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plantar fasciatis

Posted by Stefani on 3/09/04 at 17:46 (146557)

I was diagnosed with plantar fasciatis about 2 years ago and the doctor I was seeing at the time, his course of treatment was weekly and bi-weekly injections. This went on for 13 weeks, when, I learned from this group that was not a good thing, so I sought out a new doctor. This new doctor tried physical therapy and after about 3 months, we decided to go ahead and do surgery, as I had no improvement in symptoms. I had endoscopic surgery. It will have been 1 year on 4/17/04 and I am still no better, sometimes I feel I am worse. I wear an orthotic with tennis shoes 80% of the time, and birks the rest. I sleep all the time with a night splint. I have been on anti-inflamitories for almost a year for this problem and others.

I am am at wits end, I don't know what to do. I have gained weight from sitting on my butt for over a year, walking and standing for more than 15 -20 minutes at a times really start causing pain. I also have a really hard time finding shoes that orthotics will fit into.

What can you suggest?

Re: Holy $%#$* cow

SteveG on 3/09/04 at 19:54 (146565)

I am sorry, Stefani, but where do you find these guys! The first one shoots you weekly and bi-weekly, inviting all kinds of additional problems, and the second one decides to operate on you after 3 months!! This is NOT an adequate time frame for deciding if conservative treatment will work for you. He decided to operate on you because you could not get ESWT covered? And DON'T tell me he never mentioned ESWT as an option. I swear I am so lucky to have had the pods I have had (including Dr. Davis). The number of incompetent and negligent practitioners out there is alarming, to say the least. Although I am not big on litigation and its role in our society, somebody needs to start suing the pants of these characters.

Sorry about this rant, but this kind of thing really pisses me off, and you see it all too frequently on this board. Now to answer you question, you should look into high energy ESWT as an option. It is often used with failed surgery. And when you mention it to your pod, he better not say, 'high energy what'

Re: plantar fasciatis

Dr. Z on 3/09/04 at 22:07 (146583)

Did you have pain when you first got up in the morning and then tried to walk. Did you or do you have pain after sitting for any length of time and trying to walk. I am trying to determine if in fact you do have proximal insertional plantar fasciitis.

Re: plantar fasciatis

Barbara C. on 3/09/04 at 22:39 (146585)

I am a lst.timer doing this but my foot pain is wild. I have been to some of the best Dr. in Dallas truly smart guys. I try to stretch sometimes I've had one shot it worked for a few days and then pain back. Should I try how many shots ?? Will it really go away even if I do nothing say 2 yrs. from now?? I can't believe I got this. I wear Cole Hahn Nike Air Soles they help some but.... what about acupunture?? ZHelp Help!!!!!!

Re: plantar fasciatis

stefani on 3/10/04 at 07:34 (146594)

before I saw the doctor and started wearing the night splint, the pain at rising in the morning was so severe I would almost fall down. It is much better now with wearing the splint, but I still have it. I have pain that I notice while driving 40 minutes to work, when I first get out of the car, I am very stiff and have a lot of pain and stiff difficult walking.

Re: Holy $%#$* cow

Ed Davis, DPM on 3/10/04 at 22:46 (146646)

Steve:
No ifs ands or buts -- this poster needs an attorney -- http://www.footlaw.com
Her treatment is just too far outside the standard of care.
Ed

Re: plantar fasciatis

Ed Davis, DPM on 3/10/04 at 22:50 (146648)

stefani:
Did this occur in the US? If so, where?
Ed

Re: Holy $%#$* cow

Ed Davis, DPM on 3/10/04 at 22:52 (146649)

Steve:
We forgot to ask where Stefani had this treatment -- outside the US? I have asked her below.
Ed

Re: Holy $%#$* cow

stefani on 3/11/04 at 07:38 (146669)

I had the treatment in Athens GA. I really need help. The pain is really bad. It is almost covering the entire foot except the heel area now, even while sitting with absolutely no pressure on the foot except a shoe. Do I seek advice of a 3rd doctor or what? I can't go on like this. I am only 44 years old, walk like a 90 years old. Stay in pain all the time, and am fed up!

