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Burning in Arches with PF

Posted by Steve on 12/16/03 at 15:05 (140087)

I have had bi lateral PF for about 4 years now. The level of pain is manageable. I have very high arches. I have no AM pain and as long as I wear shoes with orthotics or Birks limited pain when walking. I have tried everything except surgery and ESWT. The pain level really varies from day to day and week to week. The most pain now is a burning pain in my arch and sometimes where my toes connect to my foot. Especially after sitting for long periods like at my desk at work or on an airplane or movie. Is this PF or TTS or something else? Do others have these same problems? What has worked? Thanks

Re: Burning in Arches with PF

BrianJ on 12/16/03 at 17:13 (140099)

Hi Steve --

I've had bilateral PF for about 6 years now, and your symptoms sound similar to mine. I've had multiple ESWT sessions, and they didn't help me. What has helped somewhat (especially for the burning) is the prescription drug Neurontin. I take 1200 milligrams per day, and it cuts the burning and also makes me sleep better. When I'm going to be on my feet a lot, I've also found taping to be helpful.

I think after the holidays I will try RFL, which Monte (a poster on this site) has found helpful.

Good luck, and let us know how you're doing.

Re: Burning in Arches with PF

Dr. Z on 12/16/03 at 17:17 (140102)

RFL maybe exactly what you need.

Re: Burning in Arches with PF

Pauline on 12/16/03 at 17:33 (140104)

When your P.F. began would you characterize it as typical P.F.? How and when did you notice it changing to your current condition or was it this way right from the beginning?

I'm wondering if long term P.F. sufferers go down the same paths. What if anything is similar between long term patient's cases?

I don't know of any studies done on long term P.F. patients. Quite honestly it looks like no one cares either, but with so many people getting P.F.long term maybe some should be done

Re: Burning in Arches with PF

john king on 12/16/03 at 17:54 (140107)

I have long term PF I think. The pain used to be first step pain and then evolved into just chronic painful feet. Now my feet hurt all the time and feel tender and sore. I used to stand and walk for hours and now after many years of PF I can't walk or stand for more than about 15-20 minutes without severe pain. I wore orthotics for 15 years.

Re: Burning in Arches with PF

Pauline on 12/16/03 at 18:06 (140110)

After reading posts from long term P.F. sufferers like yourself, I wonder if it would be worth while to document similarities, a study of individual progression through the years.

As most of us know, P.F. doesn't seem high on the research list and is taken so lightly that it's long term affects are severely discounted.

Maybe we need to make a case for more research.

Re: What is RFL

Pam S. on 12/16/03 at 19:40 (140117)

I know I should be able to figure this out but I cannot.....??? THX!!

Re: What is RFL

Pauline on 12/16/03 at 20:48 (140122)

This is one of Monte's posts. I hope it helps. Recently he posted a very good description. If you do a search under his name you'll find it.

Re: plantar faciitis injections to deaden the nerve? View Thread
Posted by monte on 10/30/03 at 21:25

There is a procedure called RFL (Radio Frequency Lesioning) that is used to deaden the nerve's pain receptors. I had it done on both heels and it has helped. I never heard of the shot that you are speaking about. RFL can last forever. It works best when you are able to accurately pinpoint your pain spot or spots.

Dr Cozzerelli is the doctor that I go to to perform this.

Re: Burning in Arches with PF

Steve on 12/16/03 at 22:47 (140126)

Thank you everyone for responding to my posting on burning arches.

My problem started as fairly traditional PF with morning pain but it started out at a very low level. I was recovering from a very bad ankle sprain at the time when the foot pain started. Since it started on the same foot as the sprained ankle I did not realize it was foot pain. Then I started getting pain getting out of bed in the AM. I went back to the DPM and he gave me spenco orthotics(the green ones) He never told me I had PF so I still assumed it was related to the ankle. I was kind of in a confused state for a few months thinking it was related to the ankle. My feet did not hurt too bad when I wore shoes with the spenco's. The problem was we never use to wear shoes in our house and we have hard wood floors. I use to walk around bare foot or in socks for hours in the house. After a couple more months of this I started to get unbelievable pain after walking around bare foot. By the end of the day I could hardly walk. At this point I went to a new dpm (this is 6 to 8 months after the first low level pain. The new DPM told me I had PF made me custom orthotics and gave me stretches. But at that point it was too late.

