I am a Podiatrist and have been in private practice in Oregon for nineyears. Over this period I have seen and treated a great deal ofpatients with plantar fasciitis and to a lesser extent, calcanealstress fractures.
The majority of patients respond well to normal conservative care.Normal conservative care consists of taping, NSAIDs, orthoses,ultrasound, stretching exercises, shoe therapy, and below knee castingfor difficult cases. I rarely operate on patients with plantarfasciitis. I think this is generally not indicated, and in a lot ofpractices this is an over-used, opportunistically performed procedure.
I have noticed that every three to six months or so, I will see apatient that does not respond to normal, conservative care. Some ofthese patients end up being diagnosed as having Reiter's syndrome, butthere always seems to be a certain percentage of my patient populationthat fall into the category of what I would call "recalcitrant plantarfasciitis." Typically these patients end up becoming frustrated andseek treatment elsewhere, but some of them will stay with me for along time.
I have noticed a trend within my patient population with recalcitrantplantar fasciitis. If I start questioning them regarding therepersonal life (something that most Podiatrists and Orthopedistsprobably don't do too often) I often find that they are in the midstof some sort of personal crisis. Furthermore the nature of thepersonal crisis tends to consistently involve the patient's caring fora dying spouse or relative, or a seriously ill spouse or relative. Ihave seen this happen enough times with patients that haverecalcitrant plantar fasciitis that I truly believe there is some sortof correlation.
The patients have real pain, and the condition is demonstrable on bonescan, but the healing or repair process seems to be altered.
I would be interested in corresponding with other practitioners thathave noticed a similar trend, or that feel otherwise.
Your website has been very helpful in connecting me to information. Let me know ifyou have any ideas! This thing sure is a real pain. As someone else wrotein one of your articles on your web site - this thing makes me crabby andmiserable!
I tried heel cups when the problem first began - is that the same as heellifts? They felt great on the heel but caused problems with the rest of thefoot. That is part of what led me to have custom orthotics made. Howeverthe more I read about orthotics I'm not really sure if I have customorthotics or just custom insoles. It's all so confusing. I have used theprednisone (medrol dose pack) when it was severe and I could not even standup and yes, it did help. That has been prescribed twice in the past twoyears. However that is obviously not a long term solution.
I actually am not doing the stretching, which I know is bad. I stopped abouta year ago when I got my new pair of orthotics because I just could not do itwith them. Recently I have tried to resume it, knowing that I have basicallyno flexibility in my feet or achiles tendon. It seems, however, whenever Itry to do the wall stretches that it makes it worse. So I am trying to domore massaging and stretching while sitting down, in hopes that that willgive some more flexibility. It seems to be helping some. It just does notseem like there is an answer for this thing to totally go away. When I hearabout people still running while having PF I wonder if we have the samething, since walking is an accomplishment for me! I'm going to try to find apodiatrist and see about maybe a different orthotic. In retrospect, I wish Ihad never gotten an orthotic in the first place, but now that I have it seemsthat I am dependent on it and anytime I try to go without it I end up withmassive inflamation again.
I've been reading lots of articles about orthotics in BioMechanics magazineon the internet. Have you read any of their articles? Also, Stride magazinehas had some useful info. What has led you to put all this informationtogether? Are you currently suffering from PF? Are you still able toexercise?
<A HREF="http://www.ifi-mpls.com/biomech/">BioMechanics Magazine Home Page</A> <A HREF="http://www.ifi-mpls.com/stride/">Stride Magazine</A>
scott, have you heard of using New Balance running shoes with the roll bar to"cure" Plantar fasciitis?
You've done a great service offering your thoughts and solutions on heel pain, of which I've had for about 7 months, and it has just about worn me down.
I answered an ad in Runner's magazine and got a brochure from a Dr. James a board certified orthopaedic surgeon, who has a video that will cure the problem, of which he's spent 10 years developing and perfecting. Have you heard of this video, or Amis?
It's interesting that the source of the problem is the Achilles and calf area, since the pain is definitely on the heel. It seems like my calves are flexible, but, maybe not.
Anyway, thanks for your good works, and would be interested in hearing from you if you've heard of the above.
With thanks, Gary
Dear Scott: I have been fighting Plantar Fasciitis for about 1 year. It has consistantly gotten worse. I have seen a podiatrist and an sports ortho guy (supposedly the best in the area). I am astounded that they both gave me bad information on how to treat it. The ortho doc told me to "keep running and don't use those inserts, they don't do any good". He has prescribed utlrasound therapy only after I refused an injection, opting for conservative treatment. I think I better go back to the podiatrist, he was closer to being on track. Your web page on fasciitis is a teriffic resourced. What made you decide to put that page out there for all of us sufferers out there? I'm sure glad you did. I'm going to try any and all of the suggestions I read about. I can't thank you enough.Kary
Hi there, just looking through your web page.
I have a weird story about plantar fasciitis. I got it3 years ago, through bouncing around a stage with footwearthat was not properly supportive. As I'm an active sortof person, this has continued to the present day.
One thing that helped a little was to wear supportiveair trainers (= sneakers?) .
Also now that I have seen your mentioning cycling on the page,I do seem to recall that since I started doing more cyclingrecently it has actually been improving a little,
But the amazing thing was last week. I was running to get atennis ball, missed the shot and somehow ended up treadingdirectly on the ball with my left foot. Crash I went, overon my side. The foot was undamaged in the sense that although itwas very sore for a day or two, everything still worked andit wasn't twisted or sprained or anything.
The morning after, it was still sore getting out of bed, butthe morning after that, the soreness had gone away, and themost noticeable thing upon getting out of bed was that mypf in my left foot had *completely* gone! The contrast withmy right foot was absolutely incredible. No pain, *nothing*on my left foot; on my right, the same "peg leg" feeling thatalthough it didn't hurt, my right foot very definitely wasnot wanting to do foot duties (I've never had pain, just extreme discomfort).
Anyway, I just thought you'd be interested. Useful page youhave there...
I'm new on the internet as of today, first thing I did was look for any info on plantar fascitis which I've had since last Christmas, started off with the feeling of a small stone in my shoe hurting my heel, progressing to the point where it's crippling after having been on my feet and then resting, having the heel throb painfully and almost need a walker to to absorb my weight until I could work out the pain in my heel. Have been to an Family Dr. followed by an orthopedist who confirmed via x-rays that there was no bone spur and to use Advil, stretching and be patient. I work at a computer all day, so the development of the plantar fascitis is a mystery as there was no preceding trauma, running, jumping, etc. It was my fervent New Year's goal to begin walking and start to lose the weight gained from a very hectic year working at a computer full-time and now I've been patiently waiting to have this heal. I do admit that since I work at home at a computer I have developed the habit of walking around the house barefoot...now I've bought supportive shoes with orthotics and have found that the pain is much relieved when on my feet, however, at night I can be awakened by the throbbing pain and have to stretch my foot to relieve the pain.
