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6 mo lurker, seeking answers, heel pain that dr can't figure out

Posted by MargoG on 11/27/04 at 23:52 (164779)

Hi, I've been lurking here for about 6 months since I started on my journey to figure out why I'm in such pain at times. I was making progress, but feel like this last month I've gotten no better.

Here is my (short as possible) story....

In March I started adding jogging to my walking routine. I am overweight, but was losing weight at a steady rate. My feet began to tingle up by my toes about 1/2 hour into my exercise and when I woke up in the morning pain for first steps. Family dr said plantar fasciitis and first podiatrist said contrasting soaks, icing my feet and no more exercise. Did that for a month, pain in the morning became bearable, arch pain was gone, it was just in my heel. Tried to walk the night before my appointment and had the same tingling in my toes. Went back to first podiatrist and he said, neuropathy and prescribed neurontin. I do not have diabetes, was tested just before this appointment twice in the span of a month. I came home, found this forum, read about neurontin and decided this wasn't the podiatrist for me.

Went to a new podiatrist. He took x-rays and found a heel spur. Felt in between my toes and said neuroma. Taped my feet up and everything felt much better, except my heel. Next appointment cast my feet and made orthotics. Arch pain - gone; neuroma - mostly gone, very minor tingling about 45 minutes into my run, but I can deal with that.

Heel pain - worse, or perhaps because it's the only pain left I notice it more. I think podiatrist doesn't know what to try next. He has suggested that I have tarsal tunnel and I'm having that icky nerve conduction test on Tuesday.

Here is the best explanation of my heel pain. The pain is very local at the back base of my heel. It hurts all day long, not only in the morning. But only hurts when I walk or stand, only throbs when I sit. It feels like I'm standing on a bruise. When I touch my foot around the pain it fees like I'm touching a bruise. When I walk the pain is as intense when my I'm up on my toes and my foot is stretched as when my heel first touches the floor. Pain is more intense the more time I spend on my feet. I have actually fallen down the stairs because I was trying to avoid putting pressure on my left foot.

Are there any tests, questions I should be asking my podiatrist to help him diagnose me?

Thanks in advance for not only reading this but responding.

Re: 6 mo lurker, seeking answers, heel pain that dr can't figure out

Pat on 11/28/04 at 07:58 (164782)

I don't know if this is your problem but one thing I would request is a bone scan. I started with my second bout of PF on my right foot in June. I was going to an Ortho and he sent me for physical therapy, taping, icing, ionpheresis (spelling etc) and finally a hard cast. The doctor had the bedside manner of a toad so after a week in the hard cast I went to a Pod who cut the cast off, gave me an air cast and sent me for a bone scan. My heel hurt all the time and it just felt bruised and almost like it was broken. Turns out that along with the PF I had a stress fracture. My share of the payment for the bone scan was $31 (insurance paid the rest) and I don't know why no one else suggested it. I was put in an air cast for 6 weeks and upon taking it off It still hurt to walk but not the pain that was there before. I sended up having EPF surgery on 11/3 and am still recuperating but I'm now in a walking shoe and while my foot hurts somewhat from the surgery that searing pain I had before is gone. I also had the bone spur clipped (I have some neurological problems that prevent me from fully stretching my muscles so the chances of the PF coming back were good). I'm not sure this helps but I would request the bone scan to see if you have a stress fracture. I know it sounds funny but the PF sometimes gets so bad and makes you walk weird and put pressure in weird places and that's how it happened.

Re: 6 mo lurker, seeking answers, heel pain that dr can't figure out

Darlene on 11/28/04 at 11:06 (164790)

The toe tingling sure sounds like a neuroma. You should have a diagnostic ultrasound to see for sure.
Do you have any heel numbness? For example of you rub your heel along the carpet while you are sitting does it get numb? That would indicate nerve involvement.

Re: 6 mo lurker, seeking answers, heel pain that dr can't figure out

Dr. Z on 11/28/04 at 11:11 (164796)

Hi Pat,

This could be part of Tarsal Tunnel but more like bursitis, stress fracture, periostosis ( inflamation of the bone covering), achilles tendontis. I will get an MRI and or Ultrsound.

Re: 6 mo lurker, seeking answers, heel pain that dr can't figure out

Ed on 12/11/04 at 01:32 (165468)

Not sure what the problem is, but it sounds like your running/jogging/walking routine isn't helping the healing process. Whatever you find the problem to eventually be, you could be well served to rest the foot - especially from high impact activities.

I realize that this is a tough thing to do, even more so if you are on a weight-loss regime. I am a soccer player *and* the captain of my team, and I'm recooperating from my second bought with PF - it's been difficult for me to keep off my feet but knowing that doing so might make the problem worse has kept me on the sidelines for a short while. But, better to rest the tendon now than to suffer more damaging consequences later!

If you can, you might want to try swimming as a substitue for your aerobic routine.

Good luck!