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Plantar fasciitis or stress fracture?

(19 Posts)
SkaffenAmtiskaw Sun 27-Jan-13 12:07:39

Last November I suddenly started getting very a sharp pain in my heels, more in the left one than the right one, especially when first getting up in the morning. I was diagnosed by my GP with plantar fasciitis and started wearing supportive insoles. This helped a bit as did doing calf and foot stretches every day and the pain in my right foot stopped, but not in my left foot.

I was referred to a physiotherapist who I saw a the beginning of January and who diagnosed a possible stress fracture and put me on crutches. She wrote to my GP recommending that I get a MRI scan to confirm (or not) her diagnosis as an X-ray would not show a stress fracture.

My GP was skeptical and sent me off for an X-ray, saying that as I had been walking on the suspected fracture for a while and so it might be visible on the X-ray. However it was not the case and I have now been referred to either a fracture clinic or a sports clinic which according to the GP should be able to get me a MRI scan quicker than she could (she was going to investigate which of the clinics would be able to see me first, which is why I don't know which I've been referred to).

My GP still thinks it's more likely to be plantar fasciitis rather than a stress fracture.

I've now been on crutches for nearly 3 weeks. I've had no improvement in my left foot, it's still painful, and my right foot has started hurting again because I have to put all my weight on it when I am walking or standing. This is making me think that my GP has got it right and perhaps I should ditch the crutches as they are not helping and in fact, are making things worse. Would that be a good idea or should I keep using the crutches?

Thanks in advance for any replies! smile

TheAccidentalExhibitionist Sun 27-Jan-13 16:59:41

Stress fractures of the calcaneus are extremely rare. I've never come across one without a history of trauma.
Why did she think you had one, especially as its on both feet?

Plantar fasciitis can be horribly painful.
Try a Musculo skeletal Podiatrist, this is their speciality

In the meantime - never go barefoot, keep doing the stretches, wear the orthoses consistently (you may need better ones if they were shop bought, some can be altered to be more effective. Acupuncture and rigid or sports tape. strapping can help (youtube has great videos on how to strap for plantar fasciitis) you can the tape from most supermarkets or big chemists.

Also you could try a night splint, they work absolute wonders on chronic unremitting plantar fasciitis.

SkaffenAmtiskaw Sun 27-Jan-13 18:45:25

Thanks TheAccidental. She said because the pain was not in the middle of the heel but to the side, and there is some tenderness on the top of the foot.

Can I see a musculo skeletal podiatrist on the NHS or do I need to go private?

TheAccidentalExhibitionist Sun 27-Jan-13 19:00:04

Plantar fasciitis pain is normally on the inside side of the heel. The plantar fascia ( thick sheet of tendon on the bottom of the foot) inserts into the inside of the foot, inflammation sets up at the insertion of the tendon into the bone.
The plantar fascia itself also wraps around the other side of the heel, so pain can come anywhere on the bottom of the foot or around the sides. If there is swelling the top of the foot will swell and hurt too.
I'm not saying you haven't got a stress fracture because I haven't seen your feet but to me it sounds unlikely given your symptoms.

Yes you should be able to get a referral for an NHS Podiatrist through your doctor, some areas you can self refer. Google your area and find out. The time delay might be a factor in pushing you to go private though.

SkaffenAmtiskaw Sun 27-Jan-13 20:24:00

That's really useful information TheAccidental, thanks. It makes sense!

I've had a look at NHS podiatry services in my area and it doesn't seem that I can self-refer. I am also not sure if I will be eligible for treatment as the eligibility criteria are quite narrow, but I will ask my GP.

LifeofPo Sun 27-Jan-13 20:28:07

Message withdrawn at poster's request.

TheAccidentalExhibitionist Sun 27-Jan-13 21:22:27

Agree with LifeofPo. They are usually the same price as seeing a physio. Do make sure they really understand Plantar Fasciitis before you go.