I have not heard nor have I read any comments about walking for exercise vs the fascitis; will it aggravate the situation and slow the healing and the irritation? I tried walking a few months back with Niki shoes on, walking slow until the pain lessened to a tolerable level, only to develop a "shin splint" type pain on the outside of the foot running up the outer aspect of the ankle after only about three-quarters of a mile forcing rest and return to home. Not sure whether I was walking improperly subconsciously favoring the heel and am causing another problem. Even if I can't go futher than that, I would rather get out and walk as far as I can go as long as it's not harming the process, considering how long it's gone on so far with no aggressive exercise and still not much progress, outside of the shoes making it better to ambulate around.
Any comments would be appreciated.Thanks, Suzann
I have been struggling with a flare up of this frustrating problem for almost a year. I'm not even a runner - just a recreational walker. (The other foot acted up 5 years ago, but it went away after 6 months of PT, casting, orthotics, and one cortisone shot.) One friend said it is the chic orthopedic problem - replacing tennis elbow (late 80's) and carpal tunnel syndrome (early 90's).
I have been through everything, it seems, including three shots, which the doctor said works "95%" of the time, and a pair of new orthotics which transfered the pain to the outside edge of my foot. The shots hurt like hell, and I think the last one did more harm than good. I'm currently using a night splint, stretches, ice, and the old orthotics. I just stopped NSAIDS because nothing I read said they would work! If I've seen any improvement, it's in my attitude (no longer desparate), not my foot. I'm about to ditch the orthopedist (who as much as told me he couldn't do anything else for me) and switch to a podiatrist. Any stories about the effectiveness of acupunture?
In any case, I have three reasons for writing. One to THANK YOU for assembling all this information. It's a bit bewildering and often contradictory, but it has helped me enormously.
Second is to add advice from my physical therapist. Like one of the articles you cite, she stressed building up strength in my toes. Instead of the towel exercises, I do the following. Twice a day, lying down or sitting with my legs out in front of me - particularly before I get out of bed - I "pedal" my feet up and down to stretch the muscles. Then I bend the feet back, forward, and back, and holding them in the bent back position, curl my toes under, working to get the "knuckles" of my toes visible. When I started no bones showed under the skin and I could barely curl them. Now I hold the curl for 20 secs. and repeat ten times. Also, she gave me "toe combs" or spreaders - pieces of foam rubber with 4 fat teeth that keep my toes apart. They are supposed to make me use my toes more and my plantar less. It looks like I'm getting a pedicure, but they seem to help. I haven't ever seen them in stores.
Also, where's the time honored advice of a tennis ball by the side of the bed? Before you place weight on your foot, roll the tennis ball under the heel and arch. It helps stretch the muscles.
Having had this on both feet, I heartily concur with the advice of doing every exercise with both feet. Whatever did it to one is waiting to hit the other!!
Third is to direct you to a good article by Jane Brody in the Personal Health column in the New York Times. I don't have the date, but it was in mid July of this year.
Again, thank you. I'll keep checking in for updates and new information.
I am impressed by your page.I thought I had PF and about five doctors diagnosed it as such. I have tried almost all the treatments.It turns out I have something far worse: worn out heel pad or "painful heel syndrome", not to be confused with PF. This condition means that the fat pad on the bottom of the heel no longer cushions the bone.I have found no treatment whatsoever and have been told from what should be a reliable source that it is incurable and a lifetime condition.
Nonetheless, I am looking for a particualar type of heel cup that provides lateral pressure to the indendted area of the heel just above the fat pad. This compresses the fat pad. The standard heel cups bought in stores (Tuille's (sp?) and others) do not have this feature. The ones I want are made of stiff plastic and fit firmly in the heel. The will not fall off, as most do.
If you have any information on this heel cup, please contact me.
Thanks! Your work is very helpful. I am gathering info for my long-suffering husband who is looking to run a half soon, but has problems with PF. I printed out a lot of your stuff and will make good use of it.
Hi, I saw your web page. Most everything on it has been done to me as I havehad plantar fasciitis for 16 years. I have had: Stretching, Orthotics, Anti-Inflamatory Drugs, Foot in cast, Cortisone Injections, Surgery, Nothing has helped much except using SAS brand walking shoes seems tominimize the problem. Can you recommend anything else. By the way, one of the recommendations on your page is not to go bare foot.I find that barefoot on a floor with a rug with foot slightly rolled out isthe least uncomfortable. Have even been thinking about how to reproduce theeffect in a shoe. Jerry
greetings,i have been running for 18 years and have been plagued on and off with heelpain and plantar fasciatis in both feet. i tried taping, ice, antiinflammatories, stretches, etc. i have had a variety of orthotics over theyears, over the counter and prescription. i am far from overweight. beingrather athletic and active, i have suffered many oversue injuries. a greatdeal from poor shoe design and development in the early years. i thoughtthat a pair of langer sportthotics would solve my heel, plantar pain. it onlyseemed to make it worse. i finally received some relief from a pair of corkand leather 3/4 inserts. just this year, i stumbled upon dr. kiper's web pagefor his sdo's. somewhat skeptical, but mostly desperate, i followed and trieda pair. they were not what i expected, but they work. my heel doesn't hurtand i have been able to roll up some miles both cycling and running. i wearthem all the time, even at work. so, i can't complain. i think i tried all ofthe other solutions w/o relief. sdo's work.
Yes I have been getting more action. You have inspired me to go even further with my pages. I have the most successful heel pain treatment center in the world. Over 98% of all patients treated are cured with concervative treatment. The last heel surgery I performed was back in Jan of 95. I have many more secrets that can help people. I will be publishing research data on concervative treatment of this problem.I will be working on the web page tomorrow and will link to your page.
Thanks for the information. When it comes to medical treatment, knowledgeon the part of the patient is power. Ever since I got conntected tothe internet a year ago I've been able to find out about differenttreatment possibilities for different medical problems of my my wife andmyself that our local doctors have not considered or just plain keptto themselves. When I present to them my research their initial reactionis to look at anything from the internet with a jaded eye. I had anendrocronologist use those very words a few weeks ago. Slowly themedical community, especially the HMO's are catching on because theysimply look foolish when their patients beging to know more then theydo.
