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Posted by Maureen R on 5/26/04 at 13:22 (151314)

I'm looking for any suggestions for pain relief. I had PF for more than 20 yrs. Did it all for relief (NSAID, injections, PT, ultrasound, accupuncture, etc - have worn orthodics for many years). Finally had plantar release on RIGHT foot 7 yrs ago. Biggest mistake of my life. Am now in agony. Had ESWT (post surgery, since I didn't know about it then), but don't think it's done any good; hasn't done any harm, though. Take Class II narcotics, but only helps some. Take Neurontin, but don't think it does much, either. Got the SDO's, but not enough support for an orthodic, now that I had fascia cut. I'm assuming that some nerve damage was done during surgery. I had a cerebral aneurysm clip inserted in my brain, (from head trauma from car accident - nothing to do with feet), so can't have MRI to find out exactly what's going on in foot. I also have epilepsy (car accident) and can't take anti-depressants. (I did try the only one, Trazadone, but it dried me out so much I couldn't swallow, even at reduced dose!) I've had my car altered so I drive with my left foot. Also have TTS in both feet, which is starting to kick in also. Now have the tingling in toe extremity, some burning sensation, etc). I am on my own & don't get any help with chores, so I barely do food shopping now. I still have at least 2 more years to work; drive is about 45 minutes. Obviously I've tried all the aspirin type creams and other topicals.
Whew! After all that, you get the picture - I am truly desperate. Any ideas for other treatments? Yeah, yeah, I do the night splint thing, too.


Ed Davis, DPM on 5/26/04 at 14:20 (151324)

When did you have the ESWT done? It does take twelve weeks to work and often requires more than one treatment.

How significant is the TTS?


dr kiper on 5/27/04 at 09:39 (151369)

Hi, Maureen R.
I looked up your records and noticed that you sent me one follow up [a few days after receiving them] after you received your orthotics. You said the following:

'I received my SDO's. I wore them for about an hour today & took a 20 min. walk. I couldn't wear them too long today. When walking, it did feel like a lump under arch and heel area in both feet. But my sore area from the surgery didn't feel any pressure, so it was nice to do even a little walking without the pain. So I'll try again tomorrow.'

I responded that it was too soon for me to really tell you anything at this point, but to continue [at least the first experience seemed to go well], and then follow the instructions which asked you to do a 'walking test' for me and report back with specifics for each foot.

Unfortunately I never heard from you again [that was 2 years ago]. And it is impossible for me to remember that you didn't contact me. This resulted in what is now a poor attempt at trying the SDO.

I'm sure we discussed the fact that making the orthotics work is an adjustment process, and to expect at least one adjustment. If there wasn't enough support, I could fix that.

I don't know why you weren't able to follow my instructions or contact me again. I also wish to remind you that foot orthotics do not work like eyeglasses [orthotics].


Maureen R on 5/27/04 at 12:55 (151391)

Dr. Davis,
I had the ESWT done almost one year ago. I know it takes 12 wks. I had originally figured on getting a second treatment (price included 2nd treatment), but then read several places that ESWT done on post-surgery cases is usually not very effective. I'm pretty sure most of my pain is now from nerve damage, which ESWT wouldn't help. I can't have MRI to make sure what problem is (aneurysm clip). It was quite a bit to go thru (10 injections in pained foot) & I'm on my own & need someone to help me get there. So all that coupled with what I read about it not being too effective on post-surgery cases, led me to conclude that second shot wasn't worth the pain. The TTS is becoming more pronounced; I also have it in left foot. I think I feel it more in left foot because the pain in right foot masks the TTS there. Fortunately, it's not yet constant. I've applied to work at home, hoping that would lessen some stress. But I've been told no. Do you think driving with left foot is making TTS in left foot worse? Thanks for your help.


Maureen R on 5/27/04 at 13:28 (151394)

Dr. Kiper,
Sorry, no disrespect or complaint intended. The SDO's do feel good, but as I said, since I had the fascia cut, I really need the support from hard orthodics. Your last sentence sounds somewhat hostile. I have quite a few other medical problems ongoing, & am usually exhausted from it all, so I just can't keep up with everything.


Dr Kiper on 6/01/04 at 09:16 (151685)

I did not want to have a Dr-patient communication via 'heelspurs...'
did you get my e-mail?


Dr Kiper on 6/01/04 at 09:17 (151686)

Actually if you didn't please feel free to respond to me:
(email removed)