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Sunday, September 7, 2014

Plantar Fasciitis: Email Advice

Hi Dr. Blake,

You were referred to me by a physical therapist here in SF I was seeing for a while for what I think I have is Plantar Fasciitis.  

I do quite a bit of walking and used to jog periodically until this pain developed in my left heel approx. 1 year ago. Over that time, I've seen two different physical therapists including a podiatrist in San Luis Obispo and all pretty much concluded the same diagnosis.  However my new PT seems to feel since I did suffer a severe sprain in the same foot a few years prior that I have scar tissue remaining from injury and possibly even a torn ligament that might be the root of problem.  She recommend I get x-rayed and that's how you came in to the picture.  

I'd be happy to get further evaluated by another person, however my issue is I've already spent well over a thousand dollars in doctor visits and I'm pretty much at the same discomfort as when the problem first arose.  I have insurance, but a 5k deductible, so any expenses for this I'm paying for out of pocket.  

Therefore before I schedule appointment, wanted to ask if you think an x-ray would even be able to determine if I have a torn ligament or do I need something more in dept like an MRI?  Also, because I'd be paying cash not going through insurance is there any break I could get, and if so what would be the cost for exam/x-ray?

Lastly, I did some research and found a company online  There were two particular products that when I called in the rep said they've had very high success rate with especially if used in combination: Plantar/spur Inferno wrap and Ultrasound therapy system.  The combined price for both these products with tax is just over $200 which is fine, IF IT WORKS, but hate to spend additional money on something that is a novelty with little or no results.  Are you familiar with this company/products or any products in particular that could aid in healing my foot if in fact I do have just the plantar fasciitis and not additional issues?  Also, do you think either of these products would help with healing scar tissue or a torn ligament if it turns out I have that as well?  

I'm anxious to get resolution to this ASAP.  I'm a physically active person and although this has not been a "debilitating" injury/symptom, its definitely hindered my abilities to do the things I enjoy pain free. 

Look forward to your response, thank you.

Dr Blake's response:

     Thank you so very much for your email. Plantar fasciitis rarely lasts this long, and can not be diagnosed by x ray. You would need a MRI. If you saw a podiatrist, or your family doc, a RX for Rearfoot MRI could be given to you and then you could call around to the hundreds of local facilities for their self pay rate. Without a diagnosis, and physical examination findings, it is hard to recommend anything to you right now. When you come to my facility, within Saint Francis Hospital, your current insurance will be charged an office visit and facility fee. Even with your deductible, your insurance will tell us what you owe. We can not do that. If it helps, my standard new patient office visit code is 99203. If it helps, you can go to the label section of the blog and open up the Playlist for Plantar Fasciitis.  Hope this helps. Rich

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.