Dr Blake's comment: Unfortunately, it is common to have these long acting cortisone wear off and you need boosters. I tell my patients that they may need 3 total to address the nerve pain. While you are injecting a nerve, since it may wear off, consider oral nerve meds like Lyrica, topical Neuro-eze, neural flossing, ice pack 10 minutes twice daily.
I got another steriod injection this time Depro Medrol same locations.
Dr Blake's comment: Celestone is 6 mg per ml, whereas Depro is 20, 40 or 80 mg. It is very strong cortisone, as should not be used alot in the foot unless diluted.
After a very uncomfortable steriod flare my foot started to settle down. I still suffer with the intense dull pain under my 2nd and 3rd metatarsal and my toes feel " out of joint" I can flex them but it feels swollen behind them and I cannot extend them without great ripping pain. I finally got an appointment with an orthopedic surgeon and he did xrays which showed no fractures, small heel spur. He diagnosed me with Tenosynovitis of the 2nd and 3rd metatarsals and plantar fasciitis . I agreed to PRP injections . I had a 2 week inflammatory response from those ( very painful) but my plantar fasciitis is 75% better and the Tenosynovitis is finnally settling down. I am icing several times a day. I was doing calf stretches but stretching irritated the tenosynovitis so I have stopped. The only advise I was given from this doctor was to rest and return . I have been wearing a very flat firm slipper that my orthotic fits in I can't seem to wear my running shoes because they make my toes flex. It has been 3 weeks with very little ambulation in the day I am couch bound. I tried wearing a Budin Splint but it seamed to irritate the tenosynovitis on the toes. I plan to remain on the couch another 2 weeks then I see him again for the 2nd PRP injection if needed.
Dr Blake's comment: Orthotics are tricky for metatarsal issues since the end of the plastic is where you hurt. You can try a full length Sole (I prefer the red ones) with or without a loose fitting Budin Splint. Use a single loop Budin and open it up and place around the 2nd and 3rd toe, or the 3rd and 4th toes together. Yes, avoid met pads when there is nerve hypersensitivity.
Dr Blake's comment: Definitely try the Hoka One One Bondi or similiar to give you rocker. You may also need a Hike and Bike shoe for the rigidity right now. How do you feel in a Danco clog, for cooking or short spurts?
Dr Blake's comment: Give up on it right now, until we experiment with full length ones from Sole, Powersole, Lynco, etc.
Dr Blake's comment: Nerves like warmth, motion, not prolonged stretching, non painful activities like walking. So, being immobilized is may help orthopedic injuries, the nerves hate it. I would have to know how you feel walking with crutches in a removable boot.
Dr Blake's comment: Strengthening should be happening right now. This is usually organized by the PT. If you can not balance on one foot due to pain, you at least should be able to use a stationary bike with your weight in the heel for an hour a day. You should be doing a gym program for at least ankle strengthening, knee, hip, core, cardio, some upper extremity. Consider experiment with various beginner yoga poses or pilates exercises. Over the next month, every day find one exercise that does not hurt, and keep building.
Dr Blake's comment: The relief of the SI pain is pretty striking and emphasizes the need for the lift. I am glad the lift is not on your injured side. I love orthotics and lifts separate, so you can experiment. If the lift is only a heel lift, try to take that off and use a 1/8th inch full length lift (spenco insert) for the next month on the one side to see what happens. Hope all this helps some. I do want to say that lifts under your foot on one side have a very dramatic effect on the base of the spine. If I was treating you, I would order an MRI of the injured foot, and a Standing AP Pelvic xray with your 7 mm lift and orthotics to see how the spine, hips, and SI joints look. How level are they?