I have had a problem with plantar fascitis for 2 years now. I've tried stretching, anti-inflammatories, orthotics, cortisone shots and I can't seem to quite shake it. I'm curious if any of you have had the surgery for this and if it seems to help in most difficult cases. My doctor has been saving it as a last resort and says the scarring can cause more problems and the surgery isn't always successful. I'd like to hear any experiences from others here. Also, has anyone tried a night splint?

In theory, night splints work very well. They keep the achilles tendon on stretch and thus the plantar fascia is on stretch. The problem I encounter with night splints is that most patients can't wear them and get a good nights sleep. However, I do believe they are worth a try. Heel spur surgery / Plantar fasciectomy is pretty much always the last resort. As with any surgery, there are no guarantees that this will cure your problem. From my experience, I only operate on heel spur / plantar fasciitis patients after everything has failed stretching, cortisone, stretching, orthotics, stretching, stretching, lifestyle modifications (weight loss if any weight gain has occurred)and then surgery. If my patient proceeds with surgical correction this is what I tell them. You will have to be off of your foot for 3-4 weeks. The inside part of your heel may be a little numb. You may develop a different type of pain (more of an ache) on the outside part of your foot. And last, you may continue to have heel pain. There is a website dedicated to heel pain called heelspurs.com I believe they have a message forum such as this that deals with these issues. I've been to that site a few times and it seems very good. Good luck. Remember...Stretch stretch stretch.

foot pro: I have gone through the gammut that you have just described. I had a complete bone spur/plantar fascia what ever done in august. As you said, I still have pain and discomfort. I have taken an additional 6 weeks off of work at this time to help heal. But it is getting time to go back and I am scared to death. I am so scared that I keep having re-occuring nightmares about it. I do not take any pain meds now, but put it on ice after a day of walking at the mall or just grocery shopping. I massage it every night with lavender massage lotion. I have $300 custom inserts for my shoes and even after the breakin period, they still hurt. I am required to work 45-50 hours per week as a home fashion manager for a local retail store. This is very hard on my feet. I am on the go sometimes before I even get clocked in. I am thinking on stepping down to a part time position that would be a little easier on my feet, but this makes me feel like a looser. I can't believe how much trouble I am having and the thought of that surgery, should of made things better. I am tired of hurting and gimping around like some 80 year old fart. I am 45 years young and don't feel like it most days. Do you think those splints would help? I have heard people talk about them and it makes sense to me.
thanks

In theory, the plantar fascia night splints should work. The main problem is with patient compliance. The natural position our foot is in when we sleep is relaxed or plantarflexed. If you take your foot and dorsiflex it with the night splint you put the achilles tendon on stretch. This ultimately puts the plantar fascia on stretch as well. From my experience, most people can't sleep well with the splint on while in bed. They say it is just too uncomfortable. However, if you're at the end of your rope so to speak then anything would be worth a try. You bring up an interesting point about your postop course. You say you still have pain. Just out of curiosity, where is your pain located? Is it still under the heel or has it moved to the outside of the foot? Also, what kind of surgery did you have? Did you have the heel spur removed? Did you have the surgery where they make two small incisions on each side of the foot? One last question about your orthotics. Are they extremely rigid? If so, then why dont you try putting a full length spenco type insole over the orthotic in your shoes. You may have to go up 1/2 size but that sometimes helps. Don't give up on the orthotics. They usually take a while to help. Some people respond to the rigid devices others respond to a more flexible device. My general rule of thumb is that the larger the person, the more rigid the orthotic should be due to structural support. If ou are a large person, you would flatten or bottom out a semiflexible or flexible orthotic and therefore the biomechanical control would be lost hence continued heel pain. Anyway, I hope this helps. Good luck. I'm a firm believer in stretching,stretching,stretching.

