I stumbled across a couple of articles about a month ago that I want to share with people who are experiencing problems with severe heel pain that won’t resolve, like I’ve been. Okay, I didn’t stumble across either of these articles. I’ve been reading everything I can about plantar fasciitis for well over a year now because chronic heel and arch pain so bad that you can’t really function anymore is a big deal. Honestly, before this I didn’t realize feet could hurt so much and not be broken. I’d had plantar fasciitis seven years earlier and after a couple months of stretching exercises it completely resolved. Well, not this time. This fresh bout of plantar fasciitis was relentless and extreme, effectively taking me out of commission.
If that’s the scenario you’ve been dealing with long-term too it could help you to read the following articles I’ve linked to, and if you haven’t had an ultrasound on your feet to diagnosis plantar fasciitis and your doctor is relying on X-rays alone as proof of the condition, urge them to send you for an ultrasound—a much better tool for diagnosis as the second article explains.
* Is Your Plantar Fasciitis Pain Not Going Away? It's Probably Not Plantar Fasciitis
* Study: Heel Pain, Very Common and Debilitating, Often Misdiagnosed as Plantar Fasciitis Use of Diagnostic Ultrasound Leads to More Accurate Diagnosis
Over the past year and a half I’ve done some blogging about my health issues because they’ve been pretty impossible to ignore. I’ve had slowly worsening heel pain for much longer still, but my situation became debilitating in March/April 2014, to the point that it was difficult to get down more than a single aisle at the grocery store (the shooting foot pain!), descending stairs was often torture (weird electrical pain cutting across my kneecaps) and waiting in line at the pharmacy for five minutes felt like gravity was pummelling my heels into the ground. In short, there wasn’t a lot I actually could do.
For the longest time I was told I had plantar fasciitis and patellofemoral syndrome. I went through several physiotherapy sessions (which made the pain in my feet and knees exponentially worse) beginning in January 2014 and had foot and knee X-rays which were spectacularly unilluminating. Next I was referred to a sports doctors who watched me walk, prodded my heels and arch a bit, then suggested custom made orthotics, a foam roller for my legs, rolling the arch of my feet over a frozen water bottle twice a day, a Strassburg sock (the sock equivalent of a plantar fasciitis night splint to keep your fascia from shortening while you sleep), gave me a prescription for heavy duty pain pills that I couldn’t take because they were too hard on my already ailing digestive system (pre-existing problems), and said the only thing she could really do was give me a cortisone shot. Her diagnosis: severe plantar fasciitis which had affected my whole kinetic chain and caused my knee issues.
A couple of weeks later I had to cut an April/May 2014 trip to Dublin short and fly home early because I could hardly walk let alone be out strolling around town, sightseeing (I could barely handle the stairs at my mother-in-law’s house for cripes’ sake!) and the same sports doctor, when I showed up at her office feeling desperate, insisted I should’ve been able to handle the trip, literally threw up her hands and said there was nothing else she could do for me. I turned down the again offered cortisone shot which I’d read could cause more problems than it cured and which my GP had warned me she wouldn’t want herself. But as per the sport doctor's advice I went ahead and had $500 custom orthotics made by a professional pedorthist who analyzed my gait, then adjusted those same orthotics four times over four months for me because DAMN they hurt something treacherous, only to find at the end of that period the super duper expensive insoles STILL hurt my heels so much more than if I were wearing the Superfeet insoles I’d previously bought from the Running Room (and which I still use and find helpful now).
Desperate to make headway and get my mobility back I relegated the custom made orthotics from hell to the back of my closet and in late August 2014 I began radial shockwave therapy, a treatment which supposedly helps 80% of chronic plantar fasciitis cases but instead rocketed my feet into a new level of pain that lasted for five days after each of the four treatments before ultimately returning me to my previous baseline level of OUCH.