The pain slowely transformed to the current burning pain. I now never go barefoot even in the shower. Use the orthotics, do stretching all the time and use the foot trainer. I have since been to a third DPM who made me new orthotics ( much bigger arch) and has recommended release surgery (which I will not do). I have probably been at the same pain level point now for 1.5 to 2 years. There are days when the pain is very low level and I say to my self this is not too bad, but other days the burning is really bad.The interesting thing is low activity level seems to make it worse. Especially sitting all day at a desk. Going to the gym or walking even for 1 to 2 hours make the pain less. Birkenstocks are the most comfortable foot wear for me.

Can someone please tell me more about neurontin (who gave you the RX) and about RFP. Does any one think ESWT would help. Maybe Dr Z could explain what is happening in my feet.

Thanks in advance and Happy Holidays.

Re: Burning in Arches with PF

Julie on 12/17/03 at 03:44 (140128)

Steve, may I ask what stretching you are doing 'all the time'? It could be that you are doing too much stretching, or stretching of a less-than-helpful kind. It's natural to want to 'do' something to get rid of pain, but it's awfully important not to 'do' too much, and to be sure that what we are doing is the right thing to do. And the mind can play tricks: something that appears to lessen the pain may make one feel better immediately afterwards, but may actually be causing setbacks.

If you can give us an idea of the exercises you do, maybe we can help. For example: what are you doing in the gym? I'm not suggesting that anything you're doing is wrong, just that doing too much of something that isn't really right may be a key to your situation.

Re: What is RFL

john king on 12/17/03 at 07:21 (140131)

I had RFL done on my cervical spine and surrounding nerves. It did not help me but then the injections did not help me either. What RFL does is it cooks the nerves so they are supposed to die.

Re: Burning in Arches with PF

john king on 12/17/03 at 07:27 (140132)


Yeah, I think many health care people make slight of PF and so do social security and other disability agencies. I have never heard of anyone getting SSDI for PF even though it can cripple you. You might get SSDI after failed surgery that lands you in a wheelchair. I went to VA clinic and saw the podiatrist. He said there is nothing he can do except shots or orthotics. Neither work for me anymore. I just hobble along with the pain and continue to collect my disability check every month. I don't get it for PF but the PF helped disable me from work.

Re: What is RFL

Terry L on 12/17/03 at 08:51 (140138)

I had pulsed RFL a month ago and this procedure doesn't burn the nerve it scrabbles them. This is supposely a fairly new treatment. However I got this done for RSD and it was done next to the cervical spine by the sympathetic chain.

Re: Burning in Arches with PF

BrianJ on 12/17/03 at 08:57 (140139)

Steve --

I agree with Julie regarding stretching. My burning problem definitely improved when I stopped stretching so much. You may want to lay off stretching for a while and see if it helps.

Re: Burning in Arches with PF

Pauline on 12/17/03 at 13:22 (140143)

I don't mean to get personal, but when you rub your hands over your arch area where the pain is located do you feel any lumping or jello like interior?

And secondly do you notice additional pain when your stress level or
anxiety lever is up?

One practive I always make a habit of is sitting with my feet both planted flat on the floor. This seems to help keep the fascia stretched when I'm sitting for longer periods of time. Know knee crossing.

On days when my stress level is higher, I will notice a slight return of pain then it passes and I've never gotten rid of what feels like a thin jello substance under my arch. I can actually feel something that feels like thick jello instead of being flatter like the other areas. The best way I can describe it is like jello shots in a baggie. You push on one side and the stuff moves to the other.