Re: plantar fasciatis

Linda G on 3/11/04 at 19:12 (146744)

I have suffered for almost 2 years with PF and TT and was told the feet are collapsing. I've been to 4 different physicians, orthopedic surgeon and have tried everything. I had 2 cortizone injections, taping, night splint, day boot, 2 different orthodics(which still hurt) anti-inflamatory medications of numerous varieties, ice, exercises daily, and you name it I've tried everything except surgery. The surgeon says that the surgery could make it worse than it is now. The swelling on the inside ankle bone is as painful as the PF. Does anyone have new suggestions as I have many other health factors, including fibromyalgia. I feel that at night I am trying to tense up that foot even with the night splint on. I am a part-time teller and have actually had to cut my hrs. back to a minimal. I don't think too many people understand this foot pain but I realize from this site that there are numerous people with these problems. Should I just wait it out and see if the PT and ice etc. will work or am I waisting my time? Thanks for any suggestions you can give me.

Re: plantar fasciatis

Ed Davis, DPM on 3/11/04 at 20:34 (146754)

Linda:
The swelling on the inside of the ankle bone may be due to TPD, tibialis posterior deficiency. That tendon passes by the inside ankle bone, attaches to the arch and is responsible for holding up the arch. If it is degenerating, it will feel like your arches want to collapse. Also, if swollen, that tendon can place pressure on the nearby posterior tibial nerve and be a cause of your TTS. You need a good MRI ASAP and to see a specialist who understands this-- see http://www.acfas.org to find someone in your area.
Ed

Re: Holy $%#$* cow

Ed Davis, DPM on 3/11/04 at 20:37 (146755)

stefani:
That is incredible. Contact http://www.footlaw.com as you need legal advice as well as medical advice. Get to a reputable practitioner ASAP -- one source is http://www.acfas.org
Ed

Re: plantar fasciatis

Ed Davis, DPM on 3/11/04 at 20:39 (146756)

Barbara:
A good start is to read the 'Heel Pain Book' on this site.
Ed

Re: Holy $%#$* cow

Dr. David S. Wander on 3/12/04 at 09:17 (146777)

Ed,

Although giving a large number of injections for heel pain syndrome is certainly not the standard of care, it must be established what kind of medication was contained in those injections. It is pretty well agreed upon that multiple corticosteroid injections can be harmful for a plethora of reasons. However, the doctor may have been performing simple nerve blocks with straight local anesthetic. I have certainly used nerve blocks in my office as a diagnostic and/or therpeutic modality, often with significant success breaking the pain cycle. Although I do agree that the large number of injections given is certainly not the 'norm', giving a series of local anesthetic blocks would certainly not constitute malpractice. If all the injections did contain a steroid, I'd be on the phone with the attorney also.

Re: Holy $%#$* cow

stefani on 3/12/04 at 09:52 (146778)

I do know one of the ingredients in the injection was Dexamethasone. So, what is your opinion now, considering that, the surgery and the pain. Do I seek a new doctor, or a lawyer or both. I plan to re-read the footpain book for sure!

Re: Holy $%#$* cow

SteveG on 3/12/04 at 11:32 (146790)

Dexamethasone is a corticosteroid. It sure looks like a case of negligence and/or incompetence to me

Re: Holy $%#$* cow

Ed Davis, DPM on 3/12/04 at 21:36 (146830)

Dr. Wander, Stefani and Steve:

There are a couple issues here. As Dr. Wander points out, if all the injections did not contain a steroid, then that would mitigate things. The other issue is, say, that the injections did not do a great deal of harm, I would have a problem with the fact that they were used as a substititute for care that is within norms that are discussed on this site. As such, Stefani had questionable treatment from a professional whom she had placed confidence in to treat within the standards of care.
Proper treatment was delayed by the unusual approach.

I, for one, do not like to dictate how others practice. Nevertheless, the mandate of 'first do no harm' must be an overriding consideration. I will always inform a patient if a treatment that I am recommending or about to administer is part of 'mainstream' medicine or 'complementary/alternative medicine.' Patients and practitioners should not be limited as to choices but those choices should be informed choices in which all understand the nature and consequences of treatment administered.
Ed

Re: Holy $%#$* cow

Sheila S on 3/15/04 at 05:15 (147024)

Well spoken, Dr. Ed