Quote:
Originally Posted by Eagle5US
Caution when using medical terminology if you aren't exactly certain what it is you are saying. I am going to separate the following statements for clarity:
Your post is very confusing....
Recalcitrant Plantar Fasciitis? Or RECURRENT / REFRACTORY Plantar Fasciitis?
You mention considerable pain in the DORSAL (top) part of your calcaneous...if it were also POSTERIOR (to the BACK) that would be Achilles Tendonitis.
Pain to the inferior (bottom) anterior (front) of your calcaneous could be plantar fasciitis.
You stated you had Achilles Tendonitis in your ANKLE - Achilles Tendonitis does not occur in the ankle, it occurs on the POSTERIOR (BACK) of the foot.
You mention Ultrasound Tx of your heels...I am assuming you are talking about TENS or UltraSONIC treatments? Ultrasound has no effect on relieving inflammation.
A few clinical questions...
-Have you had any imaging done? X-Ray will probably demonstrate significant heel spurs to the anterior portion of your calcaneous in the event of Plantar Fasciitis and/or to the posterior portion of your calcaneous with Achiiles Tendonitis.
-Do you wear splints at night when you sleep?
-Is your pain THE WORST when you first step on the floor (first episode of weight bearing) in the morning, getting better throughout the day unless you sit down for an extended period?
-Is your pain on the BOTTOM of your foot, or the BACK of your foot.
Once you can clarify the above questions...they may lead to more questions, but I can probably provide some additional guidance for Tx and palliative therapy. For either / both conditions if refractory (Plantar Fasciitis and Achiiles Tendonitis with associated spurs...) after failure of more conservative measures, Podiatrists often can surgically shave the spurs and provide significant relief of symptoms.
Eagle
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Eagle,
The Physical Therapy Script from the Orthopedic Surgeon said Recalcitrant Plantar Fasciitis.
The PF has not gotten better since the onset a year and a half ago. I have not been able to exercise without pain. The pain is ameliorated by rest, but returns during and following standing and walking activity. The Orthopedic Surgeon said he uses Recalcitrant and Refractory interchangeably to describe a non-resolving soft tissue condition. He said that in his opinion my PF is not recurrent as it has never resolved.
I meant to say plantar, not dorsal--Sorry. Pain on bottom of feet, underside of the heels, worst pain back part of bottom of heel. The pain is usually distributed in a horseshoe pattern around the outside edge of the bottom of the heel, as well as the center of the bottom of the heel. The pain will extend to encompass the midsole area of the feet as well when I push exercise.
There was Achilles Tendonitis. I felt the pain/tightness in the at about the level of the malleoli, hence I thought of it as the ankle.
It was Ultrasonic treatment of the heels, not Ultrasound.
I apologize for my errors. I generally try to avoid typing faster than my brain can think, but I failed with my original post.
In answer to the clinical questions:
Xrays showed bilateral heel spurs May 2009. May 2010 Xrays do not show significant change to the spurs (ambulation-related pain has increased however).
The pain had been worst when standing or when my heel struck the ground when walking,
after prolonged standing and walking.
If I had done a good job of resting for a few days, I could sometimes walk relatively short distances without pain for a day. 24-48 hours following walking, however, the pain would develop with any heel contact and would hurt at rest as well.
For the past month the pain has changed to be the worst when I first get up and after resting. I have been on a car vacation with the family the past three weeks. When I got out of the car to walk at our destinations and for rest breaks, I looked like an 80 year-old man trying to walk initially , then as the foot stretched, the pain and tightness improved and I then could walk normally. (The more I walk, the higher the price I will pay later painwise, however)
I do not currently have night splints as the Orthopod/PT did not think I needed them in January 2010. I now have a script for them and will be getting them.
The pain is on the bottom of both feet, not at the back of the feet.
Thank you for taking the time to respond to my post.