By the way, I am not overweight. I'm 5'10", 148 lbs. But, I do havediabetes and been on insulin for about 5 years. I'll see about goingto another podiatrist for a 2nd opinion.
larry again:It was about 2 or maybe 3 years ago when I went to buy some new shoes.Each different make of shoe I tried on seemed to have a lump near theball of my left foot. At first I thought it was a defect in the shoebut after I tried on several different brands over a period of severalmonths I came to the conclusion it was my foot that had the problemnot the shoe. That's when I went to a foot doctor.
The foot doctor said I was just getting old (I was only about 53 at thetime) and the padding on the bottom of my foot was getting thin. Hesaid I should no longer ware hard soled dress shoes to work and onlyware soft soled shoes. He also said to put a little foot pad under thearch to take some pressure off.
I don't recall every bending my toes way back, but I was doing walkingand slow jogging about 20 mins a day.
I finally found a pair of Turntec's I can ware for walking and to workand a pair of NewBalance for slow jogging. However, I ended up poundingaway on the inside sole where the toes bend with a hammer and punch tocreate a little "pocket" so there is not as much pressure at that point.I also ware a little triangle arch pad from time to time on my leftfoot.
I've been under the impression that I will just have to live with theproblem for the rest of my life. Well, it's now time to look for somenew shoes again.
>Oh, sorry, I wasn't reaing very well. Yes, the pain can be over the>entire fascia, or where it connects at the ball, as well as the heel.> Were you doing something that bends the toes way back while exerting?
Bless you for setting up this web page. I look forward to continuing my search for a cure!Vicki
My problems with plantar fasciitis stem from my ballet dancing on toe. I'msure this must be common in dancers, but this is my first experience with it . Thank You for all the info. You've been a big help!!!! Sincerely, Christy
Thank you for asking. I'm sorry for the delay in responding. My emailaccount is at work and I had a few days off.
I saw my doctor on Friday and we both remarked how much the first steroidinjection healed the area. Three months ago, the area was very tender and Iwinced considerably while my doctor examined it. A month ago he injected thearea with a cortisone. It has improved so much only a smaller dose wasrequired the second time out. In two to three weeks, my doctor is hoping Imay begin a walk/run/walk program. Hopefully, I'll be up and runningsteadily by the fall.
I'm going to go real slow with the comeback, Scott. This is one nasty injuryand there's no way I EVER want to get it again. I'm postponing anothermarathon until next year. I want time to get up to speed again.
Thanks again for asking. Do you have experience with this injury?
Wow...what a wealth of information you are. I certainly didn't expectthat...thank you very much.
I've printed out your email for reference. Just to answer your questionsabout the injections. My doctor injected the steroid with some localanesthetic so it didn't hurt at all. He injected the anesthetic slowly andwaited a few minutes until the area froze, then he injected the steroid.
He explained the reason for this method two ways: 1) To make the injectionas painfree as possible and; 2) To ensure that he's injected the steroid inthe right place. When the anesthetic wore off (2 hours), the area was soreas before. After 2 days, the tissue starting healing and my foot felt great.
The only pain I'm experiencing right now is from calcaneal bruising from, asthe doctor said, "Pounding the heck out of your foot". This pain is fromdirectly under my heel and is not PF.
Yes, you're absolutely correct about some physicians. My doctor warned meabout other doctors who advise patients to have their heel injected at thefat pad. Apparently, the steroid can "eat away" at the fat pad. He said thatanyone who advises such a procedure should be suspect.
I'm confident my doctor is treating me correctly. He's an athlete himself(skiing, rock climbing, cycling) and was highly recommended by one of ourlocal former Olympians. Fortunately, I've had some very good doctorstreating me over the years. One of my other doctors is the coach andofficial doctor for the Canadian Olympic Track team.
Thanks again for your advice, Scott. I'll definitely check out you website.
Yes, he's mentioned the importance of stretching although not as muchlately. My heel was so tender, he couldn't even prod it lightly without mewincing in pain. Now that the heel is calm, I'll be stretching morediligently, something I haven't been that great at in the past.
Thank you once again for your kind consideration. I don't think you're apest at all. I sincerely appreciate your advice.
For once in my lengthy running career, I've taken an injury VERY seriously.This one has been the toughest to date although the calcaneal buildup on theback of my left heel that was surgically removed was hell.
I'll concentrate VERY carefully on the stretching. To date, I am wearing newsemi-rigid orthotics.
The way I look at it, Scott, my entire body could use an overhaul. It's beenlate Feb. since I last ran and I feel so incredibly blobby. I'm going totake everything mighty slow. I'm not even thinking of a marathon until fallof 1997.
Your website is treasure of articles. Wish I had found this months ago whenI was looking for information. I'm going to take my time and go through eachsection. Thanks once again.
Btw...have you been able to access the RW Online Forum? I wonder if they'vetaken it down in wake of the Olympic games.
Hi Again, Scott:
What is your feeling on wearing a night splint? During the course oftreating this injury I was advised to wear a splint each night to hold myfoot in place. This helped to some degree although nothing as dramatic asthe results from the steroid injections.
What you say regarding re-tearing the tissue sounds reasonable. However,does this mean I'll have to wear the splint ALL the time?
Btw, has your PF gone away and are you running again? What was your comebacklike?
Just took a look at your PF HP. Great work. Haven't readit all, but looks like you've done a real service for thosewho suffer and want a plethora of solutions. With that, Iwould like to add my favorite "cure"....which has workedwonders for me and several other fellow runners in my club:I just came down with a mild case of PF again (since 1987), so I may spend some time reviewing your collection.
Thanks for taking the time to compile all that wonderful info on PF. Ihave been working with mine since October and I am very close to beingpain free. I only have a small amount of pain near the ball of myfoot! Of all the things I tried, stretching has been the mosteffective. I was really facinated about the weight component of yourarticles. I have lost 25 pounds in the past 3 months and that hassurely helped my foot along!Thanks Again!!Lynn
PF is an interesting problem that has plagued me for the better part of a year ... on and off. I have a very high arch and am over weight. I am running to reduce my weight ... yet can't overdo it because it enflames the fascia. Nice problem.
best solution to date seems to be cushioned running shoes (Brooks Radius), with soft heel pads and gel-thotics to help support the arch. I ice the foot when I get a twinge of pain.
So far, so good. Have lost 45 pounds and the rate of incidence of PF seems to be slowing. I had thought about orthotics and find your references of real value.
Thanks for the page on PF. I'll keep checking by from time to time.
