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Nervous about PF surgery, Dr.?

Posted by Heather M on 6/02/05 at 15:39 (176052)

I have had PF and possible TTS in both feet for about 8 to 10 years. It's gotten very bad within the last 9 months and I have tried all the conservative treatments, ie - PT, shots, stretching, cast, orthotics. My doc. seems to be slightly hesitant mainly I think because of the possible TTS and maybe the surgery for PF not being enough. He has already said he doesn't recommend doing the TTS surgery. I'm in MO and my doc doesn't have ESWT and my insurance won't pay for it. To make it just a little more fun I have hyperhydrosis and my feet sweat like there is no tomorrow so my doctor is concerned about infection and how fast I will heal. I guess my question is for Doctor's with paitients with both problems and how successful it is just doing one surgery. I'm not crazy about doing surgery but can't live like this anymore. I have NO morning pain only pain after standing but it only takes a few minutes and it gets bad quickly. Does that sound more like PF or TTS?

Re: Nervous about PF surgery, Dr.?

Ed Davis, DPM on 6/02/05 at 22:55 (176063)

Heather:

Lack of morning pain may mean atypical plantar fasciitis. Do you have pain at night? Did you have a nerve conduction velocity test performed?
It sounds like you need a more definitive diagnosis before surgery.

PF surgery has a fairly long recovery period, for most patients and only a modest success rate. There are differrences of opinion on the success rate of the surgery but the majority view is that the success rate is about 60-65% or so. You may want to use the search feature on this site and look at the surgery board for more information.
Ed

Re: Nervous about PF surgery, Dr.?

Heather M on 6/03/05 at 09:02 (176071)

Ed,

I have some pain at night only if I've had a bad day, ie on my feet with bad shoes. Usually if I'm home I'm on the couch with my feet up, not on the ground and I'm good. I did the MRI and it showed mild PF and the NC said possible TTS. My doctor seems frustrated because nothing seems to be making me even a little better. The PT did nothing, he gave me one cortisone shot but it did absolutly nothing. I tried the cast but the pain and tingling was really bad even after a week so we took it off. I don't really know how to get a better diagnosis, I've done the tests. I would go to another doctor but wouldn't he just do the same things? I've read a lot on this site and the opinions seem really varied. I haven't found a lot of people with atypical PF so it's difficult to find results that specifically aply to me. My doctor says his success rate is about 80-85% for PF. He thinks I'll be up and around the week after. I'm just at a loss. I don't want to waste more time on a new doctor doing the same stuff I know won't work. I went to one about two years ago when it first start getting out of hand and he gave me custom orthodics and sent me on my way. Now here I am....much much worse.

Re: Nervous about PF surgery, Dr.?

Dr Ben Pearl on 6/04/05 at 08:45 (176106)

PT may help.

Re: Nervous about PF surgery, Dr.?

Ed Davis, DPM on 6/04/05 at 12:14 (176117)

Heather:
The tingling was from the cast and does not soound like it was from TTS although an NCV may be helpful. Considering the possible challenges of your case and uncertainties, a second opinion is virtually a must. What specialty is your doctor?
Ed

Re: Nervous about PF surgery, Dr.?

Heather M on 6/04/05 at 14:45 (176123)

I had the NCV and they said TTS, but I thought those tests were never 100%. Up till now my doctor who is a DPM has been great about talking with me and he knows I've been researching on my own and has been open to talking about any thoughts I've had or questions. You mentioned a long recovery but mostly it seems that the PF is pretty quick it is the TTS release that is so long and complicated. I'm considering looking into ESWT more and seeing what my doctor can do about getting a machine in his facility. All I know for sure is I can't live this way anymore, I'm only 32 and already pretty much stuck on the couch when I'm not at work and behind a desk most of the day. Any other suggestions or things to look for or try?

Re: Nervous about PF surgery, Dr.?

Heather M on 6/04/05 at 14:47 (176124)

I did PT twice a week for a month- whirlpool, biomachine, ultrasound, marbles, roll bar, streches. No difference.