Nothing worked for me. Nothing. Not the radial shockwave therapy treatments. Not physio. Not the daily stretching exercises for my feet or strengthening exercises for areas around my knee. Not the foam rolling. Not the hellish night splint sock that only seemed to destabilize my knee further so that sometimes I’d have to hold the kneecap in place when I got up from a seated position. Not the massage therapy I went for at the local hospital where the massage therapist admitted she didn’t believe she could help me and mentioned that my feet didn’t feel to her as though I had plantar fasciitis. In fact, she told me if I hadn’t given her any explanation, from the feel of my legs she would’ve thought I had fibromyalgia rather than plantar fasciitis and patellofemoral syndrome.
Instead of feeling better over time things got odder, strange sensations—weakness, numbness, and pain up and down my legs, not just in my feet or my knees. All through this, over months and months, I was constantly revisiting my GP who sent me for bloodwork, more bloodwork, yet more bloodwork, a nerve conduction study and EMG, and a vascular study. And all through this it was difficult to stand for any length of time but nearly as difficult to sit—a strange tightness would build up at the back of my legs after awhile and I’d have to get up and start moving again only to sit down when that became too much for my heels. And all through this it would hurt my knees to bend. Low cupboards became a problem. Stairs were my arch-enemy. Picking things from the floor required careful consideration. I took to wearing knee braces which at first seemed to help provide support and then felt unbearable.
So sitting and standing for any time were both bad, what was left, lying down? I tried that for a good while too but the less I moved the stranger and more persistent my leg pains and weird sensations became—particularly in a space at the back of my legs about a foot long—until my GP suggested swimming pool exercises which helped reduce the weirdness but not eliminate it. What's also helped a bit are the Z-Coil shoes I picked up in June. They reduce the impact on your heels and joints by 60% more than regular shoes.
Despite these measures, the strange sensations at the back of my legs is constant now, just not as severe. And I’m STILL like a Jack in the Box who has to keep popping up. I can stand and sit for longer than before, but not anywhere near a normal duration. I need to move. Then stop. Then move again. Never for too long or too far mind you. Not nearly long enough to do a full time seated office job and, well, if I manage to amble around a shopping mall for an hour and a half (with seated rest periods to break up the time) I’m doing well and feel extremely pleased with myself. I often used to walk for hours at a time without thinking anything of it and miss it terribly. Now all but the shortest strolls are a thing of the past, as are concerts that require standing or things like art gallery or museum visits. Even movie watching at the local theatre can be a challenge and requires that I have enough room around me to allow me to fully extend my legs at regular intervals. This is life in the sloooow lane!
I joined a wonderfully supportive plantar fasciitis sufferers group on Facebook and traded horror stories and treatment regimens with other folks who couldn’t seem to shake their plantar fasciitis. The group helped my morale quite a bit (misery loves company), but why the hell were so many of us still suffering after following medical advice to a T and after undergoing not just one but multiple PF procedures?
And what about my blood work and the various medical studies? Well, time after time my blood work came back as perfectly fine. No sign of vitamin deficiencies or any other underlying conditions. My vascular study results were normal but my nerve conduction study results were not. The January 2015 nerve conduction study showed I have polyneuropathy that the neurologist said an older person might have without a cause but at my age there would be a reason for. However, at the time of my study he didn’t believe that my polyneuropathy was responsible for my foot and knee pain. Since then I’ve had a knee MRI which showed nothing more than very minor degeneration of the menisci, but nothing out of line for a woman my age and certainly nothing, I’m told, that should be causing the degree and wide area of pain and unusual sensations at the back of my legs. Since then I’ve also seen a rheumatologist who sent me for a feet ultrasound theorizing that I don’t have plantar fasciitis at all and that my neuropathy (which so far after, masses of blood work, is of unknown cause) is causing the vast majority of my issues.
And guess what? That feet ultrasound I had on September 10th, it was normal. I don’t have plantar fasciitis—the condition I had shockwave therapy, physio, and orthotics for and have now spent so much time, energy and money trying to cure. I mean, hell, no wonder none of the treatments worked, they were for a problem that I don’t have! And neither do I have much wrong with my knees. The rheumatologist said sometimes they can give kneecaps a cortisone shot but in a case as minor as mine they wouldn’t normally even do that, which makes sense because most of the pain and strangeness I feel is at the back (and well above and below) of the knee, not in the kneecap itself.