Sorry to hear about your condition. The ultra-sound I had three times a week fortwo weeks seemed to help, but did not completely resolve the problem. I alsoiced the heel frequently, which helped. Because I still have not completelygotten rid of the problem, but still play R'ball three times a week, I'mconsidering getting a cortosone shot into the area. The Dr. told me it wouldprobably heal the heel, but the heel would be sore for a couple of days. I'vealso heard from someone who had several shots that they didn't work, so I'mthinking it over. Your heel lifts sound like a good idea. I've started wearingrubber heel cups in my shoes.
Just found your web page - hope to spend some time exploring the partdealing with PF. I found one of the worst cures for PF: a stress fracture! After recovering form a metatarsal fracture last year, the heel pains I hadhad for a year or so were gone. I'm currently training for a Decembermarathon, however, and they seem to be making a comeback. The Reese boot Iwore for the fracture makes a dandy night splint, though. Another thing thatI've found helpful is taping my arches with Vetwrap, which is available infarm supply stores and is pretty cheap. It's elastic and self-adhesive. Take 3 or 4 turns right around the arch, not tight enough to restrictcirculation (if your feet swell a lot when you run, this might not work foryou).
Let me give you my symptoms and you can tell me if this isPLANTAR FASCIITIS. While I was pregnant with my 4th childI had a lot of swelling in my feet and ankles the last couple of months...so my feet really hurt. After the babywas born, I had a LOT of swelling that lasted about 4 weeks.Most of the swelling was gone but my feet still hurt, especiallyafter sleeping or sitting. I do stand a lot and hold babiesa lot so that is not good. The other thing is I never wearshoes unless going to the store, then I wear sandals. I usedto hear it was good to not wear shoes. After reading someof your articles, sounds like I need to get a good pair of walking shoes. The thing that has me wondering if Ireally have Plantar Fasciitis is that my foot hurts more inthe arch area and on the top right part of my foot than theheel. The back of my calf is also sore. The right foot isworse than the left. Within the last 3-4 weeks it seems thatsome of the blood vessels on the top right part of my footare puffy and the mid-shin area has sort of a blue, bruised look.This is not very noticeable but achy. Have you ever heard ofsymptoms like this associated with plantar fasciitis? Maybe Ihave Plantar Fasciitis and Varicose veins. I just don't know.I am wanting to try some more natural healing methods, versusmedication or surgery. I guess I'd feel better if I knewothers had some of these symptoms. I appreciate any adviceyou can give. THANKS!
scott thanks for your home page. I am a 43 year old soccer player, coach and referee, . I am struglling to continue my soccer efforts for my own enjoyment and health. I have searche the net and i belevie yours is the most informative site on plantar fasciitis. That incluldes orthopedic and podiatirc. MY heel problem persist due to my impatience and consdtruction work.your sites hopefully will send me to a painless soccer game refereeing and coaching. ONe of the parents on my daughters tam is a physican and has confirmed all your suggestions thanksfran
I've been meaning to write to you about my experience with thedreaded PF, so here it is:
In April of 1994, three weeks after buying some new running shoes(Nike Air Huaraches), during an 8-mile run I felt someuncomfortable twinges in my left heel. At the end of the run ithurt a bit, but I wasn't too concerned. The next morning it hurtquite a bit but improved during the day. I continued to runevery other day, thinking it might improve as so many minorinjuries do, but a week later after a 10-mile run it really hurt. I STILL continued to run throughout the summer and ran severalraces, including a marathon in October of 1994. The pain wasalways there in the morning but would decrease enough for me torun fairly comfortably in the evening. I iced my foot after eachrun, changed shoes, tried rolling a golf ball under my foot,etc., but nothing really helped much. I ran a 5K three weeksafter the marathon, and after this race I could barely walk. Atthis point I finally decided I had to take it easy.
I quit running for 2 months. The morning pain eased surprisinglylittle during this period. I got impatient and gradually triedto get back into running, starting out with walking and working upto about 3 miles every other day. The pain--which had neverdisappeared--came back as strong as ever. In March of 1995,nearly a year after the initial injury, I went to a podiatrist. He taped my arch, gave me some over-the-counter orthoses, andtold me to come back in two weeks if the pain was still there. Two weeks later, I went back! This time he prescribed physicaltherapy consisting of ultrasound treatments to drive a low doseof cortisone into the heel. I had about 12 of these treatments,and they helped a lot. The therapist strongly recommended calfstretches, which I had already been doing. He also told me I hadbeautiful feet and good running form and couldn't understand whyI had been stricken. I suspect it was the very soft heel counter(should I say nonexistent heel counter?) on the Air Huaraches--which, incidentally, didn't stay on the market very long.
I started to try to build mileage again about a month after thetreatments ended. I wore the orthoses that the podiatrist hadgiven me. The morning pain was not as severe as it had been, butit was still there. I then went to taping my arch during runs aswell as using the orthoses. That helped, too, but it becameobvious that the morning pain wasn't going away, even though itwas much improved over the previous year. In August of 1995 afriend gave me an article which discussed night splints. I hadheard of these in Usenet, but I was sceptical and hadn't triedone. After seeing the article I decided to give it a shot,making my own crude night splint out of some towels and analuminum rod that I bent to fit my leg. The next morning, myfoot felt better than it had in over a year. It wasn'tcompletely painless, but it was sure close.
The article, which you may not have seen since it's not in yourlist, is by M.E. Batt and J.L. Tanji, "Management Options forPlantar Fasciitis", in _The Physician and Sportsmedicine_, Vol.23, June, 1995. It deals with the effectiveness of severaldifferent therapies for PF and is quite interesting.
To wrap this up, I used the night splint for about a weekstraight and the pain just about cleared up completely. Istarted building up mileage again, still using the orthoses andtaping my arch, and wearing the night splint every so often if Ifelt any twinges of pain. I would say it took about 6 months ofthis sort of ritual to eliminate all traces (nearly) of PF. Thenice thing was, however, that I was able to continue runningduring this treatment. It's now been over a year since I firsttried a night splint. I would estimate that I've worn it maybe30 nights over this time period. The last time I used it wasabout 2 months ago after a 10-mile run, when I felt a little bitof pain in my heel.
I am building my mileage VERY gradually, going 5 or 6 miles everyother day, with an 8 to 10 miler every other week. My heel feelsgreat in the morning, and I hope to eventually run anothermarathon. I still tape the arch for every run and use the sameorthoses my podiatrist gave me. I wear 3/4 length Spenco archsupports in my everyday shoes just to be safe. One of these daysI'll try to wean myself of the supports, but I haven't been braveenough to try yet.
