planterfaciatis

[Santana]

Hi Guys

I've been diagnosed with planterfaciatis, and would welcome comment on effective treatments for long term relief.

Steroid injections ineffective.

Severe pain travelling up back of left leg
combined with bursitis of the right hip.

Long term medication treatment- steroid 7.5 mgs per day
plus anti inflamatories NSAIDS

Have Arthritis and Ulcerative Coilitis......(if a horse, probably shot by now)......Ideally seeeking...long term relief and return to activity......without the negatives of more steroids.

alternating between 7.5 and 5 mg every second day....

thanks

Helen

[PhysioAdvisor]

Hi Santana,

I would recommend seeing a physiotherapist for appropriate treatment of plantar fasciitis and correction of any factors contributing to the development of the condition.
Orthotics may be required and again your physiotherapist will be able to advise on whether these are appropriate for you. You may be interested in checking out the above links for some detailed information,

Hope that helps and good luck

[Santana]

Hi Physio advisor,

many thanks for the reply- and the link....I shall try the exercises/comments and recommendations and hopefully see an improvement.Regards

Santana

[tonywoodall]

Alternatively you may consider the probability of refered pain from the lower back. The clue is the pain up the leg and hip. In my experience Plantar Fasciitis is effectively treated by attention to the lower back and gluteal muscles. If all the local treatments to the foot have not worked, my assumption is that the Fascia is not the problem but the pain is another form of refered pain (Sciatica). The refered pain site can actually be painful to palpation, leading to the belief of Fasciitis.

The usual original source of foot pain from the lower back is L4,5,S1. The problem is usually one of long term lower back problems and the inflammation has spread into the Gluteal muscles. The source of the foot pain will be from the extreme lateral area of the gluteals.

[Santana]

Hi Tony

Thank you for the post and comments,

I think you're spot on - in that I had a disectomy two years ago.....and four pieces of disc were removed from the nerve bed near L4 L5.....I've had problems since with the second toe ( near big toe ) and the nerve is constantly hopping in my left instep.

I'd be delighted to take your recommendations and go to a local physio, but given your comments and diagnosis- I'd welcome anything else you might want to post regarding recommendations or treatment.


Many thanks

Helen
(Santana)

[tonywoodall]

Hi Santie,

In terms of effective treatment the right treatment is whatever works.

When you next have your foot pain, if the pain is in the right foot, a test for you could be to put a hot pack on the outside of the right rump (lateral Gluteals) whilst you are lying down on your left side. A pillow between the knees would help. If the source of the foot pain is the lateral Gluteals then the symptoms in the foot will have subsided.

The above test is handy for reducing the symptoms but it will not fix the cause of the pain, which is a lower back/Sacral joints injury.

My approach would be to mobilise the lower back and manipulate if possible. I would then be using TENS, passing the electric currents through the source of the problem (L4,5,S1,Sacroiliac joints) and including the inflammed area of the Gluteals. TENS Is a very effective pain blocker and appears to promote the healing process.

The area of inflammation is found by simply palpating (poking) the area to find pain. The area would be marked with a pen to ensure the electric currents pass though it. Bear in mind the inflammation may be on the surface of the Ilium, so the current would have be at a deep level. Remeber that electric currents go in a straight line so there is no point in just sending it along the surface of the skin.

After this, heat of some form would be useful to relax any spasm out of the gluteals and gain a short term increased blood supply to the area. The components of the healing process are carried by the blood supply so the higher the blood supply the better. but if you are doing this make sure you don't burn yourself. Skin sensitivity drops when pain is in the area.

Then I would train/coach/bully you into avoiding agravating the pain. Think simple - pain is bad, no pain is good!!! When you feel pain, you have just caused it and your healing process has probably stopped. And the cause will be one or more of the following - wrong movement, wrong posture and mental stress. When you are stressed the whole body goes tight and this tightness will restrict the healing process. Learn by your mistakes.

Finally, Physios work in different ways. Because I have almost always had success by my treatment approach, then I have to recommend a Physio who has a similar approach to me. I hope that doesn't sound too egotistical.

The above is an outline of a treatment approach.

Cheers and good luck. Tony Woodall.