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Plantar Fascitis questions requesting help!

Posted by Anne on 6/14/04 at 19:07 (152982)

I was diagnosed with pf 4 years ago. I was working as a new grad rehab PT and typically stood 8-10 hours/day 6 days/week and did a lot of squatting and lifting. I weighed 138 pounds, 65 inches and we had just got a new gym without carpeting. I was jogging to train for a triathalon at lunch on a treadmill and played barefoot sandvolleyball in the evening after work. I have a good arch, when not weightbearing, but I pronate in stance. The diagnosis was made the first time I went to see a doctor due to history and pain with palpation and there has never been any question about it. I had xrays taken in 2000 and 2002 which were both negative for heel sputs.

I have never had pain that 'traveled' on my feet and the pain has always stopped the moment I sat down.

I stopped running and playing volleyball, but the hospital where I worked was not real sensitive and productivity and volume standards are hugely important, and the implication was 'tough it out'. It was made clear to me that if I couldnt stand all day or lift patients from the floor, then I couldnt do my job duties which are required. After 18 months of pain, I changed jobs to one that includes travel, so I get car sitting breaks during the day. It is still very difficult for me to do activities such as grocery shopping and I tried to go to Disney World last summer but couldnt make the walk from the car to the entrance. I stay off my feet for the most part after work and cook from a rolling office chair. I do swim and pedal a recumbant bike several times a week in attempts keep my weight from creeping up.

My husband and I have put off having a child, because of the fear of the additional weight gain with my feet and the reguired standing and lifting duties of my job. Unfortunately, I am now almost in my mid 30's and quickly running out of time. I have tried ice, night splints, Mobic, stretching, toe curls, and custom orthotics (which was effective for a while) I wear tennis shoes everyday but on my birthday. (I did not work in ortho, so I did not have access to ultrasound, and I am not real sure how successful that is anyway.) I have not tried the steroid shots or casting, because I didnt know how I would make it throught the day at work. I have seen a podiatrist and ortho MDs.

I have been trying to research the Ossatron. Will I be able to work as a PT soon after the treatment? Is it typical to continue taking an anti-inflammatory after the treatment? What do doctors think is the success rate after 1 time? How much additional pain usually occurs if one has PF prior to pregnancy and then becomes pregnant? Can the treatment, Ossatron, be done if I am pregnant? (If I could afford to do another type of work, I would do it in a heartbeat). The ossatron is expensive and not covered by my insurance, but my husband and I are looking at selling our home, so I can decrease my hours. If I was your daughter or close friend, what would you recommend? To make matters worse, I have recently been diagnosed with hip bursitis on the same side that my pf is worse, by an orthopedic dotor who feels the bursitis is due to 'sitting too much' and wants me to stand more. (I was diagnosed based on location of pain, no physical testing was done)

Thank you very much for your time. I apologize for being long winded.

Re: Plantar Fascitis questions requesting help!

BrianJ on 6/14/04 at 21:44 (153000)

Hi Anne --

I'm not a doctor, but I've had PF for more than 7 years and have learned a lot. Here are my thoughts regarding your questions:

1. Try taping your feet (do a search on this site) to provide support and alleviate some or all of the pain. It can be a bit of a hassle, but it can also help a lot.

2. Try wearing Birkenstock sandles around the house. They have a very supportive footbed that decreases the pain for many PF sufferers.

3. Experiment with dunking your feet in a bucket of ice water each night for about 10 minutes. It doesn't feel great, but it does make the feet feel better afterwards.

4. Yes, ESWT is worth looking into, but ask a lot of questions before you commit to it. For example, what will the TOTAL cost be (including any doctor fees, anaesthesia fees, equipment fees, etc.) Get the total cost in writing up front. Also, if the first treatment is unsuccessful, will the second treatment be free, or will there be some cost? Generally, you can return to normal (non-athletic) activities very soon after ESWT, though your doctor will probably take you off of any anti-inflammatories for at least 12 weeks. How many ESWT treatments has your doctor performed. Can you talk with several of his ESWT patients?

5. If you've had PF for 4 years, I question whether you're getting any benefit from anti-inflammatories (other than a placebo effect). Long-term PF is generally a degenerative condition, not an inflammatory condition. This means the PF tissue near your heelbones has changed and is not as strong as it was originally. Check out tendinosis.org if you want to learn more about these degenerative changes.

6. Finally, a philosophical note. Life is too short to let an irritant like PF fundamentally change who you are. Sure, you can make small compromises like paying a neighbor's kid to do your grocery shopping (hate those hard floors!), keeping a bar stool in the kitchen to sit on while you're fixing meals, or keeping a plastic chair in the shower so you don't have to stand up. BUT -- Please don't give up motherhood, or walks in a grassy park, or other truly important things because of PF. Who knows, your child may grow up to cure PF!

I hope this helps you.

Re: Plantar Fascitis questions requesting help!

Madrid on 6/15/04 at 15:43 (153109)

Anne,

I hear your pain. I was like you, too. My PF got worse as time went on and I succumbed to the pain and agony. But I want you to try an alternative approach. Many times your pain may be a psychological factor. If you hold a lot of tension and anxiety you may have what's called Tension Myositis Syndrome (TMS). I'm not a doctor but I have benefited greatly from reading about TMS and how it contributed to the nasty pain and symptoms related to PF. I'm willing to bet that if you read this book your pain will diminish between 4 to 8 weeks. It did wonders for me. 80% of my pain is gone now and I hope to fully recover in a few more weeks.

Many folks may laugh at this approach. If you've tried everything, try reading this book before you pay for ESWT.

Book: 'Healing Back Pain' by Dr. John Sarno

Re: Plantar Fascitis questions requesting help!

Anne on 8/14/04 at 14:40 (157857)

Thanks Brian and Madrid. I thought I would try to see if I could get a doctor's response as well. I haven't read the book, but I got a 2nd opinion from a podiatrist and ortho doc (who specializes in foot and ankle)who both said I have classic pf. I have been getting alot of MD referrals at work for developmental motor testing (Peabody gross motor sacales) and it requires me to demonstrate jumping down 36 inches from a raised surface and hoping on each foot 8 times. It is just so painful! I want to find another occupation where I dont have to stand all day , lift, and now jump, but my parents paid for my PT education and will be furious with me.