I have had heel spurs and on both feet. I went to podiatrist who recommended forms for my shoes. But he told me it ALL came from ill fitting shoes and he was right. I immediately changed things. I could not even walk 10 feet and great pain. I switched to tennis shoes great support and added the little blue heel support from Dr. Scholls sold in Walmart for $4.00. I then had a grandson born, I rocked him every night. It seems the rocking and pushing the rocker with both legs helped me exercise. I then also started taking GGlucosamine 500mg and Chondraitin 400mg and Vit. D 1000 for absorption. Well, in approx. 2 -4 weeks my pain disappeared . Joshua is now 3 years old and I have gained a few more pounds from Christmas so I am going to try to lose a few pounds....but my heel spur in one foot is returning.....so back to this routine. But I noticed my feet turning red on the bottom when this started like the blood pooling on the bottom and tightness in my feet. So, just wanted to share and will get back with how my new routine helps.....hopefully it will. Good luck to you. Hope this may help.
Hugs and prayers. Linda

Linda, can you tell us about the medicines you were taking? I know what vitamin D is but I don't know about the others. Are they prescriptions or doctor recommended, or how did you decide to try them? I'm very interested in something that seemed to work so well for you. I had heard that it can help to take vitamin C and Calcium, but I take them and haven't noticed any difference. Ann

Glucoasmine and Chondroitin Sulfate are over the counter herbal medicines so to speak. Many athletes who have joint pain such as knee or hip pain take these supplements. The thought behind chondroitin is that it is suppose rebuild the cartilage which has been destroyed due to wear and tear or trauma. There is very little clinical evidence and these medications have not been approved by the FDA. I have heard some of my patients take them and get pain relief for generalized arthritic conditions. I would recommend before anyone take a herbalal medicine they check with their doctors for any drug to drug interactions. My wife is an allergy nurse and there are several drug interactions with these herbal medicines and allergy medicines. Some could be FATAL. In the case of plantar fasciitis, there is no joint involvement. The plantar fascia is a ligament which attaches to your heel bone and extends out to your toes. The mainstay of treatment for this condition is number one identify the causative factor (poor biomechanics, unexpected weight gain, inactivity etc...) After the causative factor is determined a treatment plan is devised. For my patients it usually starts off with stretching exercises BEFORE they get out of bed in the morning. I'll have them do this and in addition modify their shoes / insoles. I will usually try an over the counter arch supprot to see if any relief will be had from this. If not, I will progress to a cortisone injection. I will only give a max of three injections in 1 year. I will also put a strapping on the affected foot. This will help hold the foot in a more anatomically correct position. This will also tell me if the patient will respond to custom orthotics. If none of this works, then the last step is surgery. Most of the time I will perform a plantar fasciotomy. That involves cutting just the ligament. Some people cut 2/3 of the ligament others cut all of the ligament. There are pro's and con's for for each. We have found that in the majority of patients, we do not have to remove the heel spur if present. This speeds up recovery a bit. One caveat with heel spur surgery is that most of the time the patient will be numb on the inside of their heel and possibly arch. Also, I let patient's know that they may develop a pain on the outside of their foot. Good Luck

Foot Pro-- What kind of stretching exercises are you recommending?? My podiatrist did not even mention stretching for my foot problem. I would truly give it a try if you can explain how to do them. Much Thanks~

I have been suffering from Plantar Fasciitis for 2+ years in both my feet. I have had the injections, accompanied by ultra sound treatments, strapping by the doctor, daily wrapping by me, orthotics and changed all the shoes in my closet to shoes that tie and have excellent support (if you can bend a shoe from the toe towards the heel, then it isn't a good shoe).

I had an ultra sound done to find out the size of them. The average woman is a 3-3-1/2 and I am an 8 and 7!

I asked my doctor for night splints about 3 weeks ago because I cannot even put my feet up in a chair without being in complete pain. Now I sit without pain while watching TV. I also wear them at night. I cannot wear the one on my right foot all night because for some reason, it hurts my ankle. They are not the most comfortable (or romantic) thing you will ever wear, but I now wake up with NO PAIN!!

I found that wrapping my feet daily has also been my lifesaver. I couldn't walk as much as I do if I didn't wrap them.

I have limited my activities because of my feet and feel like I have to do something else to eliminate the problem/pain.

I am looking into shock treatment (don't have the exact name with me). Has anyone tried this? What do you think?

