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Is the surgery worth it? Please advice me!

Posted by Karen C. on 4/19/04 at 21:05 (149167)

I have dealt with foot pain for over 3 years now. As many, I was diagnosed with Plantar Fascitis. I went to PT for many months. The first time I went, it was much better after a hand full of visits. About 6 months later, it flaired up worse than ever. After months of PT, I had no relief. I've had it injected about 6 times in different spots. None of them have helped. In the past, I was treated by my Pain Management Doctor. She referred me to an Orthopedic Surgeon. At the first visit, he agreed that I had Plantar Fascitis. However, he feels that my main problem is Tarsal Tunnel. I go for a nerve conduction test next Tuesday. He claims that I will need surgery. For those who have undergone surgery, was it worth it? I had a lateral release on my knee 3 years ago. The pain is now returning. I'm scared to go through all of that again for a small amount of relief. Also, the Ortho Doctor said that I would be recovered in 4-6 weeks. Thats what the other Ortho Doctor said about my knee. I was almost a year before I was more or less pain free. I have 5 children. It's really hard for me to be down. I would GREATLY appreciate any advice you can give me!!

Karen Cunningham

Re: Is the surgery worth it? Please advice me!

Ed Davis, DPM on 4/20/04 at 00:00 (149182)

I would base a decison for surgery, in part, on the results of the NCV. Stating that one needs surgery before an NCV has been done is like 'putting the cart before the horse...' See Scott's Heel Pain Book as it sounds like you never had a complete treatment for your plantar fasciitis?

Re: Is the surgery worth it? Please advice me!

Karen C. on 4/20/04 at 07:12 (149204)

Can the nerve test show without a doubt that it is Tarsal Tunnel?


Re: Is the surgery worth it? Please advice me!

LARA on 4/20/04 at 07:17 (149205)

A positive NCV test is considered VERY reliable in diagnosing TTS. A negative test does not mean you don't have TTS. It has a low false positive, but significant false-negative.

However, even a positive NCV doesn't mean you should do surgery (although the previous poster is right, it's a good prerequisite to having surgery). It depends on why you have TTS, and how effective less invasive treatments are.

Re: Is the surgery worth it? Please advice me!

Karen C. on 4/20/04 at 07:30 (149206)

I have orthotics and have had for almost 2 years (I have severe back pain also). I've been in and out of PT for at least 3 years. We've tried ice packs, heat, Ionto, deep message, stretching, and everything else they have in the clinic. The one thing we haven't done is taping. Not sure if that would help at this stage. I see my Pain Management Doctor today and will get her opinion on it. She is not a big advocate of surgery. However, she has injected this foot many times and when nothing helped she referred me to the ortho doc.

So what I'm hearing is that we need to find the cause of the foot pain even if the nerve test comes out positive before considering surgery?

Karen C.

Re: It was worth it for me!

Carol D on 4/20/04 at 07:50 (149207)

Hi Karen,
I had surgery 10 1/2 months ago. I had had severe TTS symptoms for 1 year. An MRI finally showed a small tumor entrapping the nerve. The surgery was very successful. The recovery has been slow, but I have never had pain (only tiredness in foot when doing too much, too soon after surgery). The success of surgery, I believe, rests on the underlying cause of TTS. For me, it has given me my full life back. I am delighted with the results. Good luck in your quest. Carol D

Re: Is the surgery worth it? Please advice me!

LARA on 4/20/04 at 07:56 (149208)

Have you tried compression socks. I suffered with TTS for three years, finally got to a doctor that knew TTS, and within days of getting compression socks was feeling better and within months lead, and continue to lead, what looks like a normal life. I was able to avoid surgery : )

I suspect compression socks work best in people with TTS because of varicose veins (although many times it is impossible to know before surgery whether you have a varicose vein in the tarsal tunnel - I still don't know whether I do or not) or water retention issues. If you have a known mass or injury or scar tissue causing the TTS, I doubt compression socks would work but who knows.

I had orthotics too and they helped - slow the progression. AFter I had compression socks I realized the orthotics weren't adding anything and they sit in my chest of drawers.

Taping also helped for me - but was so much more inconvenient - and felt wierd - and I got a fungus infection. However taping is worth a try too.

Re: Is the surgery worth it? Please advice me!

Scott M. Reeves on 4/20/04 at 12:21 (149225)

It was worth it for me - BOTH Feet (see my other post from today)

Re: Is the surgery worth it? Please advice me!

Elaine T on 4/20/04 at 16:40 (149236)

Karen, I don't yet if my surgery worked, because it's only six weeks. But for me personally, I had to try. I think your doctor is being very optomistic about the recovery time.

Re: Why did this post three times?

Elaine T on 4/20/04 at 16:42 (149239)

so sorry about that

Re: Is the surgery worth it? Please advice me!

chris on 4/22/04 at 09:14 (149343)

Surgery worked for me also. Like you I was first dx with PF and after months of PT somehow the doc clued into the possibility of tts. Had a nerve test that was positive for something going on and surgery was scheduled.

I had both a pf release and tts. The doc found some fatty tissue surrounding the nerve and a vein.

Surgery was in 11/00 and I have been pain free since.

I shoudl also note that full recovery took longer than 6 weeks. I think I took 4 weeks off of work, wore sneakers for about 3 months, had to have pt becuase of scar tissue. My best guess was that by summer I was fully recovered.

Re: Is the surgery worth it? Please advice me!

Terri on 4/22/04 at 18:52 (149372)

I fully agree with what has been said here: get your tests done first, confirm the dx, then re-confirm it with another dr. Your dr is being VERY optimistic on the recovery time. Altho you might be on your feet within 2 months (meaning without crutches or a 'boot' on) it's going to take a long time for the nerves to settle down. I had surgery done almost 4 months ago and things are still not right yet, altho they are better.

Today, my dr's office called to schedule surgery on the other foot, I didn't return their call. Still need to think on this a little more and may wait up to a year. It's a lot to put up with, but once you have all your facts in front of you, ask if it's worth it living as is or taking the chance. For all of us, it's a very personal decision. We'll listen as much as you want to discuss with us your fears and frustrations. We've all been there and are still going thru it. Good luck to you and let us know how things go.

Re: Is the surgery worth it? Please advice me!

Karen C. on 4/23/04 at 09:33 (149405)

Thank you all for being here to listen to my concerns. My pain doctor suggested that I go to a Physical Therapist and be fitted for the more expensive orthotics. I'm not sure I want to put the money into them if they are only a temporary fix. I've had the temporary orthotics for many years. The pain doctor also has me wearing lidocaine patches over my heal for a week. I haven't noticed much of a difference yet. I'll go for the Nerve test on Tuesday then I'll have all of my facts to decided what to do next.

Those who have had the Nerve test...does it hurt??


Re: Nerve TEst

LARA on 4/23/04 at 10:33 (149410)

I liken the NCV test to going to the dentist. It's not the most pleasant experience in the world. But relatively easily tolerated and well worth the momentary discomforts. Depending on how anxious you get about such things, if you have a system for calming anxiety (drugs, medication, Reiki, breathing, whatever) you might try it before going to take the edge off - but I didn't and I wouldn't hesitate to get another one if I needed it.