Plantar Faciitis & Cortisone Shots - Foot Problems Message Board

sivyaleah · 06-25-2004, 07:22 AM

I was diagnosed last week with PF and heel spurs have developed because of it. I have a followup appointment this coming week to have custom orthodics made for me.

However, when I was there last week the doctor injected cortisone into the area to see if that would help. It was amazing to me to awake the next morning and not feel all that pain I usually had. He also told me not to walk barefoot at all (which I've been quite faithful about surprisingly since I'm not a fan of shoes in general). This week has been a pleasure - to be able to walk and not feel that agony all the time.

Unfortunately, here it is a week later and I am beginning to feel the pain again. So, I was wondering if this was a typical time frame for the cortisone to work? Obviously, I can't be going to get these shots all the time nor do I want to as I've read many things about the shots which make me wish he'd told me what he was injecting prior to doing so (wearing out of fat pad, rupture of the ligiement itself as well is a possibility if it is done incorrectly).

I'm looking forward to getting the orthodics made, until then am wearing my Birkies nonstop

Anyone have any comments about the cortisone shots? Or any other advice you can give?

Thanks!

injured betty · 06-25-2004, 08:18 AM

Ah, the old subject of cortizone shots. That seems to be the old standby for doctors. They do this hoping that the pain will subside and that you will go away. They have to try this in the step ladder step up for treating pain. I had it somewhere on my computer but can't find it. However, you might go searching Google for the web site of the on line publication "The Burton Report". It goes into extensive details about them. They are NOT GOOD. I refuse them time and time again and frustrate the heck out of my doctor.

The shot comes with a numbing agent mixed in with the cortizone. This is what allowed you to feel no pain, if but for a week, or the cortizone actually worked and whatever is causing your pain is inflammed again.

I would go back and insist on a diagnosis. Now you have to make another appointment and wait it out. My husband had this problem and ended up needing surgery after the inserts didn't work. It turns out that feet flattening out after the age of fifty is commom. That pulls on the tendon and he developed tendonitis. A fancy word for a pulled tendon. They stuck him for an ankle brace and another pair of inserts. This is the second pair within six months. Naturally, our insurance company does not reimburse us for them.

In all likelihood the spurs will not go away by themselves and that is what is causing the inflammation. Ask to have them cut out. Granted, they might grow back, but you will have better relief than just using the inserts. You want the problem solved, not a temporary solution in my opinion.

You might look up spurs. They grow for a reason. If you can get to the root of the problem as to why the spurs grew, that you be your best bet.

sivyaleah · 06-25-2004, 08:37 AM

Thanks so much for your informative post Betty.

My father had the same problem and did have surgery for it - but that was geez, like 25 years ago. I would have thought times had changed enough to be able to avoid that

I had already found out that the cortizone shots were not a cure - that's why I'm a bit peeved that he didn't totally explain to me what he was doing. I swear - it was like "I'm going to freeze your foot then I'm going to inject something into it to help" and before I knew it I was literally flying out of the chair in pain as the needle hit the area - which of course has no fat to cushion against the stabbing of it. YIKES!

I have a pretty good idea I know how I developed this problem. I believe it began when I had a very severe left ankle sprain 3 years ago (till that point I'd never had this pain before). Between favoring the right foot for more than a year and then gaining quite a bit of weight because I could barely move for that year (and then some for other reasons as well - some of which I'll blame on reaching middle age) well, I'm sure the extra weight didn't help matters either. I am currently losing weight which has helped other aches and pains thankfully (my chronic back issues seems to be getting a lot better and my knees don't hurt as much also) but my feet remained a nagging problem.

I've looked up a ton of stuff online about PF and heel spurs, so much so I feel like an expert at this point. Anyway, I'm willing to give the orthodics a spin, since I have good insurance and even if they don't pay for them, I don't mind spending the $ if it helps and prevents me from having to have surgery. The heel spurs are quite large tho, I was astounded when I saw the x-rays! They really looked like spurs!

Anyway, thanks again for answering. You definitly are giving me a bit more to think about!

jojo64 · 06-25-2004, 10:57 AM

The spurs form because the plantar faciitis tightens up and pulls on the bone in the heel. The bone "grows" a bit to accomodate the pulling and a spur results. If you opt for surgery the doctor usually does not remove the actual spurs (unless they are very large) but will make cuts in the plantar faciitis to relieve the pressure.

KarynLR · 06-25-2004, 03:47 PM

I had many cortisone shots for my PF and was unaware of the dangers of them (one of the many things that scare me about that podiatrist; I'm currently under the care of an OS foot and ankle guy who is a miracle worker), but luckily, I didn't have any ill effects. My suggestion would be to go conservative first. You have to give the orthotics a good chance to work--months, is what I was told. If that doesn't help, I'd look into shock wave therapy. It's non-invasive, which is key.

What did I do for my PF? I had a not-so-good podiatrist who did a bunch of cortisone shots and then went to surgery. I was a not-so-good patient who didn't get second opinions and didn't question the doctor... I'll take the blame for some of it. BUT the bottom line is that I had my PF arthroscopically released in May 2003, and today, I got a cast removed 6 weeks after surgery to removed a damaged nerve and clean up scar tissue. I learned today that the nerve wasn't the small bifurcation the OS and I *thought* was damaged, but the actual trunk of the lateral plantar nerve--one of the main nerves in the foot. My OS set a goal to get off the crutches in 3 weeks; and I'll probably have to have another walking cast for 3 more weeks. Than it's off to physical therapy for some more rehab. There is always the potential for more surgery too, as there is a 30% chance of neuroma recurrence from a cut nerve.

Okay, okay, I am generalizing. There are good podiatrists out there. You probably could get your PF released without major damage, but PLEASE try other conservative options before surgery. I don't think the PF surgery was warranted in the first place, and now, I'm spending my summer getting well after major foot surgery. Ask about the shock wave therapy though. It's newer, so you may need to find a doc who does it, but it's much better than risking nerve damage from open surgery.

Take care,

Karyn