Hi, I too have suffered tremedously with PF for two years. It happened mostly from me wearing poor shoes (worn out sometimes) and working overtime in a job that required lifting and standing all day. I did this for 13 years. I had to actually give up that job, a job that I really liked. The pain iniatilly was sudden, and actually nearly caused me to crawl...and, a very srong man that could bench 300 easily, now could not walk correctly. So I moved to a desk job, and found www.heelspurs.com, (http://www.heelspurs.com) and it helped alot, giving ways to wrap the foot, and stretching techniques. But the boards themselves can be ultra depressing, and while some of you may benefit from the boards, and the info, it is also littered with people who have given up, and have tragic stories of jobs lost, careers devistated. relashionships lost. etc... There are some truley succesful EPF stories as well (Endioscopic Plantar Fascioitmy) - so it's nt all bad, some went from crippled to miraculously cured. I think it depends on a very highly skilled doctor and surgeon myself, and the severity and overall damage that the doctor can truely ascertain and accurately cut. I feel, sugeons are just like auto mechanics, some know their stuff, some do not, or some are great with diagnosis, and no good at the actual EPF or whatever- surgery. This is true in every profession. So if you do get the surgery, you need to find a doc that has a good track record of successful operations. I myself have not had the surgery yet. My doc ordered the pain meds, and a shot. The shot did nothing, and I did not want the meds to cover the pain so I could not tell how bad it really was, or would get. So, I tried everything on my own, and eventually, it came down to this. Wear tennis shoes alot---good ones. Try several pairs on to feel what is really comforatable to you. Like the doc said, you need to stretch all the time. I do it in the morning, a really good calf stretch holding it for 35 seconds in sets of four for each leg. (My PF went to both left and right foot eventually). Then if you can, buy a good size back / body massager, and USE it on your feet after the stretch, I use high speed and it vibrates on the ball of my foor and the fascia (about 5-10 min). Then I rub "some" lotion on my feet, wearing clean socks with fab. softener in it. This is my daily routine for stretching and has taken pain over time way...way down. I can walk normally now, but no running.

Here is the "really" important part for me here. I believe there is a direct link to your spine, your gate at midstep, and the shape of your foot in correlation to pronation that you develop over years. Get this, I had not been to the chiroprator since the back injury I had three years ealier, and had never been to one before that injury. But after reading about the possible correlation to chiropractic health and your (gate) - (IE: step during the weight bearing process) I decided to go back to him. He did an eval. and did discover one leg was "slighly" shorter than the other, and that I did have pronation. He asked about my visits with the foot doc, and said to keep going, and that a combo routine might help alot. So he treats me, popping ankle, leg, shoulder, neck, and finally pulling on the bottom of my feet, lengthening my spine back out to a degree. I had NO,i mean NO heal pain when I woke up the following morning. I had NO heal pain at all for about 3 months, and then, it came back, but not as bad as before. That's when I started stretching more, and eating right, getting plenty of water, and working out the "oblique" muscles as well as my whole body. Now I get my spine and heels/back/neck adjusted every month or so, and I have about 1/4 the pain i used to have, and sometimes it goes away. Point of this post? be careful of reading too many "my life is over" posts at heelspurs.com. Keep trying, stretch every chance you get, and make an appointment to a good local chiroprator, and "see" if it helps you the way it did me. It may help, it may not, but the link to my spine and foot problems was (clearly) evident after my first treatment. Also stay with your foot docs too, keep up any self treatments he prescribes for you. In the end, I am looking at ESWT treatment, that is non-invasive, but is about $5000.00 US for each treatment per foot, and insurance does not cover yet. You can get it done in Canada for $1500.00 per 3 treatments for each foot though, and you can read more about it at www.heelspurs.com (http://www.heelspurs.com)

I hope this helps someone, and it is truely an injury that needs more research, and better treatments. If you want to read posts from a very reputable foot doc, then look for Dr. Zucherman's posts in there. He also had a video of an actual PF surgery. And Scott, the founder of the site, had a "foot tapeing" video. There are several docs in there that seem to know their stuff. The doc that posted above seems to give really great advice too, and basically summarizes what to do, save the chiropratic option.



[This message has been edited by Via_Man (edited 05-06-2003).]

Have had the problem for about 10 years. A young Podistrist want to operate, I asked one that was a bit more experienced & older. He said only about 50% were successfull & I would be bed-ridden for months while the re-attached parts were healing to my heelbone.

I decided to just say no.

Motrin helps 2 or 3 time a day.

The best help was a set of stainless steel custom insterts I purchased out of a magazine. They were called "Feather Springs" or something like that. I have been wearing them for about 7 years now. They cost about $150 then. I had to add some heel cushion to them.

I did work on my feet all day & would come home with pain & tears everyday. After the FeatherSprings I just came home hurting a bit. I can now take those first few steps every morning without pain.

They still hurt but I am not on my feet all day.

G