Home The Book Dr Articles Products Message Boards Journal Articles Search Our Surveys Surgery ESWT Dr Messages Find Good Drs video

Frustrated after Doctor's Appointment

Posted by Lana on 11/17/04 at 08:51 (164153)

Sorry for the long post but I am feel really frustrated. I had an appointment with my podiatrist this morning. I have PF for over six months and this is a second podiatrist I am seeing. The first time I saw him was a month ago. He prescribed Celebrex and he also ordered customer orthotics for me. I've got my orthotics today. My podiatrist measured the thickness of the plantar fascia using ultrasound and he told me that inflammation is getting worse. He wants me to either take Celebrex or get a cortizone shot immediately. I don't feel good about both of these options. I took Celebrex for two weeks last month. I stopped it because of all the publicity about Vioxx. I did not have any pain in my heel while on Celebrex but the minute I stopped it, the pain was back. So my feeling is that it was masking the pain but it did not do anything for inflammation. I have high tolerance for pain and my pain is not that horrible so I don't feel that I need to take pain medications constantly.

I told my podiatrist that I have already tried Celebrex for two weeks and I did not see results. I also did phisycal therapy during last two months (I had 15 treatments) but it did not do anything for me. I am using night splint every evening. Now I want to give orthotics some time to see if they will make my PF better and I don't want to do anything else during this time. He did not agree with me... Now I feel much more frustrated than before this appointment.

Again, sorry for the long post. What do you think I should do?

Re: Frustrated after Doctor's Appointment

Elyse B on 11/17/04 at 09:37 (164155)

join the frustration club. I have seen about 4-5 podiatrists. Keep reading these boards, trying different things and don't depend on a podiatrist to 'cure' you. Orthotics are the only thing they know.

Re: Frustrated after Doctor's Appointment

Lynn F. on 11/17/04 at 10:33 (164162)

Have you considered shockwave therapy (ESWT)? It sounds like you may be a candidate. They say 6 months is the right time to consider having it done. I had it 6 done weeks ago and is still early yet. I have good days and bad. They say it can take 6-12 weeks to see improvement. You may want to look into it.

Before having ESWT I was taking Vioxx then Bextra (which is also being touted as unsafe. Ugh!!) Once you have ESWT you cannot take anti-inflammatories as it can prohibit healing. Good luck.

Re: Frustrated after Doctor's Appointment

Pat on 11/17/04 at 10:34 (164163)

Ultimately the decision is up to you - I've been through this route with every treatment known to mankind before they couldn't do anything else and I had surgery on 11/3 (my insurance wouldn't pay for ESWT so I didn't try that). I also had orthodics after my bout with PF last year and it came back a year later so I've been through it all. The problem with PF is that it's chronic and you have to do the stretches, icing, etc. diligently. Last year mine was 'cured' with a cortisone shot (the most painful thing I ever had done) but even with wearing the orthodics for a year it came back. If you're not happy with this doctor try a third one but he seems to know what he's doing as far as the ultrasound and all that. The problem is that orthodics is not an overnight fix - it takes a while to get use to them so you may want to consider that.

Re: Frustrated after Doctor's Appointment

LARA on 11/17/04 at 10:50 (164165)

Lana. I had similar symptoms. I never had my plantar tested, but was diagnosed with PF and took ibuprofen (12-16 tablets a day) which worked for many months at keeping the discomfort under a threshold that made me a bitch, unfit for human companionship. However, it didn't cure anything because I didn't have PF, I had TTS. The treatment for me (works for lots of people, doesn't work for lots of people) is to wear compression socks. You might try that and see if it helps.

Good luck.

Re: Frustrated after Doctor's Appointment

LARA on 11/17/04 at 10:56 (164167)

Considering ESWT is a great suggestion. BEfore doing it, be sure to rule out TTS, because ESWT is contraindicated for TTS.

Re: options

Ed Davis, DPM on 11/17/04 at 20:55 (164208)

There is a lot that can be done for plantar fasciitis. The best place to start is with Scott's Heel Pain Book on this site as it gives you quite a few treatment options. The thickness of your fascia correlates with the condition of the fascia, that is, if the fascia is abnormally thick that implies that there may be poor tissue quality. We were not able to address tissue quality directly for a long time but can do so now with ESWT. Another option to decrease inflamation in the fascia aside from oral anti-inflammatories and cortisone injections includes physical therapy. I realize that you have had that but what specific modalities were used in PT. Some good PT options may include iontophoresis ( a way to use a mild electric durrent to drive a mild steroid through the skin without breaking the skin), ultrasound used agressively, deep tissue massage, finishing with ice massage and a taping designed to decrease strain on the plantar fascia.

Re: options - Quesions for Ed

Lana on 11/18/04 at 08:08 (164242)

Thank you so much for your help! I My physical therapist did ultrasound for 5 minutes followed by deep tissue massage and foot exercises. I wonder if 5 minutes of ultrasound is enough? I am originally from Russia and I had ultrasound treatments there for a treatment of chronic tonsillitis. I remember that every ultrasound session lasted 15-20 minutes. The ultrasound was very effective. It cured my tonsillitis and I avoided tonsillectomy.

I will also ask my physical therapist to add iontophoresis and ice massage to my treatment. I want to try all conservative options before considering ESWT.

Re: options - Quesions for Ed

ormsby on 11/28/04 at 13:30 (164802)

Can you explain what iontophoresis is and how I find someone to do it?