Bottom line: PF won't disappear on its own in anythingapproaching a reasonable amount of time. Aggressive treatmentwith a combination of techniques such as taping, arch supports,and night splints is the only way to tackle this problem. Eventhen, it took me over a year to really get rid of it (and whoknows if it isn't still lurking just around the corner).
Thanks for the effort, Scott, in putting together your web page.
scott: many thanks for organizing your plantar fasciitis page. I has beenextremely helpful and consoling to me during my long bout with pf. I havehad it now for about 6 months-- there is a good bit of improvement and I amno longer so depressed about it. I did have a cortisone injection, but ithelped for only a week.... in general , it is very important to tell folksthat it takes a very long time to heal--with or without drugs, no matter. anyway, i am grateful to you, and I hope your pf is all gone!
Just having been diagnosed with PF, I am amazed to find all of this information on the net. Your homepage is particularly interesting and helpful. Although I've just been to the physician and begun the NSAID's, I've been experiencing this pain for a few months now and it is increasingly getting worse. I will read some of your information to obtain more knowledge about PF. My first impression from reading the info. and other peoples feedback to you is how serious it sounds. I really thought that it would be something that would likely go away on its own after awhile, so I'm a little bit anxious about it at this point.
Anyways, thanks very much for all of this helpful information. It's great!!!
Your page is very helpful...it has the most information I have been ableto find ANYWHERE on the subject. I have been suffering from heel painfor over a year now and was diagnosed with PF about a year ago. Istarted with custom orthotics. I thought these were helping at firstbut the pain continued and even worsened. After being on my feet for awhile, the orthotics also cause pain in my arches. (I have always hadflat feet) I lasted with the orthotics for about 7 months then wentback to my podiatrist. At this time, we decided to try cortisone shotsin each foot. I had no relief from the shots and in fact could not walkfor 2 days afterwards due to the intense pain the shots caused. Out offrustration, I went to see an orthopaedist who gave me plastic heel cupsand pads and perscribed 4 advil, 4x day. The heel cups pinch the crapout of my feet and are very uncomfortable. I find the orthotics morehelpful. Back to the podiatrist who sent me on for physicaltherapy....ultrasound, whirlpool, and stretching. STill not relief.All of these methods feel very good while they're happening, but provideno lasting relief. Now I'm trying a night splint. I've been at it forabout 10 days with no relief at all. Not even first thing in themorning. The physical therapist thinks I should feel a littleimprovement by now, but then I read the article linked to your pageabout the 4 month study. To be honest, I don't think I can go on likethis for 4 more months. I am young and not overweight and the pain inmy heels is really disrupting my life. I am starting to feel a lot ofdiscomfort in my knees and hips now too and worry about the long termeffects on my joints, etc.
Am I giving up too easily? I read some of the stories you included frompeople who have suffered for 6+ years...why bother? Why not try thesurgery and cut to the chase? I go to see my dr again tomorrow and feelthat we will discuss surgery. Do you think I have tried all othermethods? I haven't been perscribed any steroids...should I ask aboutthat? Do you have addresses of others who have elected surgery?
Thanks for the advice!Nicole
Scott-I discovered your page through a walking newsgroup and found it very interesting, having suffered with PF for several years. I went through the gamut of exercise, orthotics, physical therapy (with ultrasound), cortisone shots, etc. My orthopedist was reluctant to recommend surgery but we had just about run out of options. A friend who has a very narrow foot like mine mentioned that she had started wearing New Balance walking shoes and found them very comfortable. I tried them (also using Spenco 3/4 arch supports) and have been pain free for a number of years. Each person's situation is different but in my case a change of shoes made the difference. I walk every day so it has been wonderful to be able to do it without pain.
My doctor diagnosed this and showed me how to exercise. He gaveme anti-inflammation pills. Did not talk about shoes or inserts,butit does seem that flat shoes (or sneakers) are no good. Knapp shoes,with good arch support, seem good. Al Willis age 70, 40 pounds overweight.
I am amazed. Thanks for all the info. I've suffered with relentless PF for over 4 years, been through physio for the last year - treating my lower back to alleviate the pain, been through three different podiatrists, one who claims to be "The Foot Doctor" (Canada) - all to no avail. Current orthotics are okay but don't make pain go away, just alleviate the symptoms during the day. It's so bad I don't want to get out of bed in the morning. I have printed out your articles and illusrations and will start following some recommendations.
thanks for the fabulous site!!!
Thank you for consolidating so much helpful information on PF. I am alreadybenefiting from your work.
I thought I might pass along something I use at night to minimize the painwhen arising. I put on a sock and then tape an othotic to my foot. I useduct tape (like you) and firmly secure the orthotic by taping it high on theinstep. I also apply a short piece of tape from the heel of the orthoticover the sock. I tried using duct tape without a sock at first, and Ithought I'd never get it off - hence the sock.
I'm using a Birkenstock orthotic, but I plan to check on the Spenco productsas my arch is rather high and I should be able to get a better fit using theprocedure you describe - i.e., boiling water.
A podiatrist in Denver who examined me will custom fit an orthotic for $290. I've seen the device which is a 3/4 othotic with an integral heel lift. Butgiven the success with methods you have described I plan to try them firstand see if I can be among the "healed."
I don't know why PF chose me. I've been active all my life: I swim, bike,hike and I'm not overweight. But I do have high arches and, after retiring12/31/95, spend much more time on my feet.
Thanks again for you efforts.
I can't believe the extent of work you have done on your plantar fasciitis web site! I have had chronic pf for almost 4 years -- undergone multiple anti-inflammatories, stretching, icing, orthotics, inserts, and most recently injections (it hurt like hell...). I'm excited to wade through all of the links you have provided and hope to find a small glimmer of hope somewhere. Have you heard of anyone trying acupuncture and what the results were?
> Hello;> > First, thank you so much for the thoughtfulness of allowing us to email a> question. I'm sure you get a lot of them!> > My wife has PF in both feet; the right foot being the more painful. She> has worn both the plastic ($50) orthodics and the custom ($200) type. Her> condition became noticeable and painful 4 years ago. She initially had a> series of cortisone injections over the first two years (6 in the right> heel, 4 in the left) which gave her relief for about a month or two each> time.> > Into the third year of her condition, we tried a different Podiatrist, a> Dr. Pam Buckman at the Adler Podiactric Clinic in Jacksonville, Florida. > The new doctor prescribed the custom orthodics, together with the foot> stretching exercises and cushioned running shoes which my wife (Susan)> wears religiously.> > To date, my wife is no better. She has even taken new employment in ajob> in which she is not on her feet often, due to the pain she endures daily.> > The doctor is insistent that my wife try the cast treatment at this time;> however my wife is fed up with the pain and not being able to walk and> wants the surgery, so we are now awaiting my HMOs (PruCare) review and> approval of the procedure.