The rheumatologist wants me to see a neurologist, which will be the next step, but my GP warns the wait could be six months. They’re thin on the ground, unfortunately. And I can’t help but feel angry and short-changed by that sports doctor who pushed a cortisone shot that I didn’t need and who didn’t bother to send me for an ultrasound even though she said she’d never seen a case of plantar fasciitis that had lasted longer than a year, and I was at a year and a half and counting when I walked into her office in April, 2014.
For the moment I don’t know what’s really wrong with me, what’s given rise to the polyneuropathy that’s apparently caused—and continues to cause—me so much trouble, but it isn’t plantar fasciitis. If you, too, have been suffering for a long time and keep getting the term ‘plantar fasciitis’ hurled at you, go get that ultrasound. Print out the two articles I linked to at the start of this post and hand them to your doctor if that’s what it takes to convince them you need one. Because it just might be that plantar fasciitis isn’t what you’re suffering from either, and that no amount of rolling your foot on a frozen water bottle or stretching your calves will make one teensy bit of difference.
If that’s the scenario you’ve been dealing with long-term too it could help you to read the following articles I’ve linked to, and if you haven’t had an ultrasound on your feet to diagnosis plantar fasciitis and your doctor is relying on X-rays alone as proof of the condition, urge them to send you for an ultrasound—a much better tool for diagnosis as the second article explains.
* Is Your Plantar Fasciitis Pain Not Going Away? It's Probably Not Plantar Fasciitis
* Study: Heel Pain, Very Common and Debilitating, Often Misdiagnosed as Plantar Fasciitis Use of Diagnostic Ultrasound Leads to More Accurate Diagnosis
Over the past year and a half I’ve done some blogging about my health issues because they’ve been pretty impossible to ignore. I’ve had slowly worsening heel pain for much longer still, but my situation became debilitating in March/April 2014, to the point that it was difficult to get down more than a single aisle at the grocery store (the shooting foot pain!), descending stairs was often torture (weird electrical pain cutting across my kneecaps) and waiting in line at the pharmacy for five minutes felt like gravity was pummelling my heels into the ground. In short, there wasn’t a lot I actually could do.
For the longest time I was told I had plantar fasciitis and patellofemoral syndrome. I went through several physiotherapy sessions (which made the pain in my feet and knees exponentially worse) beginning in January 2014 and had foot and knee X-rays which were spectacularly unilluminating. Next I was referred to a sports doctors who watched me walk, prodded my heels and arch a bit, then suggested custom made orthotics, a foam roller for my legs, rolling the arch of my feet over a frozen water bottle twice a day, a Strassburg sock (the sock equivalent of a plantar fasciitis night splint to keep your fascia from shortening while you sleep), gave me a prescription for heavy duty pain pills that I couldn’t take because they were too hard on my already ailing digestive system (pre-existing problems), and said the only thing she could really do was give me a cortisone shot. Her diagnosis: severe plantar fasciitis which had affected my whole kinetic chain and caused my knee issues.
 |
Desperate to make headway and get my mobility back I relegated the custom made orthotics from hell to the back of my closet and in late August 2014 I began radial shockwave therapy, a treatment which supposedly helps 80% of chronic plantar fasciitis cases but instead rocketed my feet into a new level of pain that lasted for five days after each of the four treatments before ultimately returning me to my previous baseline level of OUCH.
Nothing worked for me. Nothing. Not the radial shockwave therapy treatments. Not physio. Not the daily stretching exercises for my feet or strengthening exercises for areas around my knee. Not the foam rolling. Not the hellish night splint sock that only seemed to destabilize my knee further so that sometimes I’d have to hold the kneecap in place when I got up from a seated position. Not the massage therapy I went for at the local hospital where the massage therapist admitted she didn’t believe she could help me and mentioned that my feet didn’t feel to her as though I had plantar fasciitis. In fact, she told me if I hadn’t given her any explanation, from the feel of my legs she would’ve thought I had fibromyalgia rather than plantar fasciitis and patellofemoral syndrome.
