Plantar fascia (Heel Spur)

[illmonkey]

I suffer from this on my right foot. Its getting to the point i cant put weight on my foot in the mornings, i need to limp about until its ok.

Does anyone else suffer from this?

I went to the doctor and he recommended a few things, one of which is to by some heel cup. I tried some from Boots, but it didnt seem to do much, so they went in the bin 6 months ago.

Can anyone recommend some cups/support? (I've seen a few like here: http://www.drfoot.co.uk/acatalog/Heel_Pain.html )

Edited by illmonkey on Wednesday 17th September 10:27

[gopher]

I had this a couple of years ago, my doctor recommended anti-inflammatory pain killers (Nurofen type stuff) - Took 250mg twice daily and it was gone in about 10 days.

She didn't mention anything about heel cups or the like, however a friend of mine gets a severe reaction to that type of drug and so is still suffering after 12 months now despite a couple of painful steroid injections.

[illmonkey]

gopher said:

I had this a couple of years ago, my doctor recommended anti-inflammatory pain killers (Nurofen type stuff) - Took 250mg twice daily and it was gone in about 10 days.

She didn't mention anything about heel cups or the like, however a friend of mine gets a severe reaction to that type of drug and so is still suffering after 12 months now despite a couple of painful steroid injections.

He did suggest the injections, but after reading up it seems they arnt proven to help! I've also had some injections to the bone and it hurts a fair old bit! So would like to avoid.

After you took the pain killers it was all fixed, so you dont suffer anymore? Did you get prescription or just literally Nurofen?

[gopher]

illmonkey said:

After you took the pain killers it was all fixed, so you dont suffer anymore? Did you get prescription or just literally Nurofen?

Yup, all fixed, had a minor re-occurrence but a couple of days back on the nurofen got rid of it, although on both occasions the nurofen made no difference at all until a few days in, and then it seemed a minor improvement, then it just went.

The nurofen was prescribed - thinking about it I don't think the dose I had was available over the counter at the time, not sure about now.

ETA

illmonkey said:

He did suggest the injections, but after reading up it seems they arnt proven to help!

My friend did feel an improvement after the injections but it wasn't huge and he's not sure it was worth the pain of the injections themselves, although he seems to complain about it less now than he used to.

Edited by gopher on Wednesday 17th September 10:45

[knk]

NSAIDs such as ibuprofen (400mg three times a day with or after food) and start a program of stretching and strengthening as per attached. http://www.arc.org.uk/arthinfo/documents/6522_info...
If no better after 4 weeks see your GP and they may consider a corticosteroid injection. Ultrasound guided injection by a specialist sports physician is best.

Best wishes.
Kam

[turbobloke]

Isn't losing weight also recommended for this, given that someone is overweight in the first place?

[broadside]

Go and see a State Registered Podiatrist who has an interest in Biomechanics. You really only have four main choices:-

1 - Leave it alone
2 - Injections
3 - Surgery
4 - Try and accomodate it. Foot orthoses to try and redistribute body weight and support structures of the foot

I would go for option 4. Injections are painful as you have to push the needle through alot of tissue to get where you need to deliver the anti inflammotories. Surgery is a final option really as the Boney spur once removed can potentially come back.

[fergy]

My wife is an orthotist and sees people suffering from this daily...her recent advice to a femail collegue of mine was....

==================================================================

Weight loss if appropriate.
Gentle calf stretches.
No flat shoes or barefoot, try wear slightly higher heels.
Try silicone shock absorbing heel pads. Boots may stock these.
R.I.C.E. Rest as much as possible, apply Ice packs to the painful area, Compression bandage may help, Elevation
Ibroprofen ( or other anti inflammatories ) can help.
If it is no better in 6 weeks having followed the above advise then get referred to an orthotist or podiatrist.

If your very flat footed you would benefit from bespoke orthotic inlays made from a cast/impression of your feet. Flat feet don't function well biomechanically and can lead to all sorts of aches and pains.

[illmonkey]

Wow. Some top advice. Thanks guys.

I'll print that guide out and see how I go while taking some heavy pain killers. Rather not have to but 3 sets of shoe inlays!

[Ian_S]

Had this for about 5 years now, all the treatments mentioned above havent worked for me, i have had about 20 cortisone injections now between both feet, they last for about 3-6 months making me pain free, but then come back. Although very painful I felt they were worth it.

Regarding insoles, get your gp to refer you to the appliances department at the local hospital/orthopaedic foot surgeon who will make you some FOC, moulded from your feet. I have tried the bought ones, and custom made by chiropodist etc and weren't as good.

I have had 2 lots of surgery on this over the last year to try and fix it, first one was last year and partial release of the plantar and release of tibial nerve, and involved cutting the side of the heel open and was not nice at all.
This second one is a new type of surgery that i'm recovering from now with physio and hydrotherapy, he went in behind the knee and partialy released the medial head of gastrocnemius(sic?)

Only 5% of people require surgery, most fix themselves within a couple of years.

[illmonkey]

Ian_S said:

Had this for about 5 years now, all the treatments mentioned above havent worked for me, i have had about 20 cortisone injections now between both feet, they last for about 3-6 months making me pain free, but then come back. Although very painful I felt they were worth it.

