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How to find out the right PF-diagnosis ?

Posted by P A Persson on 5/04/04 at 04:12 (149984)

After reading Scott´s heel pain book and this messageboard for several month, i still don´t understand the difference between what doctors call heelspur, PF and in some cases Cronic PF. Sometimes it seems to be different words for the same thing (with all the same measures) and sometimes it seems to be a slight difference (with different measures depending on the diagnosis). Is there a difference in diagnosis and measures?
The doctors I´ve met allways stucks with the diagnosis 'heelspur', without doing MRI and in most cases even without a proper examination of my feet ('use orthotics, good shoes, rest your feet as much as possible and it will pass away'). I´ve got the feeling they don´t understand the complexity of the problem, specially if I compare with the knowledge I found in this messageboard and in Scott´s heel pain book.
I would say i´ve got 'cronic PF' (unable to walk for 1,5 years), but I don´t know if that is the case or if I am doing the right measures to heal up (orthotics, good shoes, almost no walking, stretching, icing)?

Re: How to find out the right PF-diagnosis ?

SteveG on 5/04/04 at 09:51 (149991)

The 'spur' is caused by the strain of the fascia pulling on the heel. However, not everyone that has PF has developed a spur. Chronic PF just refers to PF that has persisted over a length of time - over 6 months. The spur shows up on an ordinary x-ray. You cannot tell if you have one by simply examining your feet.

Don't worry about the spur - as you noted in the book, the spur is not thought to be the cause of the pain and the treatment if the same whether you have developed one or not.

Re: How to find out the right PF-diagnosis ?

Ed Davis, DPM on 5/05/04 at 16:04 (150092)

As Steve mentioned, the 'spur' is not really central to the problem. In fact, it really does not exist. It is a shelf of bone that forms at the origin of the plantar fascia. Since x-rays are two dimensional, the shelf is viewed from the side creating the appearance of the 'spur.' The shelf represents elongated bone to which the fascia attaches and may represent an area of excess pull of the plantar fascia -- that is where the relevance ends.