SkaffenAmtiskaw Mon 28-Jan-13 08:02:22

I've remembered I've actually made an appointment with a podiatrist for the week after next. I had completely forgotten! I don't know if she's a musculo-skeletal podiatrist but she lists biomechanical problems as one of the areas she's competent in.

TheAccidentalExhibitionist Mon 28-Jan-13 15:27:47

Phone up and find out. I'm sure she won't mind. If she doesn't think she can help I'm sure she'd refer you to someone who can.
Good luck

pud1 Mon 28-Jan-13 15:37:32

TheAccidentalExhibitionist - can i hijack and ask a question. i have been told by my GP that i have Plantar fasciitis but it is on the ball of my left foot not the heal. every thread i read about it on here is about the heel. can you get it on the ball of the foot.

TheAccidentalExhibitionist Mon 28-Jan-13 20:54:05

Pud1 it's unlikely. The plantar fascia inserts into the ball of the foot but ball of the foot pain is far more likely to be something else. It's really common to get pain here, especially if you are walking slightly abnormally and overloading one particular area of the foot.

Imagine that the joint under the big toe is number one. Feel along the cascade or row of the metatarsal heads on the ball of the foot. Where is the pain? Is it on a joint or between a joint or over multiple areas?

MummyDuckAndDuckling Mon 28-Jan-13 22:01:42

I've suffered from this now for years. Started in left foot and after a year of annoying my GP into helping me, I eventually had the steroid injection in my foot. Few days later it was gone!! Pain is now starting up in my right foot so I'm hoping to have it done again before the pain gets to the extreme stage it was in my other

SkaffenAmtiskaw Mon 28-Jan-13 22:06:26

years! oh my goodness I knew it could take a while to get better but I didn't realise it could be years sad

MummyDuckAndDuckling Mon 28-Jan-13 22:09:41

Yes!! The physios / GP that I seen were very reluctant to offer the injection. The stretches etc done nothing for the pain, I tried it all!
Finally, someone took pity and I got it. But yes, I was about a year of proper pain/couldn't put foot flat on floor in the morning/limping before I even saw the hospital specialist. Even then, it was the 2nd time of seeing him before I got it

TheAccidentalExhibitionist Tue 29-Jan-13 14:23:42

Vast majority of people don't need steroid injections. See what the private pod says. There are many, many things that can be done before resorting to steroid injections, including acupuncture to the heel which is extremely effective.
Why risk scar tissue to the area with steroids?
It won't necessarily take years either, Mummyduck you've had a rotten time but most people recover fairly quickly with the right combination of treatments. It's when you're fobbed off by the GP for months without knowing how to treat it that it lingers on and on.

MummyDuckAndDuckling Tue 29-Jan-13 16:36:44

Oh I agree! I wish mine had gotten better without the steroid injection but there was just nothing better happening. The injection was a life saver and the pain was away within a few days

carbondated Tue 29-Jan-13 18:34:49

Glad you are seeing a podiatrist. The NHS one I saw the other week for constant top of foot pain/shin pain, used a 'tuning fork' to test for stress fractures in my shin. He tapped the fork and then held it all along my shin. I asked what he was doing and he said it was to test for stress fractures. He said if there was one I would have hit the ceiling when the vibrating fork touched it! Sounded unusual I have to say!!!!!

I hope you soon get a diagnosis and action plan. If it is plantar Fasciatis, my friend had it quite badly and it subsided gradually without any intervention. She wore very well padded shoes (like crocs, which she HATED!LOL) for a few months and it just gradually improved.

Bearcat Wed 30-Jan-13 07:49:06

I had plantar faciatis for about a year.
It just disappeared over night.
I had no treatment (GP told me steroid injections very painful and lets see how it goes).
Hasn't come back again for the last 10 years, but I always wear slippers in the house, never go barefooted.

SkaffenAmtiskaw Wed 30-Jan-13 08:01:47

That's one of the worst things as far as I'm concerned, not being able to be barefoot sad

I'd be barefoot all the time if I could!

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