is it possible to fully recover from pf ?Posted by Ron on 8/11/04 at 01:38 (157479)
from posts ive seen here, i got the impression that people do not recover from pf
is there any statistics regarding recovery % from pf ?
is there evidence of people who recovered without surgery ?
Re: is it possible to fully recover from pf ?Julie on 8/11/04 at 02:00 (157481)
Most people recover, with accurate diagnosis and appropriate treatment. An important factor is that the sooner PF is dealt with after onset, the more likely a relatively quick recovery.
The doctors here have often aid that 90% of cases of PF resolve with conservative treatment. These message boards attract the more recalcitrant cases, which have become chronic or which for one reason or another are more complicated.
Surgery is the last resort, after all conservative treatments have failed. For many who have tried, it has caused more problems, though for some it has been successful.
I am not a doctor, but I am a recovered person (without surgery).
Re: ...Ron on 8/11/04 at 02:44 (157482)
at last i recieve a direct answer ....
regarding your recovery,
can you do everything you want (long walks, running etc ) ? meaning
the problem has no effect anymore
how much time did it take you to recover ?
i would still like to hear more information from doctors
Re: ...Julie on 8/11/04 at 05:11 (157483)
Yes, Ron, I can do everything I could do before PF, everything I want to do. I don't run, but do a lot of hill walking and have no trouble.
I started dealing with my PF almost as soon as it began. Having searched the internet for 'heel pain' I quickly discovered this website, and the heel pain book, which put me in the picture. At the same time I went to a podiatrist, who gave me a very full examination including an evaluation (by treadmill and video) of my biomechanics). Rest, taping, orthotics, and good shoes were the mainstays of my recovery, which took about five months.
I am quite sure that the two factors which were crucial were the full evaluation and diagnosis that I had, which identified the cause of PF, and dealing immediately with it.
Re: ...Dr. David S. Wander on 8/11/04 at 13:12 (157554)
Ron, statistics vary but the national average is probably 80-90% in reference to patients that recover from plantar fasciitis without surgery.
Since I am very aggressive with plantar fasciitis, I would say that at least 95% of the patients seen in my office recover without surgical intervention or ESWT.
However, since mechanics can play an important role in plantar fasciitis, there can be recurrence if the cause of the fasciitis is not addressed. Therefore, proper weight must be maintained, flexibility of the Achilles and hamstrings must be maintained, proper shoegear must be worn, any orthoses that you have should be worn, etc.
I personally have had plantar fasciitis for many years, and obviously I know the treatments that work for me. However, my daughter swims competitively, and when I'm walking around the pool barefoot (even though I tell patients not to), by the end of the swim meet my heel is hurting. Fortunately, as soon as I resume my orthoses or PowerSteps and good shoes, my discomfort resolves quickly. I hope this information helps.
Re: is it possible to fully recover from pf ?Ed Davis, DPM on 8/11/04 at 14:38 (157569)
Yes and the key is to 'arm' people with information as this site does.
The toughest cases are the ones that have chronicity and and have been undertreated or 'mal'-treated for an extended period of time. ESWT has finally given us a big tool for the tough cases.
Re: ...Ed Davis, DPM on 8/11/04 at 14:43 (157570)
I think the key is to be agressive with conservative treatment -- a concept that sometimes does not register with the medical community at large. I teach residents (PSR-24) and agressive to the residents equals surgery -- they have difficulty seeing how one can be aggressive with conservative treatment (any hints on how I can get this message across to them?)
Re: ...Julie on 8/11/04 at 15:22 (157579)
Ed, I know your question was addressed to Dr Wander, but I'll put my two cents in. Surely the key is thorough evaluation and accurate diagnosis of the problem and its cause(s). From that follows a comprehensive treatment plan that addresses the cause(s). That takes skill and experience on the part of the doctor, and intelligence and patience on the part of both doctor and patient. In comparison, surgery may be the easy option: could that be what some of your residents (and their patients) are after?
Re: ...Dr.David Wander on 8/11/04 at 19:20 (157601)
Ed, I was a residency director for a surgical program, and the residents weren't happy if they weren't cutting. I used to have the residents rotate through my office to see that the post op regimen is not always as easy as the actual surgery. This also exposed the residents to patients that were undergoing aggressive conservative care and this allowed the residents to see how happy patients can be with non surgical care and that often these patients left the office with significant relief, not to mention that these patients are an excellent referral source. When these residents experience their first post op complication, you'll see their enthusiasm for conservative care skyrocket!
Re: ...Dr. Z on 8/11/04 at 19:39 (157606)
One important pearl is to teach the difference between plantar fasciitis and plantar fasciosis. Once that concept is in place maybe the resident will start to understand pf DISEASE