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inflammation question

Posted by Linda V on 1/07/05 at 19:04 (166671)

hi,
recent news articles indicate that inflammation may cause as much coronary problems as cholesterol...people with high C reactive protein tests have shown to have more heart disease than others. Would chronic PF people have this? Especially of interest since so many anti-inflammatory drugs are now not recommended. Thanks..and thank you all for your time and effort and caring in answering all these questions for all of us in our quest to solve our foot problems.

Re: inflammation question

Ed Davis, DPM on 1/08/05 at 20:55 (166731)

Linda:
The key factor that we are discovering is that our bodies handle chronic inflammation very poorly. Chronic inflammation of the coronary arteries speeds the developement of atheromatous plaques that narrow the arteries.
Chronic inflammation of the plantar fascia can lead to intractable (difficult to cure) plantar fasciitis due to a gradual deterioration of tissue quality thhat occurs. ESWT essentially converts the chronic inflammation into acute inflammation which the body responds well to by going into action to heal the area.
Ed

Re: inflammation question

Dr. David S. Wander on 1/09/05 at 08:24 (166768)

C-reactive protein has been around a long time and has always been a useful, but non specific indicator of inflammation. Recently, Creactive protein has been utilized as a predictor of cardiac disease. This is presumably from the inflammation surrounding the vessels. If you have a chronic or acute inflammatory condition that causes elevation of the creactive protein, this does not mean that you have cardiac disease or are at higher risk. Therefore, all patients that have rheumatic diseases with elevated c-reactive proteins are not necessarily at higher risk of cardiac diseae. There are guidelines regarding cardiac risks, with most labs having any c-reactive protein value below 2.0 to be low risk, 2.0-3.0 to be average/moderate risk and greater than 3.0 to be high risk. However, most NON cardiac elevations in the C reactive protein tend to be much higher than 3. If you have other cardiac risks (overweight, high blood pressure, smoker, diabetic, etc.) you should be more concerned. Speak with your doctor about C-reactive protein if you have concerns.

Re: inflammation question

Dr. Z on 1/09/05 at 21:53 (166820)

Linda V

Unless the chronic plantar fasciosis is caused by a systemic inflamatory disease such as RA or lupus I don't believe there is going to be any changes in C-reactive protein test

Re: inflammation question

Kathy G on 1/10/05 at 09:13 (166839)

Interesting, Dr. Z. There is an arthritis board that I went to when my doctors were questioning whether I had sero-negative RA. Most of the posters there aren't as well-informed as those who come to these boards, but one woman told me to have that test done. I did a little research on it and came to the same conclusion as you. Since my arthritis hasn't progressed that much, I haven't mentioned it to my doctors.

I think the news media handled the report poorly, didn't you?

As for anti-inflammatories, I don't really know what those of us who are on them are going to do. No doubt, they will all be off the market or carry warnings within the next year. As for me, since inflammation is a huge problem and I don't seem genetically predisposed to cardiac problems, I'm just going to take a chance and continue to take Celebrex once a day although it isn't nearly as effective as it was twice a day.

Re: inflammation question

Dr. Zuckerman on 1/10/05 at 13:45 (166854)

What kind of arthritis do you have ?

Re: inflammation question

Kathy G on 1/10/05 at 18:16 (166867)

It's osteo although my PCP and Rheumatologist differ on that. All the tests for RA are negative but my PCP suspects I have seronegative RA. My Rheumy thinks there's only a ten percent chance of that. I am currently having a really hard time with it but I'm waiting it out. I don't want to start on any RA meds unless it's absolutely necessary. I may have to go and get another cortisone shot in my hand in the near future, however.

The hand surgeon who did my last one did it with computer aided imagery so he was able to get the needle right into the joint. It was by far the most effective shot of cortisone I've had in my hand. (It was the third.) Trouble is, he says I can only have one more because my Rheumy had done two prior to that, over the course of eighteen months. The hand surgeon believes that you can have only four cortisone shots in a lifetime in the CMC joint of the hand. After that, he says it weakens the joint. My Rheumy says I can have one every four to six months.

I believe that having a shot every four to six months, if it's effective, is far better than going on methotrexate or one of the other RA drugs.