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To all those thinking of EPF

Posted by Debbi R on 12/22/04 at 08:18 (165969)

I wish I had found this site before I allowed them to do my surgery. I am not saying this will happen to everyone, but I wish I would have never had the procedure done.
I was first diagnosed with Plantar Fascitis in my right foot in 1998, after having a cortisone injection, all was fine until 2002. Both my feet were bothering me and I returned to the podiatrist, cortisone injections in both feet. My right foot is fine, however, my left was a different story. I tried taping, physical therapy, exercises, ultrasound, massages, orthotics, and every other non-invasive treatment recommended by my doctor before agreeing to EPF in August of this year.
Today, I am in more pain than I was before the surgery. I walk with a limp, had to get a handicapped placard, and have to see a pain specialist because I couldn't take Vicodin ES anymore and had to be put on a patch. It seems my life now revolves around my foot. Fortunately for me, I can still work thanks to the generosity and kindness of my boss and coworkers, but if I had a job that required me to be on my feet more I would not be working.
The best my doctor can tell me is that there is a large amount of scar tissue in my heel and a 'possible tear' shows up on the MRI. I am reluctant to let them cut my foot open again for fear of the consequences.
Please, think long and hard before having the surgery done.

Re: Debbi

wendyn on 12/22/04 at 11:15 (165978)

Debbi, I'm sorry to hear about your experience. All I can add to your post is 'Amen'.

Re: To all those thinking of EPF

Ed Davis, DPM on 12/22/04 at 21:54 (166014)

Sorry to hear what you had to go through. This site has a lot of similar stories. I would consider the 'gold standard' for difficult cases of PF to be ESWT which should definitely be considered before surgery. ESWT, like any treatment, is not 100% successful but, the downside is minimal and, in 22 years of practice, have never encountered a treatment with a better reward to risk ratio...

Re: To all those thinking of EPF

Kathy C on 12/26/04 at 06:13 (166138)

So sorry to hear about that Debbie, I had mine done in August and was fine for while now Im way worse and headed for Complete release of the Plantar Fascia. SO I am hoping this will do it. I also Have tarpel Tunnel syndrome and I think it happened from the last surgery cause I never had it before and if I did I never knew until after surgery. I am to the point what do I have to lose with going forward with this surgery. I have talked to others who have had and said it was a miracle surgery for them after they healed up. So I am praying this will do it. The Dr told me my fascia was Super Thick. That she had never seen anyones so thick like mine and really feels this surgery thursday will solve my problem. I will pray for ya and keep ya updated on how im doing!

Re: To all those thinking of EPF

Ralph on 12/29/04 at 16:54 (166279)

Wow, a complete release. I don't think I've seen all your posts, but did you get a second opinion about having a complete release? I wonder if the doctors here favor this treatment or have performed it on their own patients. Did you ask their opinions on this surgery? As I said, I probably missed some of your posting history. Sorry if you answered these questions before.

Re: To all those thinking of EPF

Debbi on 12/30/04 at 15:54 (166309)

Dr. Ed,
Question, the doctor doesn't believe the pain I am having now has anything to do with my fasica, and I agree. However, I am wondering if you think ESWT would help the pain I am having now?

Re: To all those thinking of EPF

Dr. Z on 12/30/04 at 16:03 (166311)

If there is no fascia disease or pain then ESWT isn't going to help you

Re: To all those thinking of EPF

una v on 12/30/04 at 20:51 (166323)

let me know how yur surgery goes. i was also told by my pod that i have super thick fascia. i just had my second cryo surgery this morning on my left foot and i'm hoping i have no more problems after this. hope your surgery goes well.

Re: To all those thinking of EPF

Mike C on 1/01/05 at 22:04 (166382)

Have you tried stretching your calf?
One foot about a foot length behind the other. Front knee bent rear knee straight, bend as far forward on the back ankle keeping heel on the floor. Hold for 20 seconds, 20 repetitions 3 times daily.
It will take 4 to 8 weeks to appreciate improvement but, as ankle motion improves the plantar fascia will be unloaded.
Do not let anyone cut the plantar fascia. If your symptoms do not improve after stretching considertion should be given to lengthening the gastrocnemius tendon. Questions: (email removed)

Re: To all those thinking of EPF

Debbi on 1/03/05 at 12:32 (166441)

Dr Z,

That was what I thought, but it was worth a try.

To everyone else,
Thanks for the support. I will make it though this, if anything, I am a fighter. I refuse to let it get me down. I just want all to be warned about the dangers surgery poses and realize that it may make matters worse instead of better. All along I believed that it would get better or stay the same, I never imagined it getting worse. Here I am today, living proof of it.
Please think twice and look into ESWT before letting someone cut your foot open. I wish I had.