Scott, today is the first day I was wearing the heel cushions that I ordered from you link. It's great staff. I feel I can walk muchbetter. I have a question, the cushion has a left side a little lowerthan the right side, and unfortunately cushions are not marked as leftand right. Should the higher side of the cushion be on the inner sideof the foot or visa verse? Also do you take the spur inserts out or doyou keep them?
When I found your web page, I felt a great relief. Thank you so muchfor your efforts in educating the suffering. I have been under goingtreatment for plantar fasciitis nearly four months. I'm currently in acast and have been for over seven weeks. The pain is still quietintense. My doctor told me I had ruptured the plantar fascia on my leftand my right foot is getting worse. I have this cast on for two moreweeks then he's ordered a MRI to compare the damage to both feet. Itake Indocin. I haven't been able to go to work in over six weeks.
Your information you so kindly provided gave me other avenues to pursuein my attempt to over come this injury. I plan on starting some of theexercises you suggested today.
Luckily, I work for a great bunch of folks and they have me set up athome telecommuting via computer, fax and phone. It's working out great.
But working at home, with a cast on has it's disadvantages too. I'm soisolated here. Your web page gave me a connection I needed to keepmyself going and hopefully speed up my recovery. Thank you so much.
I had excrutiating pain from plantar fasciitis. The cortisone shots werea godsend to me and I would recommend them. I have an acquaintance whohas had her feet taped for so long that the skin began to break down andher doctor would not consider shots. Well I can walk 10 miles 3x a weekwhile she can barely mAke it to the bathroom. Don't speak for everyonehere. I have had excellent results. Carol
Most docs do not try and treat the symptoms only in order to continue treating the patient. Cortisone shots are indicated in very painful situations or to break the pain cycle. The best shots for the heel are generally given by podiatrists as they are more familiar with this area. The MDs are usually much more painful in their approach. Personally, a patient has to beg me for a shot as I prefer to treat the problem. I prefer taping, manipulation (adjusting) and stretching to get them through the pain till they get their orthotics which then can start working (although in some/most cases it still takes time to work)
Scott:Found your page very interesting. Thought I would share my story withyou and see if you have any suggestions or thoughts. Initially I hadbeen diagnosed with a heel spur on my right foot. Eventually found myway to an orthopedic dr. who had me wear a rigid plastic heel cup. Itworked wonders and had no problems since. But then my left heel startedgiving me some trouble so I wore the heel cup on that foot awhile. Butthen the pain started showing up in other areas of my foot. (along theoutside edge and through the top middle area). I set up an appointmentto see the orthopedic dr who treated me before, but the appt. was toofar away and hurt too much to wait so I opted for another orthopedic dr.We started out using Aleve and then eventually switched to Relafen foranti-inflammatory. He also recommended good walking shoes-(Reebocks). Iwore them religiously-even for office work, even though they aren't verydressy. During the summer that isn't so bad because casual slacks workout ok but now I am back to wearing dressier shoes-hope this isn't aproblem. But... I am not sure if I am impatient or what but this seemsto be taking forever. I think I have been doctoring with this PF sinceFebruary. I was going to try going off the Relafen but when I startedthat I felt like the pain was worse. Although, I am not really sure,because sometimes I can go several days feeling really great and thenboom I have a few bad days. I walk every morning with my neighbor for 20to 30 minutes. Is this a good thing to continue or should a person givethat up? - it is the only real exercise I get. Neither doctor I haveseen has recommended any foot exercises?? I also have some swelling inmy ankles and on my left foot on the outer upper side (hard to describethe area) Is this normal with PF? I would welcome anysuggestions...Thanks! Carol
I have been suffering from P.F for 17 months. In that time I have lost 37 pounds, I wear custom made orthodics, I have had cortizone injections, physical therapy, et al. I still have no relief. I would say that the pain is getting worse and I am now starting to feel similiar pain in my left foot.
I am very frustrated. Any ideas on what I can do next?
I read in Health Beat's article that shoes with a moderately high heel might relieve the strain on the plantar fascia. Being a guy, a trip to the local shoe store proved futile. Next I visited a shoe outlet and searched high and low for a pair of men's loafers, wingtips, or whatever, that had a heel heighth of more than an inch. No such luck.
Then the shoe sales clerk asked me what I was looking for. When I told her, she said her husband had plantar fasciitis twice, and they'd found a remedy. She brought me to an unused section of the shoe store, went into the back, and returned with a pair of dark but handsome lace-up oxfords. They were size 13 in women's shoes (size 11 in men's), with real leather uppers and a two and a half inch block heel.
I thought it was strange, but after a years worth of pain, visits to podiatrists, and half a dozen over-the-counter orthotics and heel lifts, I was willing to try anything.
They look very much like any man's shoe. Even the heel is shaped like those on men's shoes, except that it's considerably higher. At first I only wore them around the house, but the neighbors convinced me that they were close enough to a man's shoe to fool just about anyone.
I've worn them to work for a couple of months, and to date, only two individuals have noticed the higher than normal heel, and even then they asked if I was wearing a special kind of orthopedic shoe for my plantar fasciitis. Quite honestly, I told them I was.
I've combined wearing the shoes with the usual massages and stretching, and my heel pain has all but vanished.
I certainly wouldn't recommend men suffering from plantar fasciitis go out and purchase a pair of stilletto heels! On the other hand, I've found that a solid leather lace-up shoe made with a built-in heel provides both heel-lifting, arch, roll support. I believe having these features integrated into the overal design of the shoe provides a significant advantage over add-on orthotics and heel lifts, independent of the fact that it was orginally made for a woman.
During a recent trip to Europe, I encountered an interesting fashion trend that is already making it's way into the States: Chunky shoes. Both men's and women's shoes are sporting wide two and three inch heels, with minimal platforms, in shoes with solid leather uppers. If you're willing to jump on that fashion train, you're sure to find another possible avenue of relief for your plantar fasciitis.
Bottom line: If the shoe fits, wear it!