Do you have anything like that?

Re: Burning in Arches with PF

Steve on 12/17/03 at 15:51 (140150)

Thanks Julie, Brian and Pauline for your thoughts. Here are the answers to some of the questions you raised:

The exercise I do vary from day to day but include the following. Walking for about 45 minutes, swimming the crawl for about 30 minutes, a bunch of the cybex machines at the gym. Leg press, hamstring curl, hip abductors and hip aductors(sp), recumbent bike, walking on treadmill, elyptical trainer, and some of the upper body cybex machines. I do not do all of these every day but try and do at least one every day.

The stretches I do include the following; sitting up on floor pull back on toes with towel, lying on back leg in air and straight and pull down on foot with towel,leg stretch in door way, level 1 of foot trainer, light wall stretch for calf (runners stretch) and wall stretch for calf with foot in the blue rocker thing that is sold on this site, and standing quad stretch. I find that the next day after stretching the pain is less.

Regarding some of the other questions. If I am stressed or under a lot of pressure the pain is worse. I do not have the jello feeling that you described. However, about 1 year ago the DPM did an ultra sound test and said I do have some fibromas on the fascia and some areas where it is enlarged. No heel spurs. If I press on the fascia it hurts more at the attachment to me heel that along the middle of the arch.

This site is a great way to exchange info that will help everyone, Thanks

Re: Burning in Arches with PF

john king on 12/17/03 at 15:59 (140151)

I would say to keep doing the low impact exercise as much as possible. Once the pain or condition keeps you from walking then you are headed on a downward spiril. I say this because walking is basic to a healthy spine and muscular system. I would just do whatever I could to keep my mobility. If you can walk 1-2 hours you don't need surgery. If I could walk for 30 minutes without pain I would be happy. This condition can get much, much worse. Neurontin might help if it is nerve pain. I would try it.

Re: Burning in Arches with PF

Dr. Zuckerman on 12/17/03 at 16:32 (140159)

If you don't have discrete insertional plantar fasciitis with pain after sitting for any period of time then neither ESWT or PF release is going help you.

If is possible you have posterior tibial dysfunction. You may even have problem with your nerve receptors. This is why I recomended RFL if in fact your pain receptors are the root of your problem
Neurontin is used for neuropathic burn. Seems to help burning alot.

Re: Burning in Arches with PF

SteveG on 12/17/03 at 16:33 (140160)

Steve - that is a bit intense routine for someone with PF. First of all, I would give it up on the treadmill. The treadmill is what gave me PF, and many posters have mentioned the same thing. In fact, one of the pods mentioned that the treatmill can often cause PF. I would also cool it on the leg presses. They put a lot of pressure on the bottom of your feet. I was doing them for a brief period to help with a problem with my knees, and they made the PF a lot worse.

Re: Burning in Arches with PF

Pauline on 12/17/03 at 17:35 (140165)

Any difference in a treadmill and just walking outdoors as far as making one's P.F. worse?

I got my first case after starting a walking program. Everything was fine for the first year, then one morning it hit like lightning. I had no clue it was coming.

I can't pin point anything else to it's beginning.

Re: Burning in Arches with PF

Dorothy on 12/17/03 at 18:03 (140170)

Shoes that have taken a pounding for a year? Hard surfaces? One year's worth of aging? Repetitive overuse injury? Doing no exercise other than the walking program i.e. the repetitive overuse? What were you walking on?

Re: Burning in Arches with PF

Dorothy on 12/17/03 at 18:07 (140171)

Is a leg press the same thing as a squat but done on a machine? Is this where you lie on your back with your knees bent and your feet against a surface and you 'push off' with your feet/legs until your legs are straight? Is that a leg press?

Re: Burning in Arches with PF

SteveG on 12/18/03 at 00:06 (140187)

Yep, that's a leg press

Re: That's an awful lot of stretching!