Regarding insoles, get your gp to refer you to the appliances department at the local hospital/orthopaedic foot surgeon who will make you some FOC, moulded from your feet. I have tried the bought ones, and custom made by chiropodist etc and weren't as good.

I have had 2 lots of surgery on this over the last year to try and fix it, first one was last year and partial release of the plantar and release of tibial nerve, and involved cutting the side of the heel open and was not nice at all.
This second one is a new type of surgery that i'm recovering from now with physio and hydrotherapy, he went in behind the knee and partialy released the medial head of gastrocnemius(sic?)

Only 5% of people require surgery, most fix themselves within a couple of years.

Its gone on for some time. I cant remember last time if it was the other foot (im 70% sure it was!). I reckon a year for this foot.

[gopher]

turbobloke said:

Isn't losing weight also recommended for this, given that someone is overweight in the first place?

Can't speak for the OP but I was only about 5lb over weight when I had it. (Wish that was still the case )

[Ian_S]

broadside said:

Go and see a State Registered Podiatrist who has an interest in Biomechanics. You really only have four main choices:-

1 - Leave it alone
2 - Injections
3 - Surgery
4 - Try and accomodate it. Foot orthoses to try and redistribute body weight and support structures of the foot

I would go for option 4. Injections are painful as you have to push the needle through alot of tissue to get where you need to deliver the anti inflammotories. Surgery is a final option really as the Boney spur once removed can potentially come back.

From what i'm told there isn't normally a problem with a spur, it's just mistakenly referred to as this. It tends to be the plantar tearing where it meets the heel bone minutely.

1. ignore this
2. try this if orthotics and stretching don't help.
3. last resort
4. try this first as mentioned in my other post above. Stetching the calf regularly should help too.

[Ian_S]

illmonkey said:

Ian_S said:

Had this for about 5 years now, all the treatments mentioned above havent worked for me, i have had about 20 cortisone injections now between both feet, they last for about 3-6 months making me pain free, but then come back. Although very painful I felt they were worth it.

Regarding insoles, get your gp to refer you to the appliances department at the local hospital/orthopaedic foot surgeon who will make you some FOC, moulded from your feet. I have tried the bought ones, and custom made by chiropodist etc and weren't as good.

I have had 2 lots of surgery on this over the last year to try and fix it, first one was last year and partial release of the plantar and release of tibial nerve, and involved cutting the side of the heel open and was not nice at all.
This second one is a new type of surgery that i'm recovering from now with physio and hydrotherapy, he went in behind the knee and partialy released the medial head of gastrocnemius(sic?)

Only 5% of people require surgery, most fix themselves within a couple of years.

Its gone on for some time. I cant remember last time if it was the other foot (im 70% sure it was!). I reckon a year for this foot.

this is what you get if you don't do something about it, hopefully this will spur you to sort it.

[illmonkey]

Ian_S said:

illmonkey said:

Ian_S said:

Had this for about 5 years now, all the treatments mentioned above havent worked for me, i have had about 20 cortisone injections now between both feet, they last for about 3-6 months making me pain free, but then come back. Although very painful I felt they were worth it.

Regarding insoles, get your gp to refer you to the appliances department at the local hospital/orthopaedic foot surgeon who will make you some FOC, moulded from your feet. I have tried the bought ones, and custom made by chiropodist etc and weren't as good.

I have had 2 lots of surgery on this over the last year to try and fix it, first one was last year and partial release of the plantar and release of tibial nerve, and involved cutting the side of the heel open and was not nice at all.
This second one is a new type of surgery that i'm recovering from now with physio and hydrotherapy, he went in behind the knee and partialy released the medial head of gastrocnemius(sic?)

Only 5% of people require surgery, most fix themselves within a couple of years.

Its gone on for some time. I cant remember last time if it was the other foot (im 70% sure it was!). I reckon a year for this foot.

this is what you get if you don't do something about it, hopefully this will spur you to sort it.

Yea thanks for that. Hopfully it will spur me along Geddit? No ok...

ETA: I also have had cold feet. Im assuming due to bad circulation. Is the pain a side effect of lack of blood? I also cycle a fair bit, is this a bad idea? I'm not overweight either.

Edited by illmonkey on Wednesday 17th September 11:37

[illmonkey]

Just an update for the caring ones....

I found my old shoe supports and have worn them over the past week or so. It has helped loads. No pain in the morning. One side effect is that it feels like its bending my foot too much, so i get aching arches, but that's alot less painful than the original condition.

I purchased some new work shoes too. My old ones were worn alot and they made me walk on the slant of the shoe. These new ones feel alot more supportive already.

Thanks for all the advise, if it comes back/worsens i'll follow some of the ideas up.

[mko9]

Put a pair of running shoes or something else with good arch support by the bed at night. Don't take a single step barefoot when you get up. Put on the shoes to keep from overextending everything on your first step. Give it time to heal, it doesn't clear up overnight.

[sparkythecat]

Platar fasciitis- I had a bout of this a couple of years ago. It eventually sorted itself out, when I started varying my footwear, and wearing different footwear every few days. I'd previously worn the same brand and style of boots, every working day for 5 years, just getting a new pair every 6months.
Now I have 3 different styles on the go at once and change them every 2-3 days.

[Miss Pitstop]

Depending on where you are based, these guys are very good. Based in Cardiff with clinics in Bristol.

http://www.feetinmotion.co.uk/sports_injury_clinic...