Sunday, August 18, 2013
Plantar Fasciitis: Email Advice
Hi Dr. Blake,
My name is Stacey (name changed) and I just recently came across your website.
I have been suffering pain in my feet for about 9 months now.
The diagnosis is plantar fasciitis and i have seen several different podiatrists who suggested different methods of treatment which have been unsuccessful.
I had custom made orthotics which I have worn now for about 5-6 weeks.
I work in a pharmacy so I am on my feet for 8 hours a day and am finding it painful with the orthotics. I was told this is to be expected and that the average person will see results in 15 weeks.
I am very worried I may be doing more harm than good and fear I may never rid myself of this awful condition. I find it very stressful and wonder if I should stick with the orthotics.
I am now considering reducing my hours at work or taking long term leave.
I would greatly appreciate your advice.
Dr Blake's comment:
Thank you so very much for emailing me. Plantar Fasciitis can be a very stubborn entity, but most patients can get it under control. On my blog I have so much advice regarding plantar fasciitis, that I hope you can find some further answers.
The most important thing is to make sure you do have plantar fasciitis. MRI scans are the most telling, and may help direct treatment differently. Typically, you initially get an MRI of the worse foot, and start with that.
The treatment for plantar fasciitis is lumped into 3 primary areas that can fluctuate in their importance from month to month. All three areas should be treated daily, and changes in each category made to help find what works. The 3 areas are flexibility (stretches), anti-inflammatory (icing, PT, meds, etc), and mechanics (off weighting, arch support, avoiding negative heel positions, etc.)
I will assume you are icing for 10 minutes 4 times daily, wearing your orthotics which transfer weight to your arch, avoiding barefoot walking at home, taking many sit down breaks as your employment allows, stretching the plantar fascia hourly as long as the stretch does not hurt, taking 2-3 advil 3 times daily unless their are stomach issues, and have a few PT visits scheduled unless their is insurance issues. If you are not doing this, try to get it accomplished.
Read everything on my blog on plantar fasciitis so you can have as meaningful as possible conversations with your treating physicians. See if they will prescribe an MRI, PT, night splint, etc. If you do not have a well organized plan for home, taking time off will not help. You must start over, and reset your goals biweekly. Orthotic devices alone will never get the job done when you have pain for this long, and you may need a very special soft orthotic (like the Hannaford) just for standing. Orthotics feel the best jogging, second best walking, and worse standing. There goal is primarily to change how you walk.
I hope this helps you. Please keep me in the loop. Hopefully, your job will allow some moderation. Good luck Rich