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Need advice - pain for 2 years now

Posted by DavidW on 7/20/04 at 08:58 (155908)

Dear Doctors, I am a 37 year old, 6', 185lb healthy male that has foot pain for 2 years now. I am completely discouraged and not sure how to continue. I have given up on doctors ($10,000+ in bills so far with zero relief). I am asking for your advice on how to proceed with my problem. I have been reading about ESWT, and wonder if it would work for me. Below is a summary of my foot pain history.

Hobbies up until January, 2002 included: Hiking, walking, biking, weight lifting, roller blading.

Pain History:
January, 2002 March, 2002: Foot pain begins very suddenly and for no apparent reason. First symptoms include very painful and throbbing heels upon standing or walking for any length of time greater than 10 or 15 minutes. Pain subsides slowly when sitting.

Mid 2002 - July, 2003: Pain continues when standing or walking for more than 10 or 15 minutes. Pain starts as discomfort, and increases quickly to an intense pressure/pain/burning sensation that begins in my heal and emanates forward into the arch. Activity extremely limited due to pain. Pain slowly subsides when off my feet. No pain in the AM upon waking. I began visiting Podiatrist #1 during this time period. He was convinced that I had a 'mechanical problem and prescribed custom orthotics. I wore the orthotics religiously during this period with no pain relief. Many visits to Podiatrist #1 and many adjustments to my orthotics with no pain improvement. He informed me to perform any activity that I wished, and provided no other advice. I tried to, but increased activity lead to extreme pain. He finally gave up on me.

December, 2003: Pain continues when standing or walking making physical activity impossible. Pain only when standing or walking, subsides slowly when resting, never in the AM. Also, it does not hurt at all when pressing on my foot anywhere (no hotspots). Went to see an Internist. Internist gave me a physical and ordered a blood series. All blood work came back negative.

January, 2004: Went to see a Hematologist (at the advice of the Internist). More blood tests, all with negative results. Went to see a Neurologist (at the advice of the Hematologist). Neurologist gave me an exam and scheduled an EMC.

February, 2004: Pain continues with no improvement. Still wearing the custom orthotics. Visited the Neurologist and had an EMC test, all results negative. Went to see Podiatrist #2, who ordered an MRI and X-Rays of my feet.

March, 2004: Second visit to Podiatrist #2. He gave me some cushy inserts and said to come back in 1 month. I asked about the MRI and X-Ray results, he said 'you would be hard pressed to find anything wrong , and prescribed physical therapy. I went home discouraged and began my own research. I found http://www.heelspurs.com .

March, 2004 - April, 2004: I began 4 weeks of physical therapy, 3 times a week. Therapy sessions included heat, electric stim, stretching, and ultrasound. I began my own stretching and icing routine, twice daily. I began using NSAIDS when pain is worst.

April, 2004: Went for my return visit to Podiatrist #2. I explained that I had no change in my pain and was limited to 15 30 minutes on my feet at any one time. No pain in the AM or to the touch. Pain subsides with rest. He gave me a different kind of cushy orthotic and said to come back in 3 months. I asked him about stretching, taping, icing, ESWT etc, he had no advice. I left discouraged and knew I would not return. I religiously continue my daily stretching and icing. Also began taping daily using the method described on http://www.heelspurs.com . I stopped using the custom orthotics because they caused more pain than not wearing them. I ordered and started using PowerStep insoles instead and they feel great.

April, 2004 July 2004: Stretching, icing and taping every day. Pain has improved a little so that I can take short trips to the supermarket etc. for 30 to 45 minutes or so. Each 30 minutes on my feet requires a couple of hours off my feet to recover. Still no pain in the AM or to the touch. Physical activity still very limited.

Tests to date: Blood series, physical, MRI, X-Rays, EMC, physical therapy, NSAIDS.

Doctors seen: Internist, 2 Podiatrists, 1 Hematologist, 1 Neurologist, 1 Physical Therapist.

I believe that I have plantar fasciitis (although no doctor has given me that diagnosis) although my symptoms are not typical of PF.

I just want to mow the lawn and play with my 2 year old without being in pain. Please help.

Thanks,
DavidW

Re: Need advice - pain for 2 years now

Marty from SLC on 7/20/04 at 13:02 (155920)

I'm not a doctor but your story is like many here. Don't give up, you must keep looking until you find a doctor who can help you.

Where is the pain?
Do have any burning?
Do you have any zingers?, (shooting shockers kind of like).

Re: Need advice - pain for 2 years now

DavidW on 7/20/04 at 13:52 (155923)

The pain is very generalized but begins in the heel area. If I am on my feet for more than a short while, the pain expands to the arch and other areas as well.

It is hard to describe, but the pain begins as a pressure, and gets more intense like a dull, deep ache. No definite pinpoints of pain or zingers. If I continue to remain on my feet, many times the pain will escalate to a burning sensation.

I feel that from Scotts book and other research I have done, I know alot about PF. As I spoke with both of the PODs I went to see, I feel like I knew more than they did and that was discouraging.

Re: Need advice - pain for 2 years now

Pauline on 7/20/04 at 15:08 (155930)

David,
I'm not a doctor either but as Marty suggests your symptoms are very similar to many others that have posted on this site.

From your time table it looks like you've gotten a bit of relief when you ditched the cusom orthotics and began using Power Step. This might very well be your turning point.

My advice would be to continue to do all the conservative treatments suggested in Scott's Heel pain book which you know you can look at on this site for free.

If you haven't added contrast baths with warm and cold water you your daily routine you might consider trying it. Massage your feet gently when in warm water but not in cold. Personally I think this helps to confuse the nerves a bit and might help.

Continue the stretching, taping and icing as well and every time you sit down use a cream to gently massage your feet ending by stroking them toward your heart. Gently stretch and massage the entire foot.

AS I said earlier I'm not a doctor, but after reading this site I think you have a good handle on what your diagnosis might be. Maybe getting rid the the custom orthotics in favor of the Power Steps might be the start of your recovery.

Listen to your feet and find and use what ever is comfortable for you as you did with the Power Steps.

ESWT is always an option and with Mark telling people how to get treatment as less cost might be something you want to try.

Other than that, it's just keep the faith and keep doing the conservative things that Scott has suggested in his heel pain book.

My Medical Disclaimer:
I am not a doctor and the above post is my personal opinion. Everyone experienceing any foot pain should be properly evualated by their physician. Hot water and ice can cause damage to bare skin and anyone using either for treating their foot pain should use caution.

Re: Hi David

Niels on 7/22/04 at 07:26 (156036)

I have read your story and just want to tell you that it -unfortunately- resembles my story very, very much. Even my daughter and I are of the same age.I really long to be able to carry and take care of my 2 yaer old daughter and to just be able to stand on my feet and to do all the things a man is supposed to.

Maybe you should consider ESWT. I received ESWT twice without any lasting effect, but maybe because i have suffered fro more yars than you have and probably because I did not get ESWT correctly. I live in Denmark, where ESWT is not at the same stage.

I believe that it is important to accept that the pain is part of your life, in order to prevent it from ruining your life. And to focus on the bright sides of your life. Of course still doing everything possible to fight the foot pain.

Niels

Re: Need advice - pain for 2 years now

Monte on 8/20/04 at 09:42 (158457)

David....This is Monte. Did we ever speak on the phone and email each other about a year or so ago? If I am wrong...I am sorry

Thanks
Monte