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Accessory Navicular problem ultrasound or electrical stim?

Posted by Louise on 6/29/04 at 00:03 (154137)

I have been having a great deal of pain in the ankles and feet when I walk along with the numbness and tingling by evening.

I've worn a fairly hard orthotic for many years (fairly hard plastic coated with sorbethane) and in the last few years, I've been getting more pain. A new pair of orthotics (similar in concept) led to no improvement at all..

Foot and ankle orthopedist diagnosed me with accessory navicular and very very flat feet. He said that I need PT to gain strength, ultrasound, and I need to learn certain exercises . He also said he didn't believe in orthotics. I have to say that I stopped wearing my running shoes and my orthotics for the last week. I've replaced them with Teva sandals - I feel somewhat better!

The Physical Therapists where I go are all annoyed because they say that electrical stim is far superior to ultrasound - but the doctor didn't recommend stim. They say there is a lot of research suggesting ultra sound is only slightly effective and then only for some people. Electrical stim is much more effective, they say.

Does anyone have any thoughts and/or information about this?



Re: Accessory Navicular problem ultrasound or electrical stim?

Dr. Z on 6/29/04 at 10:12 (154148)

Do both !!!. May want to also add ionophorisis

Re: Accessory Navicular problem ultrasound or electrical stim?

Louise on 6/30/04 at 09:17 (154207)

They wont let me do both. The physical therapists are limited to 20 minutes per person by insurance and they are supposed to go over exercises, teach me more exercises, and do whatever treatments are involved.

They do stim. I can pressure them to do ultrasound INSTEAD OF stim, because ultrasound is what's written on the prescription. But there is no way to get both.

What is ionophorisis?

Thanks Again.


Re: Accessory Navicular problem ultrasound or electrical stim?

Ed Davis, DPM on 6/30/04 at 12:01 (154243)

PT can be helpful but an accessory navicular creates a mechanical imbalance requiring a good orthotic.

Re: Accessory Navicular problem ultrasound or electrical stim?

Louise on 7/01/04 at 22:58 (154360)

I had what I thought was a good orthotic for years. They were made by pedorthists from a foam mold and then a cast. They had a plastic arch, soft sorbethane covering, a soft met pad and posting.

Over the last year, the arch began aggravating the pains in the foot and very much in the inner ankle. I had a new orthotic made with a new mold, but the same thing happened.

I saw a foot and ankle orthopedist, the one who xrayed and diagnosed accessory navicular. He doesn't believe in using orthotics at all, saything they weaken the muscles.

I'm seeking a second opinion (out of my own pocket because insurance wont pay). I'm not sure what I need. At the moment, Teva sandals are causing much less pain than the orthotic inside a running shoes.

My guess is that I need a very soft and only mildly supportive orthotic as a compromise between those who say I must have an orthotic and those who say they're no good for me.

Might this be a viable compromise?


Re: Accessory Navicular problem ultrasound or electrical stim?

Pauline on 7/02/04 at 08:26 (154374)

I'm not a doctor, but I've never been able to wear any of the custom orthotics I've had made. My belief 'Sometimes our feet know better than our heads'. I personally think you already said the magic words you've found comfort without them. Part of your relief could come from the fact that by wearing a sandal your foot is not enclosed by a shoe pushing against the extra bone. If the next doctor says orthotics you can try them again to your specs. based on your earlier experience and sample orthotic at hand, but try to get a guaranteed return policy so if they don't help you can get your money back.

What ever you do don't jump into surgery to remove that bone without serious consideration and study. Also read up on the subject on the internet and in Pub. Med.

Re: Accessory Navicular problem ultrasound or electrical stim?

Ed Davis, DPM on 7/02/04 at 22:54 (154432)

There are a number of specific orthotics designed for your problem that go beyond the 'average' orthotic -- Richie brace, Arizona brace, Mueller TPD...