Plantar Fasciitis

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Hiya,

 

I was originally diagnosed with PF 15 years ago and have treid about 15 different treatments but none help and currently my PF is the worse it has ever been. I am constantly limping and the pain in my right foot is excruciating (I have it in both feet). I often feel like no one really understands what this is like and that I am putting it on! Below are the various things I have tried:

1. Othotice (custom made by a podiatrist) - expensive

2. Gel pads

3. Heel Cushions

4. Over the counter Orthotics

5. Reflexology

6. Aromatherapy

7. Reiki

8. Gels / Deep Heat Rubs

9. NSAIDs

10. Injections of cortisone (twice through the sole of my foot - ouch! and once through the side of my ankle)

11. The strongest pain relief my chemist would sell me

12. Physiotherapy (who also taped my right foot)

 

I am running out of ideas and am at my wits end as to what my options are. Would an operation help? Is there an operation for PF?

 

Any advice?

 

Peter

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Update (25th November)

 

Where do I start probably with a moan! After eventually seeing an Orthopaedic Specialist at my local hospital (Bournemouth, UK) and an attempt to inject more steriod (which did nothing after 2 hours) an had another appointment and they suggested a light general anesthetic so that they could inject the steriod deeper into my heals. Went for the procedure and was all over with fairly quickly and returned home a tad groggy from the propofol. For a few days it seemed to have worked but sadly any affect was not permanent. I then had my follow-up appt and what a waste of time. Everytime I go I feel like I have to go through my whole sad, sorry story and am left feeling like I am making it up or exaggerating. Anyway the consultant was not there so what was the point. Have now got another appointment for today!!! Am seriously considering asking for an operation now as I am out of options. My heals (both feet) are as bad as they have ever been. I hobble about and at no time can I ever go round the house bare footed - to painful!!! AARRGHHHHHHHHH

Cortisone shots (steroid) take a few days to work, if they are going to work. I've had a ton in my knees and shoulders, and some in my feet. The last ones in my feet never worked. If you have no pain relief after about a week after you get the shots, then they didn't work. I tried almost everything I could (excluded the things that I couldn't do such as eswt)  until I finally had the surgery 5 weeks ago. Not compeltely painfree but soooooo much better (probably about 90%  better)in the worse foot, which, because it feels better,  made the other foot, no longer compensating for the worse foot, feel better.

Dear present sufferers!

A year ago I couldn't walk any distance because of severe plantar faciitis in my right heel. UK treatment routines did nothing to help my condition and I was left convinced that they knew very little about how to heal a partially severed fascia (which is what PF condition is). All these silly stretch exercises merely caused more damage to an already damaged ligament. Then in Russia some physiotherapy experts offered me low level laser treatment combined with magneto therapy and ultrasound (in that order). Two sessions of 10 treatments over a period of dispersed my scar tissue from the torn fascia and reduced the internal inflammation. This was designed to take pressure off the capillaries in the heel thus increasing the flow of nutrients and proteins to the healing zone. This is how the body heals itself!! Already four months ago I resumed my exercise routine which starts each morning at 7 am with a 6 km walk. Some times I get a slight twinge which reminds me of 2010 but it quickly disappears and I think "I'm cured". So there's light at the end of the tunnel and steroid injections are a waste of good money and an excuse by the medical profession for the proper care we expect from them.

 

The first couple of times I had PF, the shots worked. This last time, they never did. When I had acupuncture (my treatment of last resort for this PF), the acupuncture MD suggested cold laser treatment-wondering if that's the same thing-but it never happened because he dismissed me before the full treatments, saying it wouldn't worked. It was Thanksgiving here in the US yesterday and I have to say having much less pain in my feet after 6 months had to be near the top of my list of things I am thankful for.

Hi Carol - and Peter if you're following the discussion!

Yes cold laser is the trade name for low level laser. We normally associate laser with heat but at low intensity it is barely warm and it is the light photons which provide the energy to our wounded zones. Laser by itself is not the answer but combined with other treatments it forms an essential stage of the healing process. My therapist described the laser stage as a breaking down of the scar tissues which had formed in the fascia; a preparation for the later therapies. Next came magneto therapy in which the wound area (in our case the heel) was held in a strong magnetic field for around 15 minutes. This reduced inflammation in the heel area and took pressure off the veins which carry nutrient around the body, so the flow rates increased. Next came 5 minutes ultrasound applied directly to the pain area to stimulate the flow of fluids in the veins and capillaries in that region, delivering nutrients and importantly proteins to the wound. As I've mentioned earlier, thats how wounds heal themselves. The daily treatments took around 40 minutes, going from specialist to specialist and I had ten sessions, then a break of two months followed by another ten sessions later. The improvement always came about two weeks after treatment, me suddenly realising my pain levels had diminished. Of course, as I've mentioned, these treatments were given me in Russia, courtesy of friends in the medical profession. In the UK they don't believe in this (un-proven was the word they used) but I am walking proof that this well structured treatment works. So if you can talk about this with your specialists and organise treatments of this kind, you'll be on the road to recovery within a few months.