Dear Scott: I greatly enjoyed your home page. I have been diagnosed with plantar fasciitis. I have suffered for over 1 1/2 years. I am 32 years old and have been through all the treatments. I hate to say that it has become something that I think will always simply bother me. My problem is this. Every time that a try to return to normal excercise, I end up with a stress fracture on the top of my foot. No doctor has been willing to describe the connection between the two. Have you ever heard of this? I am a teaching librarian at a elementary school with 13 classes a day. I'm always on my feet. I need some help to improve the quality of the my life! Thanks, Tammy
I presume my pf is not as severe as yours. But the pain I wen through I thought I was the only one on earth going through this sort of pain. Any way, my doc prescribed arch support, and if that was not enough, he prescribed Tuli cups. Wearing all that every morning felt good for about an hour, then the pain travelled to the toes and the front of the foot. Over the week end I felt good because all the gear was at eork, and I wore plain Nike Air, prescribed by physio. So one Monday morning I decided Not to wear the gear. The pain started to subside. I still go to physio once a week, cold packs, exercise and proper foot wear is doing the trick. I feel much better and I think I will be on a jogging program next week. Vitamines and Calcium tablets may have played a role, but one thing is for sure, arch supports and cups etc etc are not for every one.Zul
My name is Ruth Werner, and I am in the process of putting together a textbook about massage and various kinds of diseases and conditions. I found your PF page extremely useful!
I have 2 questions for you: a. what is the reference source for "a very long article"?
b. would you be willing to be "interviewed" for an up-close-and personal" segment on what it's like to live with this condition? I could probably take excerpts from your PF page, with your permission.
Thank you for this good work you've done!
Thank you for your helpful information. I have had PF for about oneyear now, after taking up power walking to lose weight. (I lost 28pounds just by eating healthier and walking for an hour each day) ButI also ended up with an aching right heel, which only got better bybeing on DayPro. When I went off the DayPro, the pain came rightback.
Unfortunately I had to quit my power walking because of it. I amcurrently waiting for my orthotics to get in at the podiatrist's. Isure am hoping these help. I am 35 and am in very good healthotherwise. So exactlyhow well do the night splints work, and what makes them differentfrom regular orthotics? Also, can you tell me more about casting, and why that works?
One of the main reasons my right is sorer than my left is because myright leg is a half inch longer, and I can hear it scrape the ground harder. Is there anything special forthat? OK OK, something other than a hacksaw. (I know-disgusting!)
I won't get shots either because it is true that while they providerelief ( I had them in my shoulders forbursitis), they did hurt like hell, and I would go through surgeryagain in a heartbeat before I ever get a cortisone shot in an inflammed area. Surgery was ten times morehumane.
Thanks again for your homepage. Very informative and interesting!!
I have experienced pain from plantar fascitis for about eight months. I took 600 mg. of Ibuprofen three times a day initially. It helped for a couple of months. Eventually the benefit of the Ibuprofen was much lower. I am now taking 200 mg of Ketoprofen once a day with great results. I use it in conjuction with a plastic orthodtic on top of your basic Spenco. It seems to be getting better.
Hi Scott,I have plantar fasciitis and also Painful heel syndrome. I was givencortisone injections, which didn't work, was put on anti-inflammatorys,had my feet tapped for two weeks which has helped the pain when risingfrom bed. I still have pain in the heel, was told I have little paddingand was fit for Orthotics. Hopefully, this will work. I had read fromone of your readers that he had this Painful Heel Syndrome also, Tonywas his name. I was wondering if you would know if he has found anytreatment for this? Or if you would know anything about the fatpad onthe bottom of your foot, and what treatment there is for it. I have beenin pain for about nine months now, and also pain in the hip, buttocks,and back of the legs on top. Hurts to stand, and hurts to sit. I don'tknow what else to do. Please help!Thanks, Judy
I have been experience PF for the last 2 years. I injured my archileswhile tripping over a concrete step. At that time the specialist put me in aboot that could be removed at night. However, since this boot did nothave a good arch support, after being in the boot for 4 months my archbegan to hurt. After 3 specialists and having a cast on for a month Ifinally sought help from Chinese medicine. The method used to treat myfoot (now inflamed, swollen and archiles pain to "boot") was AccuScopeelectronic treatment along with oral tonic medicines. This workedwonders. I couldn't believe that this doctor worked on my foot for 2 1/2hours each visit. I was used to waiting 2 1/2 hours in the traditionaldoctors office only to see him for 2 to 3 minutes.
The other thing that had helped my foot in the past was medicine that Iwas on to treat my asthma. This was a combination of an antibioticalong with a form of prednisone. While on this medicine my foot clearedup and I had no pain. However, after being off the medicine for about 2weeks, the pain returned.
Rest was not an option for me as I work and am on my feet the majorityof the day. I believe the Chinese medicine was the most helpful. Theonly problem with it is that it is not covered by my insurance.
Hope this helps.
Thank you for putting a link to our page on yours.If your have plantar fasciitis and would like a free sample of ourproduct please let us know. don't forget to state your shoe size.
This product was invented by Dr. George G. Budak DPM a podiatrist since1958. He started designing it in the late 1978 and finally got around tohaving it produced in 1989, basically he kept it in his head for 10yrs.Now he has been using it in his practice for the past7 yrs. and we have been using it in our orthopedic shoe store for about 5 yrs. it works about 97% of time and we offer a 30 day back(no questions asked gaurantee) on average it last about 1-2yrs beforeit has to be replaced. and all that for under $50.Thank Agian,George
I developed heel pain in both feet last September. I was, and still am, however, in a state of denial and continued to run. I am training for the Honolulu Marathon which happens in two weeks and did get desperate. I did get treatments which consisted of friction massage, aggressive stretching and anti-inflamatories. Viola! I think it's working after three sessions. I ran 2.5 hours this morning with no pain (none even when I first stepped out of bed and no pain after the run when I used to feel it too.). I was told the friction massage is to break up the scar tissue. It was difficult as part of my injury was directly below the heel. The massage is excruciatingly painful, and I was in tears most of the time. The results are wroth it to me, however. I keep my fingers crossed that I've been permanently cured. I hope other sufferers will consider something like this. Good luck with yours.
I have a few more sessions butthink the worst is over (It almost equals a spinal tap.) He taught me howto apply friction myself. With success, I probably won't need a shot whichI undersltand is worse than a spinal tap.
Frictions are always followed by icing. It's nothing really esoteric. Theinflamed soft tissue, tendon in this case, is rubbed back and forth acrossthe grain. Treatments are normally every other day. Also,anti-inflamatories (Daypro in my case) are used along with the massage.Incidentally, my physician, Dr. Bernard Portner, is a noted sports physician(physiatrist) who is a runner, and his wife is a better runner (sub threehour marathoner). He advocates friction massage as the first treatment forinflamed soft tissue. I've had it done successfuly with other injuries.
