Kathy G on 12/03/03 at 08:16 (139250)


Except for a very short time, immediately following PT, I never experienced morning pain. My pain always got worse as my day progressed. I guess the majority of people do experience morning pain but I didn't. Makes us special, right?

Re: Chronic Pain and Rest

AndrueC on 12/12/03 at 08:48 (139844)

I tried it but it didn't really work.

I actually found (and still do - can't get out as much in this weather) that resting actually irritates my feet slightly. It's as if they quickly get out of practice walking. Luckily these days the difference is minor (I feel the odd twinge instead of feeling nothing) but I take care when I haven't used my feet much for a while.