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Friday, June 16, 2017

When Something is not Plantar Fasciitis: Email Condition

Dr. Blake,

I've been diagnosed with Plantar Fasciitis 3 months ago,  however I'm not sure if  I actually have that condition.

The Doctor did zero testing. I had googled heel pain and up came Plantar Fasciitis and I have high arches.  I found a local podiatrist and I sent a message asking if she treated this condition as well as plantar warts.

Turns out I don't have plantar warts but I definitely do have heel pain which came on suddenly for no apparent reason and has gotten steadily worse. 
Dr Blake's comment: Typically plantar fasciitis (an inflammatory condition) has a gradual onset over weeks, and usually months. 

I've been told that usually PF cause pain first thing in the morning but not for me. I have no pain in the morning. My pain appears after I been walking slowly and gently for a limited period. 
Dr Blake's comment: Definitely this is not plantar fasciitis, more like a heel bruise, heel bursitis, or some tendinitis/myositis of the local muscles. 

The doctor suggested the following treatment which I have done.

I purchased a compression sock and I wear it .
I take Aleve on off for selected period of times.
I soak my foot in Epsom salt until its a prune
The doctor taped my foot (made it more painful).
The doctor wrapped my foot in gauze with a cushion inserted and then applied a lite casting plus another wrap on top for a sprain. This was a disaster because the cushion had slipped to a position on the top of my foot where the foot and ankle meet.  I took it off in two days it was supposed to stay on for 7.

I have a prescription for PT but have yet to attend as I am not convinced about the diagnosis.
Dr Blake's comment: Sometimes PTs just blindly follow the Rx, and sometimes they try to give you an independent diagnosis. They can still follow the doc's RX if it is general enough. Definitely ask around to find a good independent thinker. 

The doctor has also suggested cortisone shots which I have declined.
Dr Blake's comment: Good for you. If you have a small fracture or small tear, these can be made worse. 

I also have all sorts of inserts which maybe ​contributing to making things more painful.
Dr Blake's comment: You have to try these, and sometimes you will be surprised what feels good, and what increases your heel pain. Amazing how many people continue to wear inserts that bother their feet in some way, although sometimes they have no other option. 

The issue  is that this condition is getting worse a case of the creeping pain, which is now gone up to the ankle and calf in the affected​ foot and also to a lesser degree in the other leg/foot which I believe is responding to my change in gait. I am hobbling around almost to the point of immobile.

Can you help me. I live in Emeryville CA . I have Medicare and AARP Supplemental policy. This situation is rapidly becoming debilitating and I really need to do something.
Dr Blake's comment: I am just across the bay. Come see me after an MRI if you can get it, and bring anything you have. 


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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.