Confused about MRI results on foot

Be conservative.  Don't have surgery.

I am a retired radiologist who had a terrible time with PF last January which was 80% cured in 8 weeks and 100% cured in 4 months. I used to read MRI. The plantar fascia is a thick fibrous tissue that supports the bottom of your foot and arch. The PF extends from the front of the bottom of the heel bone ( calcaneous ) to the base of your toes. The spur is apparently a result of PF, not a cause. The chronic inflammation causes some calcium deposits which become a spur. Leave it alone. If you don't treat the PF it will likely regrow. Inflammation of the adjacent soft tissues just means that the inflammation is sort of spilling over into nearby structures. Really they are just looking at fluid ( edema ). MRI is great for looking for water.

The coalition is not that rare. It just means that the two bones, the calcaneous and the navicular are firmly joined by fibrous tissue and maybe even a bony bridge. Normally they are joined by some ligaments but your union is more firm. I is not a huge problem and leave it alone. You have had this all your life and yes, your bio mechanics are not perfectly normal but acceptable. 

The injections are not supposed to cure the PF. The steroids calm down the inflammation which is overwhelming your ability to heal and should allow you to improve if you do all the other things discussed on this site.

Doknabox has some good posts on the site which you should review and cushion was his magic and it might be yours but try everything in addition to cushioning.

Get the injection and do the stretching and also try the Low-Dye taping. Also get the heel supports , I think they are HTP and I still use mine.

You can get everyhing you need on this site other than the injections. There is a lot of good practical information here. Review some older posts.

Hi, just wanted to give you some information that may help you to understand the seriousness of surgery and the amount of recovery time. I suffered from a small extra accessory bone on my navicular to which a tendon had incorrectly attached. I also suffered severe pf and didn't walk without pain for two years prior despite lots of treatments including wearing an ankle brace. My foot was turning inward and my feet went flat. I grew a bunion to top it all. As nothing worked I elected surgery and did not realise the extent this surgery has on your mobility.

I had my first foot reconstruction in Nov 2014. My husband had to give up work to look after me(he worked away). I couldn't get upstairs and slept for 6weeks in an electric recliner chair. Thankfully I had a downstairs toilet. It involved me hopping around with crutches. Not as easy as you think. Apart from hospital visits I didn't get out for two months.

I had my second foot reconstruction on May 1st this year. A much more involved operation as the bunion was also sorted. I had a calcaneal osteotomy which basically means my heel was repositioned.

I had the accessory bone removed and the tendon repositioned to its correct position and the bunion sorted. I was in back cast for two weeks, cast to my knee for 7weeks non weight bearing (no foot on floor at all and foot raised above hip even in wheelchair). No standing. Then in walking cast and crutches for another 7 weeks. Then elbow crutches until I could walk without, about 2 weeks. My husband again had to look after me and friends helped when he went to work at a local job he took to look after me. The surgery was so serious I was the only patient on the consultants list that day.

I am now walking very well and the pain has reduced greatly from the operation. Unfortunately I fell over when I tripped over my crutches while recovering and broke a small bone in both feet which made recovery more painful. I took pain relief for nearly 4months.

As you can see this is major surgery and not to be contemplated unless you have a good support system. I have been very lucky and things are healing well and it all looks good. If you asked me would I do it again I would say yes but only as I had good support. Not if I didn't. Only if you have a high pain threshold. The consultant actually said I was brave when I went back for the second operation. Please think things through. Without my husband I would have been in hospital for weeks and only home with carers. You can't manage as easily as you think.

No you can not crawl upstairs on your knees as you can't put your foot on the ground to stand up when you get to the top. Try hopping upstairs. Some can but not many. At the worst times I got around by kneeling on a sits stool. I had to have a raised toilet seat as I couldn't stand up off the seat. Now it's over I am glad I did it but it has been a long recovery. I was warned it might not work at the beginning. I have been fortunate.

My full recovery is expected to be 18 months for each foot. Believe me you need it. A standing job would be impossible.

Whatever you decide I wish you well. This was not to put you off but to forewarn of the issues you would have to contend with.