 

I probably could not have had the treatments that break down the scar tissues as I have an autoimmune blood disorder that makes me bruise more easily than most people. It was for that reason that my hematologist wouldn't let me get eswt. I have scar tissue in my left knee from a knee replacement (I am having an arthroscopy for that Dec. 28) and I know people with a similar problem that have had a fairly new treatment called ASTYM (it breaks down the scar tissue during a long series of treatments)-which people now also are getting for PF-but for the same reason as not being able to have the eswt, I couldn't have that either-so the odds are probably couldn't have had the cold laser as well. Anything that can cause bruising (which I believe the laser could-so although the acupuncture doctor said he would do it (and never did), the odds are I probably would've ended up having to decline it if it had definitely become part of the treatment plan), I can't/couldn't have. I ended up having the surgery almost 6 weeks ago and feel much better for it, but it probably would've been better to have been able to do a  non-surgical treatment-=but that wasn't going to happen.

You're right about the ESWT and the ASTYM if you have a bruising issue, it would be too invasive for your skin. However, laser should not aggravate your condition, though a specialist opinion would be best. And the magneto therapy would probably help your knee problem if properly applied around your joint through a hoop shaped element. But for the heel, magneto treatment would definitely assist your recovery, in my view. Ultrasound stimulus to accelerate fluid circulation in the region of your plantar faciitis should help you heal without causing internal bruising.

Hopefully I will not get PF as badly as I had it ever again. My run-ins with it always came about after my 3 knee replacement surgeries, and since, I sure hope so, lol, I am not having another one of them, I'm keeping my fingers crossed that I will remain PF mostly-free for the rest of my life. I had it bilaterally, worse in one foot so that's the foot I had the surgery on. The other foot has improved since it's no longer compensating for the worse foot, and hopefully it won't decide to worsen again. But I will definitely be keeping in mind those non-invasive and non-bruising treatments.

Thanks for previous comments. Saw Orthopedic Specialist and they are going to try the PF Release surgery - whatever heel is bad on the day is the one they will do. Them all being well take things from there. Am now waiting for the date to go have it done. As I have had PF for so many years I am prepared to take the change on the operation. If it don't work then I will have an easier time accepting the condition as God's Will. Will have to organise work etc but am feeling confident that when I set the goal three years ago to get my PF sorted I am finally getting somewhere beyond meds and taping and occasions injections.

Peter, I just had the release on the worse foot too, with plans to do the other foot if necessary, once I recovered. It wasn't necessary (as of now, 6 weeks later).  My foot and ankle orthopedist specialist told me to come back if that changes. So now that I have my feet mostly fixed, I can finally have a knee fixed-only about 10 weeks after the foot was fixed.

Hopefully the surgery will help you as it has helped me. I am not 100% pain free but a whole lot better than I was and no longer need pain medication at night to escape the pain that always got worse at bedtime (I had atypical PF, according to my ortho) than when I got up in the morning.,

Caroline, thanks for your reassuring reply. My PF seems to be constant throughout the day but I must say that when I go to bed I am constantly stretching my ankles out as they hurt and it is not until I fall asleep that I am unaware of the ache. In the morning it is always the first thing I notice. I cannot walk bare foot and keep a pair of slightly wedged sandals (that I use as slippers as they are the best thing for my PF) by my bed to slip on as my feet hit the floor. I have just been on YouTube and watched some surgeries and testimonies and they have had a very reasuring affect as well. It is just a matter of time waiting for my hospital admission date now. It is a day surgery proceedure but I will have to take 2-3 weeks of work apparently - so I shall have to try and put something in place in readiness (I am a College Lecturer but will need to source cover for my job as I am the only Full-time person in my small team). I just hope I am not waiting for months. A part of my does not expect 100% success but anything is better than what I currently have - two heels constantly in pain that sometimes really gets me down (and believe you me I am an eternal optimist!).

I had a cast for the first 11 days after surgery, removed on the 11th day, along with the stitches. It was a walking cast and I managed to do volunteer work,  a few hours at a time, sitting at a desk with it. But I wouldn't have wanted to be on my feet more than necessary. Once the stitches and cast came out, my ortho told me to "take it easy" until I saw him next, which was 3 more weeks. I had to continue to wear my orthotics - which I will probably have to do the rest of my life. I think at this point, if I were in a job where I needed to be on my feet part of the day, I could probably manage it. I managed to get through the surgery without several of the complications, including losing the arch of my foot (I kept checking, lol) and getting an infection. The scar isn't pretty. In fact, my ortho told me it would look, according to him, "funky" for a while, which, indeed, it is, lol. My surgery was on an out-patient basis. I had to be there at around 7AM for an 8-8:30AM surgery time. The surgery itself took about 30 minutes, with my foot numbed and a sedative given in a holding room, so I don't even remember being in the OR at all. I was home a little before 11AM and didn't need pain medication until 5PM! It was lovely. I do have a thread here if you want to bother looking at it. It starts the day of my surgery and is called "Had my endoscopic plantar fascia release this morning 10/17/2011."

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