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

FRUSTRATED

Posted by KimN on 2/05/05 at 21:55 (168589)

I have been suffering from Plantar Fasciitis since April of 2004 and 0=I am so frustrated. I have done the physical therapy, steroids, anti-inflammatory pills (twice), night splint, removable cast boot and 2 cortisone shots. I am still having discomfort but, not as much as in the beginning. I guess I am just writing to ask if surgery would be right for me. My doctor wants to put me in a cast and crutches for 4 weeks but, to be honest I am tired. I am a Dental Assistant so I stand all day and I am not sure what to do. Can you give me some advice please?.

Re: FRUSTRATED

Dr. Z on 2/06/05 at 02:13 (168598)

Have you investigated ESWT?

Re: FRUSTRATED

Dr. Wishnie on 2/06/05 at 07:04 (168602)

Kim:

It is time to look into ESWT. No cast, no surgery, no complications. Get your life back. Dr. Wishnie

Re: FRUSTRATED

KimN on 2/06/05 at 15:30 (168631)

My podiatrist did tell me about the ESWT but, he said that is later down the road. He said that insurance won't cover it unless I have like a year on record of things done that have not worked. I guess after the orthodics and the possible cast route he may do it. I am tired of feeling pain and want resolution. I have also been wondering how much the orthodics will help me. I have heard from a number of people that they do not help. I have seen one and they are very hard, and seem like they would be uncomfortable. He is charging me $500 for the pair so, I don't want to waste my money.

Re: FRUSTRATED

vince on 2/06/05 at 16:31 (168644)

Your podie is either ill informed or lying to you. The FDA protcal is for you to have PF for 6 months and failed to get better from any 3 of many conservative treatments. They can be anti-inflamatory meds, stretching or PT,ovet the counter orthotics, pading or strapping,night splint, injection therapy,casting and rest. My suggestion is get you doc 'ESWT for Dummies' or find another podie.

Re: FRUSTRATED

Ralph on 2/06/05 at 17:39 (168645)

Have you tried the taping suggestion found in the heelpain book on this site? I gave up on my orthotics and have been taping daily. I think it's helping me. I'm not that much better yet, but I'm not any worse either.
From what I've been reading here some people like the orthotics and many do not. You could always try taping before spending the money.

Re: FRUSTRATED

elvis on 2/06/05 at 22:24 (168663)

Kim........When I first had PF new orthotics helped dramatically within a week. After my 8th marathon in 2 years (2001-2003) then the orthotics didn't help anymore. I haven't run in a year and am considering ESWT. I would recommend the orthotics and other conservative treatments firs for whatever it's worth to you.

Good luck!

Re: FRUSTRATED

Dr.Wishnie on 2/07/05 at 12:11 (168690)

Kim:

There are a lot of people out there that have heel pain. Orthotics work about 90 percent of the time. Ten percent of millions of people is still a lot of people. It is routine to get orthotics first since they help so many people. Dr. Wishnie

Re: FRUSTRATED

Ralph on 2/07/05 at 12:55 (168693)

Dr. Wishnie,
Do you know if someone has a prosthetic made and has difficulty or pain when wearing it, is the item remade or what happens at that point? Is it revamped until its satisfactory for the patient?

Many posters here have posted that they couldn't wear the orthotics their doctors made and that the doctor seemed to lose patience in fitting them until they were comfortable for wear. They said they ended up with an expensive pair of orthotics that they cannot wear and were out the money paid for them because there was no refund.

I have one pair sitting my my closet and my story is the same as some of the others that posted here. Shouldn't we be able to wear the orthotics that we spend so much money on? I feel I wasted $400. That was a pretty expensive trial for me. After my experience, I definately feel either the orthotics should be able to be worn or we should get a refund.

Re: FRUSTRATED

Cori Plastina on 2/10/05 at 11:46 (168838)

Hi Kim,

It sounds like you have tried a few things to help with your continuing heel pain. I have read your original posting and the advice/opinions thus far and I would have to agree for the most part. Normally I would not recommend treatment to any individual who has not had the diagnosed condition for less than six months minimum. After six months most individuals have tried most conservative forms of therapy and will start to consider ESWT as an alternative. In reading your posting I have noticed that you have not tried the orthotics and are hesitant due to cost and the fact that they might not work. I would recommend that you give them a try as most people do find that they help considerable with the heel pain. I am unsure as to how the orthotics are done in the US however, in Canada I do not believe there is a regulatory board for orthotics so virtually everyone is making them. Make sure if you do have them made that you research the individual who will be making them for you. If cost is the issue I might suggest that you try some gel cups or heel pads for temporary relief. In any event if the orthotics do not prove to be effective you may be looking for the alternative. Take care and best of luck.

Cori Plastina, PainFree ESWT Senior Therapist

Re: To Cori

Ralph on 2/11/05 at 20:24 (168916)

Does it cost as much for orthotics in Canada as it does in the states. Can you please tell us what would be considered the average price there?

Re: To Cori

Cori P on 2/12/05 at 07:09 (168922)

Hello Ralph,

The average cost for a custom pair of fitted orthotics in Canada would be around the $400.00 range. This is of course an average as every clinic will have its own price list. I believe the costs are so high because there is no regulatory body to set a proper cost for something which may have the potential to help alot of people.

Cori P, PainFree ESWT Senior Therapist

Re: To Cori

Ralph on 2/12/05 at 11:31 (168928)

The pair that I purchased cost the same amount, but I think I remember someone posting they paid $800 which seemed really excessive in my opinion.

I don't know the regulatory procedures here, but I do know that they can be make by physical therapist, and I've even seen advertisements at places that sell ski boots too and of course Podiatrist make them too. That's where I purchased mine.

The ones made in the sport type shops do not require any RX. They just use a machine type thing that you stand on. I don't know if an RX is needed to have them made by a Physical Therapist either. I know my physical therapist made them, but I never asked him if I needed an RX from my doctor to purchase them. I'll have to call there on Monday. The Speciality Medical Supply Store by me does require an Rx from a doctor. They make custom braces etc. Then there are all kinds of sites on the internet that don't seem to require any RX either so it's difficult to know the difference between all these places that offer to make orthotics and what you are actually paying for?

Re: FRUSTRATED

Ed Davis, DPM on 2/18/05 at 00:28 (169295)

Ralph:

I can give you a 100% guarantee that I can make orthotics that you will find comfortable and wear. What I cannot do is give you any promises as to their therapeutic effect. Therin, lies the 'rub,' as we are creating a prescription device specifically designed to have a specific therapeutic effect and must balance effectiveness with comfort and patient tolerance. The key factor is that orthotic therapy is a PROCESS, not simply a device and involves cooperation between physician and patient including the investment of time to make the necessary changes in the device, shoegear, dealing with problems of tight heel cords (creates orthotic intolerance) and so on...
Ed

Re: FRUSTRATED

Ed Davis, DPM on 2/18/05 at 00:31 (169296)

Cori:
You have made several excellent points. Unfortunately, there is no such regulatory body in the US either but there is a voluntary organization, PFOLA, which are a group of labs that promise to adhere to proper standaards in orhtotic fabrication. I will look for their link.
Ed

Re: FRUSTRATED

Ed Davis, DPM on 2/18/05 at 00:36 (169297)

Cori,
The link is http://www.pfola.org
Ed

Re: FRUSTRATED

Ed Davis, DPM on 2/18/05 at 00:44 (169299)

Vince:
That protocol is a bare minumum for consideration. Many conservative treatments may not be appropriate for a number of PF cases so the 6 month figure is very arbitrary.
Ed