Re: To all those thinking of EPF

Dr. Z on 1/03/05 at 12:58 (166443)


Very easy to determine. If the pain is located with palpation ( pressing on the area) and the ultrasound and or mri is abnormal in that area you do have plantar fasciitis. Still need to rule out nerve entrapement and other causes, but if they are ruled out they ESWT could help you

Re: To all those thinking of EPF

Debbi on 1/05/05 at 00:19 (166524)

Dr. Z

Thanks. The pain is in the arch, outer part of my foot, and in the very middle of my heel (not where the original fascia pain was. The mri showed a possible tear in my tendon and that was the extent of it. Nerve entrapment has been ruled out, however, I am scheduled to have a bone scan in two weeks.


Re: Debbie

Judi on 1/06/05 at 22:07 (166626)

Hi. I had the EPF surgery on Oct. 13 on my left foot . I am in a similar situation as you. I have more pain now than before the surgery. My pain is no longer in my heel except on occasion but its not the same pain as before the surgery. I now have pain from about the middle of the outer left side of the left foot to just under my toes-all except under the big toe. I am also having LOTS of pain in my left knee now which is quite severe. That pain is like a shooting pain in the back of my knee that runs straight down into my foot. I work standing all day in a factory and I have 2 small kids so this has been a real inconvenience for me. I want you to know I sympathize with you and I hope everything works out for you---please let us know how things go for you.

Re: Debbie

Pat on 1/10/05 at 18:26 (166870)

Hi Debbie,
I had this surgery on 11/3 and just went back to work. I have a sit down job but I'm at a different site every day and dragging my briefcase, laptop, etc. so it's hard. I go out and do something and feel like coming home and sleeping. I have more pain in the back of the heel (where you rest your foot when you're driving)and the doctor said it's normal healing. I had this surgery 10 years ago and everything that could go wrong did including the doctor cutting a nerve. I still can't bend three of my toes on that foot. My recent surgery though wasn't bad but I'm so out of shape and my foot is always sore. I know it takes time to heal but I'm tired of pain. I feel so bad for you having to stand all day long. I don't know how you're doing it because I know with this surgery I can't stand in line at the grocery store in one spot for 10 minutes without wanting to kick the person in front of me out of the way! LOL! It sounds like with you it may be related to some type of nerve. What does the doctor say? Are you in physical therapy? If you want to email me at (email removed) you can. Sometimes I have a hard time figuring out where the message replies are on this board.

Re: To all those thinking of EPF

Mike c on 1/14/05 at 16:56 (167155)

Extra corporal shock-wave therapy is vertually without any hard scientific basis. This is absolutely NOT to be considered a 'gold standard'. There are no statistically significant studies suggesting this modality works.

Treatment should be directed at the cause of the problem - Tight Calf Muscles.

Plantar fascia release compromises normal function of the foot and should be done only in cases of deformity resulting from neuromuscular problems.

(email removed)

Re: To all those thinking of EPF

Mike C on 1/14/05 at 17:39 (167176)

Extra corporal shock wave therapy should not under any circumstances be considered a 'gold standard'. There is no science to support this modality nor is the mechanism of action well understood.

Any 'gold standard' needs to be consistanly successful and have a sound basis.

Treatment of plantar fasciitis should be directed at the cause of the problem. The cause is tight calf muscles restricting range of motion of the ankle.

(email removed)

Re: To all those thinking of EPF

Dr. Z on 1/14/05 at 18:03 (167180)

I agree Equinus or reduced ankle motion is very important when evaluating
Plantar fasciitis or fasciosis.
ESWT has been in with our group consistantly sucessful when ALL factors are evaluated and considered including reduced ankle motion.
ESWT is only as good as a proper evaluation as is all treatments. . There are many different causes for pf. Equinus as well as ESWT aren't the gold standard for plantar fasciitis/fasciosis. They both are important and needed to be considered and evaluated and use as indicated. The treatment of plantar fasciitis is an art as well as a science. It was my understanding that there was a sound basis for ESWT that being neovascularization due to microtrauma from the interaction of soundwaves on the plantar fascia tissue. Dr. Rompe has articles that have reviewed this before.

Re: To all those thinking of EPF

Dr. Z on 1/14/05 at 18:18 (167182)

Restriction of motion at the ankle, knee or part of the lower extremity
could be why you are having arch and other type of foot pain. A complete lower extremity biomechanical evaluation with gait study could give you the answer to this foot pain.

Re: To all those thinking of EPF

Mike C on 1/15/05 at 07:12 (167236)

The results, however, are not consistant. I have seen several patients treated with ESWT who developed fibrotic changes (scar tissue). This is by no means the answer to plantar fasciitis.

Re: To all those thinking of EPF

Mike C on 1/15/05 at 07:58 (167239)

Dr. Rompe has also stated that further evidence based research is needed to develop recommedations for the use of ESWT.

Re: To all those thinking of EPF

Debbi on 1/15/05 at 13:03 (167261)

I will ask my podiatrist about the biomechanical evaluation with gait study, thanks for the information.
The funny thing about all of this is my left foot and ankle have better ROM than my right. Due to the PT I have done and continue doing for my left foot, my calf muscles are loose.