Julie on 12/18/03 at 05:14 (140193)

...and I would be willing to bet that it's impeding your recovery. I believe you when you say that the pain is less the following day, but I'm concerned about the overall, long term effects of such an intense, sustained level of activity, so much of it weightbearing. I'm probably talking into the wind here, because I know how difficult it is for an exercise freak to change tack (I used to be one, and wouldn't have listened to anyone who advised me to cool it) but I really think you should re-think your programme in the interest of your future foot health (and general health, because your feet are always going to impact on that).

Weightbearing exercise is not useful for most people with PF. The things I am doubtful about in your case are:

(1) the treadmill
(2) the eliptical (not as bad as the treadmill because no impact, but still weight-bearing
(3) the leg press (very likely to pull on the fascia at the insertion point, as Steve G says)
(4) the wall stretch (again, weightbearing)
(5) the standing quad stretch (weightbearing again, and possibly the worst of all, because while you're stretching one quad, ALL your weight is on the other leg)
(6) walking 45 minutes (if you can do this without needing to be carried home your PF can't be all that bad, but I don't want it to get worse or get chronic)

If you did step back from all these, the decrease in your activity level might make you very unhappy, and that would increase your stress level - not a good thing. So I would suggest you increase all the other gym work you're doing. Apart from the leg press, the lower body stuff is fine, and you could also do more upper body work. You could also increase your swimming to an hour: this would replace the cardio effect you're getting from the treadmill and the elliptical. In fact, if you swam for an hour every day you would get all the exercise you need without doing any damage to your feet. If you enjoy swimming, this would be a great option.

You mentioned in an earlier post that sitting all day makes things worse. Of course it does: it shortens your calf muscles and slows your circulation, particularly to the extremities. But don't just sit - work on your feet while you're at your desk. Do the yoga foot exercises once an hour - toe curling and stretching, ankle bending and rotations. And if you've let time go by without doing them, do them before you get up from sitting.

Finally, don't pull too hard on the towel. You're aiming to gently lengthen your calf muscles, but gently is the word: you don't want to irritate your achilles tendon or your fascia.

I hope all this is some help.

Re: Treadmill vs walking outdoors?

Julie on 12/18/03 at 06:01 (140194)

At least walking outdoors got you some fresh air. :) Seriously, though, I think either can be a factor in PF, especially if associated with increased level of activity, if other factors have predisposed one to it.

But I would guess (but it's just a guess) that the treadmill is probably more likely than normal walking to tip a vulnerable foot into PF, because people tend to 'go at it', increasing speed and incline. Walking fast uphill for the cardiovascular effect seems bound to stress a vulnerable PF more than normal walking.

Re: Burning in Arches with PF

john king on 12/18/03 at 11:07 (140207)

Dr. Z

When you say discrete insertional PF pain does that mean acutal heal pain? I don't have heal pain. My pain is the entire foot especially the arch and heel cord. So in my case ESWT or PF release would not be good? I am crippled up by this thing. Me feet are o.k. in the morning but start to hurt as I walk around during the day. The more I walk and stand the more my feet hurt. With rest the pain seems to diminish.

Re: That's an awful lot of stretching!

Steve on 12/18/03 at 12:37 (140213)


Your post was very helpful. I am going to modify my work out schedule based on your info. how about the recumbant bike?

Once again - Thanks for taking the time to give me so much information.

Re: That's an awful lot of stretching!

Julie on 12/18/03 at 16:29 (140236)

I'm glad you think what I said is going to be helpful, and I hope that it will. Don't forget to come back and let us know how you fare with a modified workout plan!

I think the recumbent bike is probably all right: just be aware of how it's affecting you.

Re: Burning in Arches with PF

Rose on 12/18/03 at 19:59 (140250)

Have you considered surgery? It worked for me....after years of surgery...I am sooooo much better already

Re: Burning in Arches with PF

Dr. Zuckerman on 12/18/03 at 21:17 (140256)

You probaby have what we call atypical pf. ESWT and or foot surgery isn't go to help you