Instead of feeling better over time things got odder, strange sensations—weakness, numbness, and pain up and down my legs, not just in my feet or my knees. All through this, over months and months, I was constantly revisiting my GP who sent me for bloodwork, more bloodwork, yet more bloodwork, a nerve conduction study and EMG, and a vascular study. And all through this it was difficult to stand for any length of time but nearly as difficult to sit—a strange tightness would build up at the back of my legs after awhile and I’d have to get up and start moving again only to sit down when that became too much for my heels. And all through this it would hurt my knees to bend. Low cupboards became a problem. Stairs were my arch-enemy. Picking things from the floor required careful consideration. I took to wearing knee braces which at first seemed to help provide support and then felt unbearable.
 |
| Using the torturous night splint sock on my trip to Dublin in April/May 2014 |
Despite these measures, the strange sensations at the back of my legs is constant now, just not as severe. And I’m STILL like a Jack in the Box who has to keep popping up. I can stand and sit for longer than before, but not anywhere near a normal duration. I need to move. Then stop. Then move again. Never for too long or too far mind you. Not nearly long enough to do a full time seated office job and, well, if I manage to amble around a shopping mall for an hour and a half (with seated rest periods to break up the time) I’m doing well and feel extremely pleased with myself. I often used to walk for hours at a time without thinking anything of it and miss it terribly. Now all but the shortest strolls are a thing of the past, as are concerts that require standing or things like art gallery or museum visits. Even movie watching at the local theatre can be a challenge and requires that I have enough room around me to allow me to fully extend my legs at regular intervals. This is life in the sloooow lane!
I joined a wonderfully supportive plantar fasciitis sufferers group on Facebook and traded horror stories and treatment regimens with other folks who couldn’t seem to shake their plantar fasciitis. The group helped my morale quite a bit (misery loves company), but why the hell were so many of us still suffering after following medical advice to a T and after undergoing not just one but multiple PF procedures?
And what about my blood work and the various medical studies? Well, time after time my blood work came back as perfectly fine. No sign of vitamin deficiencies or any other underlying conditions. My vascular study results were normal but my nerve conduction study results were not. The January 2015 nerve conduction study showed I have polyneuropathy that the neurologist said an older person might have without a cause but at my age there would be a reason for. However, at the time of my study he didn’t believe that my polyneuropathy was responsible for my foot and knee pain. Since then I’ve had a knee MRI which showed nothing more than very minor degeneration of the menisci, but nothing out of line for a woman my age and certainly nothing, I’m told, that should be causing the degree and wide area of pain and unusual sensations at the back of my legs. Since then I’ve also seen a rheumatologist who sent me for a feet ultrasound theorizing that I don’t have plantar fasciitis at all and that my neuropathy (which so far after, masses of blood work, is of unknown cause) is causing the vast majority of my issues.
 |
| one of my knee X-rays |
The rheumatologist wants me to see a neurologist, which will be the next step, but my GP warns the wait could be six months. They’re thin on the ground, unfortunately. And I can’t help but feel angry and short-changed by that sports doctor who pushed a cortisone shot that I didn’t need and who didn’t bother to send me for an ultrasound even though she said she’d never seen a case of plantar fasciitis that had lasted longer than a year, and I was at a year and a half and counting when I walked into her office in April, 2014.
For the moment I don’t know what’s really wrong with me, what’s given rise to the polyneuropathy that’s apparently caused—and continues to cause—me so much trouble, but it isn’t plantar fasciitis. If you, too, have been suffering for a long time and keep getting the term ‘plantar fasciitis’ hurled at you, go get that ultrasound. Print out the two articles I linked to at the start of this post and hand them to your doctor if that’s what it takes to convince them you need one. Because it just might be that plantar fasciitis isn’t what you’re suffering from either, and that no amount of rolling your foot on a frozen water bottle or stretching your calves will make one teensy bit of difference.
***