Anyway, my left foot has completely healed as the affected area was in twoplaces easy to get to--in the arch where the pf attaches to the heel andfurther in front towards the ball. My left foot is a little trickier as theinflamation is directly under the heel towards the back and inside. It hasimproved considerably, but I'm not out of the woods yet. Still, I don'texpect it to stop me from a good performance in the marathon. As Imentioned, it is not painful when I get out of bed in the morning, just alittle sensetive. It disappears soon after taking a few steps. I could letyou know in about a week and a half as to how it did.
I have had pain in my left foot since February 1996 and it is nowNovember 1996. About three months ago I started having somePhysiotherapy my the painful left foot and was told I had P.F.. I becamefrustrated and confused as the symptoms did not get better. I accessedyou home page about two months ago and found it greatly broadened myunderstanding of the problem. I purchased some Nike Air Trimax runningshoes for daily wear. I made my own night splint which I have used everynight since. I also made some heel raises. These measures gave me someimmediate relief. I like to do alot of energetic sports but I found thatI have had to stop doing any vigorous activity. Over the past threeweeks I am pleased to report that the pain has gradually reduced tozero. However, I find that as I try to increase the level of activity Imust be very careful. Walking short distances does not cause painwhereas more vigorous activity does. I have found that I can swim (frontcrawl only) without increasing the pain. Now the pain has reduced I havestarted a stretching regime. I am currently stretching the plantar bypulling back the big toes and using my thumbs to apply a firm localpressure (and hence stretch) directly around the "hot-spot". I find thatafter this local stretch the plantar feels very good. Sometimes, if Ipress too hard, I later become aware of an uncomfortable feeling in theplantar although it is not particularly painful. I do not useanti-inflammatories and have not had any injections. I am fortunate inhaving a sedentary occupation.
I am now confident of beating the P.F. although I do not expect it totake less than several months. I feel that the quality of rest is veryimportant and also that a night splint should be used. I should say thatmy splint is adjustable so I can reduce the dorsiflexion if the painincreases.
I wish you well with your own P.F.
Scott, thanks for the informative page on PF. I have been fightingPF for about 18 months. At this time, I have been successful (knockon wood) to return to running. I tried many things but here is whatworked for me.
1.) I got orthotics. I only wear them to run. When not running I wear a good running shoe which is made for excessive pronation. Right now I like the Brooks Addiction. By the way, lookingat the picture of your shoes, I would say they are worn out. I used to wear the orthotics all the time, but I feel they make your foot 'hooked' on them. I believe the running shoe is crucial to controlling PF. I have to have a straight, combination lasted shoe. The orthotic sits under the liner on the cardboard last. If any pain starts back up for more than 2-3 runs I buy new shoes. The foot doctor jacked up the arch a bit after about 3 months. His comment is you have to stop the PF from strumming like a guitar string. Not sure if this did anything, but made me feel he was doing something. The doctor was against taping, I like your duck tape process. Taping never worked for me, I could never get it right.
2.) I took 6 months off from running. This seemed to let the pain spread out over the arch and lessen. I went on a 10 day backpacking trip with steel shank boots and the pain disappeared. Again, I did not wear othotics at all during this time. I still had slight pain in the morning, if I went barefoot or wore sandals at the beach. I also found out that playing volleyball on sand, caused no pain, again the arch was supported by the sand.
3.) I stretch the calf 3-4 times a day. Whenever, I sit around for awhile, I stretch before walking. People at work think I am nuts.
4.) I cut my running distance in half and work out in the gym on weight equipment. I do alot for the knees and calfs. Also, I know when the shoe is wearing out if my inside knee starts hurting after a run. This is a sure sign that my foot is pronating. I used to run from 45-60 minutes, now I never go over 30 minutes. I am 43 years old and my pace is cut also. I also only run on flat ground. Hills cause pain. Pushing off on a hill, I can feel the arch pull.
5.) I ice the foot after running, I run at lunch, when I get home at night, I ice the foot using a large bag of frozen peas. It moulds to the arch very effectively. I wear a sock until I cannot stand the cold pain. Also, when I shower after running I hold the foot in pure cold water from the shower. In the winter it is very cold, in summer not much. When you are done you can throw the bag of peas back in the freezer.
Thats it for me, I read all yours and others posts and it lookslike everyone has PF to a different degree and cause. Again, thanksfor the page and good luck.
You are to be commended and admired for the research work you have done toprepare this information. I am a PF sufferer for several years and it hasall but sidelined me from doing anything. I have heel spurs in both feet,pf in both feet and have done everything listed in the books short ofsurgery, which I will not consider and still have no results. I'm on my6th pr. of custom orthotics, 2 different kinds of nite splints,rockerbottom adaptations to the sneakers,nsaids,ultrasound,whirlpool,5 shots of cortisone which made things worse,17 MD's and podiatrists,MRI,bonescan,repeated x-rays,and still no results. I would very much like to hearfrom you and if you have any other suggestions I would greatly appreciateit.
Are you yourself a PF sufferer? I am not a runner or into any form ofexercise. This just came on and will not go away. Please e-mail me whenyou have a moment. Perhaps you can put me in touch with someone who is asbad as I am on you e-mail list.
Thanking you very much for all the time and energy you have spent on thisdisabling condition.
[In reference to the pain of shots:]Why not ask your doctor to perform a (painless) posterior tibialnerve block at the ankle prior to local depot-steroid infiltration?The anaesthetic block is minimally uncomfortable and if perfomedwell, provides dense anaesthesia to the sole of the foot for an houror so.... the infiltration to the sole of the foot is then painless.
I had excrutiating pain from plantar fasciitis. The cortisone shots werea godsend to me and I would recommend them. I have an acquaintance whohas had her feet taped for so long that the skin began to break down andher doctor would not consider shots. Well I can walk 10 miles 3x a weekwhile she can barely mAke it to the bathroom. Don't speak for everyonehere. I have had excellent results. Carol
My PF was so bad, I cried after coming home from work (after standing mostof the day). I went to the podiatrist, got a cortisone shot in the heel, and feltrelief instantly. This was used only for this type of severe case, accoding to him.I only biked (no running) for 6 weeks. After receiving my orthotics, I began slow running, and within 18 mo.,ran a marathon. I consider myself cured. I still stretch every day, though, too. That also helps keep the PF atbay.
My experience with cortisone: no pain, but no permanent solution. In one casethe pain was *temporarily* relieved, then returned. In another case, there wasno effect whatsoever. Lenore
Plantar Fasciitis, heel spurs, and heel pain home page