Plantar fasciitis recent diagnosis

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Hi I have just been diagnosed by my GP and it appears I have PF. I first noticed a numbness in my right heal and felt like a blister sensation. Did nt think too much of it and gradually developed heal pain when I put pressure on this heal. I was doing some running at the gym to burn a few calories and maybe that triggered it. Ha ha that was a mistake and now have this condition. Have researched a bit on the Internet some say its your carf that's causing it some say stretching is good hard floors bad others say the reverse. Lots of advertising sales cures out there as to be expected. My heal feels bruised to me but it's been like it for a month now with no improvement hence my visit to my GP. Only advice Is  do exercises and take anti inflammatory tablets three times a day with lansoprazole which I am not getting on well with. Have now got constipation and day before yesterday felt really confused and not myself at all. So now off medication apart from anti inflammatory 400g before I sleep. Have still got the heal pain any good advice would be appreciated..Paul

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  • Posted

    Morning Paul! So sorry you're in so  much pain. That stinks!

    You're going to get lots of good conservative advice here.  Rest, ice, stretching, NSAIDs, cushioning, orthotics etc.  If any of those or a combination of them work for you, great!

    But if you are dealing with quite a bit of pain for a longer period of time, I'd suggest checking out Extracorporeal Pulse Activation Technology (sometimes referred to as ESWT or shockwave therapy).  Ask your GP, or better yet a podiatrist.  Find someone who is familiar with the technology and the benefits.  In a nutshell, you'll need about 3-5 weekly treatment sessions that will take only 5-10 minutes.

    Best of luck to you!

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    • Posted

      Hi many thanks for advice. Have not heard of ESWT before. Thankfully not really painful but makes me walk more on the ball of my foot and don t think my toes particularly approve ! Cheers 
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  • Posted

    Got it! Hopefully you caught the issue in its very early stage so good foot care and shoes will do the trick.
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    • Posted

      Sound advice I think my old work boots won t have helped! They are going in the bin. Cheers 
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  • Posted

    Paul,  Sorry to hear about your PF.  I have researched and written extensively about PF. Search for my other posts.  Good luck.     doknabox
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    • Posted

      And I wouldn't count on ESWT.  Cushion - that's what your heel needs.

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    • Posted

      Hi many thanks for your reply. I will have a read through your other posts tomorrow. It s good to be able to form a positive plan of action. Cheers 
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    • Posted

      Hi Dr. Rehert aka doknabox,  Silly me. I should've asked. Have you spoken with a medical professional/DPM about ESWT/EPAT recently (within the past 1-2 years) to better understand the technology and hear it from an expert? Hard to comment on something when you don't really understand the technology, the evidence and the success that people have had with it.

      I don't trash your recommendation of "cushioning." Why trash a technology you know little about and have had minimal experience with to date?

      I have much respect for you as a retired doctor and former gynecologist but come on....there's not an opportunity to have an open dialogue here on this forum for all options and modalities??? Really???

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    • Posted

      You're right I know little about ESWT.  But I know how to review medical literature and I couldn't find any credible evidence that convinced me that ESWT was better than placebo, or  worth the $1000 to $2000 they charge, when cushioning costs only $20 or $30 dollars.  And it worked for me.  It's nothng personal, just show me the evidence.  Please!!!

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    • Posted

      Really appreciate your note back.  

      From what I've seen, cost for ESWT/EPAT starts at $450 for a series of 3-5 treatments. Long gone are the days of $1000-$2000 for a treatment. (There is a big difference bwtn focus vs radial when it comes to ESWT. Radial is what is what I've been recommending for those with PF not responding to the conservative stuff.)

      As for evidence, best place to look is the NIH website (pubmed-dot-gov).  Search ESWT/EPAT/Radial/

      In the meantime, here are a few:

      “Two emerging technologies for achilles tendinopathy and plantar fasciopathy.” Clinics in Podiatric Medicine and Surgery

      “Ultrasonographic evaluation of low energy extracorporeal pulse activated therapy (EPAT) for chronic plantar fasciitis.” Foot & Ankle International

      “Comparison between extracorporeal shockwave therapy, placebo ESWT and endoscopic plantar fasciotomy for the treatment of chronic plantar heel pain in the athlete.” Muscles, Ligaments and Tendons Journal

      “Extra-corporeal pulsed-activated therapy (“EPAT” sound wave) for Achilles tendinopathy: a prospective study.” The Journal of Foot and Ankle Surgery

       “Successful treatment of chronic plantar fasciitis with two sessions of radial extracorporeal shock wave therapy.” Foot & Ankle International

      “Radial extracorporeal shock wave therapy is safe and effective in the treatment of chronic recalcitrant plantar fasciitis.”The American Journal of Sports Medicine

      “Extracorporeal shock wave therapy for chronic painful heel syndrome: a prospective, double blind, randomized trial assessing the efficacy of a new electromagnetic shock wave device.” Journal of Foot Ankle Surgery

      “Comparison of radial versus focused extracorporeal shock waves in plantar fasciitis using functional measures.” Foot Ankle International

      “Extracorporeal shock wave therapy for chronic painful heel syndrome: a prospective, double-blind, randomized trial assessing the efficacy of a new electromagnetic shock wave device.” Journal of Foot and Ankle Surgery

       

      “Extracorporeal Shock Wave Therapy for the Treatment of Plantar Fasciitis.” Foot & Ankle International

      “Ultrasonographic evaluation at 6-month follow-up of plantar fasciitis after extracorporeal shock wave therapy.” Archives of Orthopaedic and Trauma Surgery

      “Preliminary Results on the Safety and Efficacy of ESWT for Treatment of Plantar Fasciitis.” Foot & Ankle International

      Hope this helps. 

      Again, I appreciate that cushioning worked for you but for those with more serious/chronic cases that don't want to go down the surgery path, this is such a great alternative that really deserves a look.

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  • Posted

    Sounds as though you have identified PF at an early stage. Unfortunately PF can often get worse or return for no apparent reason unless you take some preventative measures.

    Good supportive cushioning shoes are a must – most folk find Asics Gel Nimbus the best, Crocs are also great. Wearing non-supportive shoes like Vans or Converse especially for long periods on hard surfaces can really do damage. You can buy gel insoles and heel cups to put in work boots and shoes which will help.

    Calf stretching for many works well and should be done every day. One foot close to the wall, the other behind and at a slight angle, then push hard against the wall for until you feel the calf muscle stretching, a minute for each leg repeated several times.

    Naproxen is a good pain reliever and anti-inflammatory which GP’s now prescribe with Lansoprazole as they this can help avoid stomach inflammation. However this is a new thing and never used to be done and personally I never bother the Lansoprazole and take just Naproxen.

    Sounds like you haven’t had a bad PF flare up and you really don’t want to!!!It is the most excruciating, debilitating pain, that can lay you up for days on end – best avoided at all costs.

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