Nearly 5 years of plantar fasciitis...what next?

[Blutopia]

I injured my right foot back in Feb 2015, on the first day of a new job when I ran for a train. That was when it all started, I had pain under my heel where I must've overstretched it - and it's been agony ever since.

In the first year of the pain I saw a podiatrist and paid £600 for gait analysis and custom made orthotics. No effect.

In the second year, I got a referral on my work insurance to an orthopaedic surgeon who recommended 12 weeks of intensive physio, with potential for an op (gastro-something release, relating to excessively short calf muscles I think??) if the physio didn't work. I had the physio - which is the most pain I have ever experienced - and did all the exercises I was given, but it barely made a dent in the foot pain. Unfortunately I changed jobs right at the end of the physio treatment and my insurance was cut off, so I couldn't go back to the surgeon.

I took out my own insurance which excluded plantar fasciitis for the first 2 years, so I carried on walking around it and doing the exercises. My insurer covered me, however, for left sacroiliac joint pain, and I went for physio on that - and the new physio felt that it was the direct result of limping on the bad right foot. I'm past the moratorium on my insurance for the foot now and they said they'll cover me - but the physio wrote a letter to my GP recommending a cortisone injection, as the standard interventions - physio, stretching, sound wave therapy, icing, etc - were having no effect.

I scored my first cortisone injection in January this year - bingo! No pain. It was the first time I've been pain free in 4 years, it was awesome.

Sadly the pain started to creep back after about 5 months, so I asked for another injection in July - which has had precisely zero effect. I'm in more pain with it now than I've ever been, I'm gutted.

I've continued with stretching - holding a stretch for up to 15 minutes, daily - no improvement. It flares with 8/10 pain when I touch my heel down, and again when I lift off.

I'm considering going back to the GP with it, but what can they do now? I've read that they can try putting in a cast for a few weeks, but is there actually anywhere to go with it or am I destined to have it forever?

[lljkk]

so are you in pain every time you walk at all?
What can you do for exercise?

Every story I've heard of PF has a different ending. There are youtubers who say they needed yrs to find effective treatment. I'm just saying you're not so unusual.

[Blutopia]

Yes, pain with every step - it reduces the longer I'm moving, but it's always there. Much much worse once you stop. So I can walk for exercise, just walk through the pain, but I pay the price afterwards when it's agony to touch my foot to the floor after a rest. This week I've had two days of six hours of driving - it vaguely throbs when resting on the accelerator, but when I go to walk after being in that position for 3 hours the pain is indescribable.

Agreed, I'm not so unusual. I guess I'm stuck with it then, after 5 years of no improvement other than a blissful 5 months after a steroid injection.

[lljkk]

Which part of your leg is tight, linked to it?

Have you tried ice treatment?

Heel rises help me. I don't benefit from stretching calves, I suspect that stretching my hamstrings helps, that my tight hamstrings are the source problem area.

Wearing heels makes mine worse.

Everyone is different (!)

[somewhereovertherainbutt]

Seriously, try the Bowen Technique #notwoo #fixedme thebowentechnique.com/practitioners/find-a-practitioner/

I had an awful sacroiliac issue coupled with plantar fasciitis and literally tried everything (was even on opioids for a bit). Bowen was the magic bullet.

[CiliatedEpithelium]

I had it for two years. It was slathering it with Ibuleive gel, covering it with a plastic bag and then a sock at night that got it to turn the corner.
I have had my SIJ's pinned though too.

[CiliatedEpithelium]

Could you have a heel spur now instead of straightforward PF?

[CiliatedEpithelium]

I also made a little horseshoe arrangement in my shoe with a hollow middle to take the pressure off the centre of my heel. I think this started it healing too.

[sleepwhenidie]

Everyone has found different solutions when you read threads like this...

Where are you? I struggled with PF for 18m that got steadily more agonising. Tried lots of recommended solutions (not steroids though, I was sceptical) and when my hip starting hurting, which was pretty alarming, I ended up seeing a sports injury specialist in Covent Garden. They use laser and shockwave therapy together (which I understand is unique, rarely do both get done together) and they also recommend an exercise and stretching plan that they run through with you in the gym. He put me on two scales, one for each foot and I was putting 5kg more of my weight through my less painful foot which was obviously leading to the problem with my hip and in time would have affected my back.

I am almost pain free after approx 10 treatments but it is pricey (£85/session) and not covered by health insurance. It feels well worth it to me though! I can play tennis without being in agony afterwards and am about to start running again. Let me know if you want the name of the place.

[TooStressyTooMessy]

I was on this thread recently which might be helpful OP. If you’ve had it that long though you may have tried lots of the things already.

[lindyloo6]

Suffered years of pain with this problem and finally had surgery to release the tendon. It took a couple of weeks to recover and have never had pain again in my heel. I think you should push for surgery, I felt like a new woman after. That was about 9 years ago.

[cptartapp]

I've had SIJ issues and PF. Terribly painful. I have mild scoliosis and one leg longer than another though-'all linked apparently. The PF settled after several months after me basically wearing wedges all year.

[TooStressyTooMessy]

It’s so difficult isn’t it as everyone has different things that worked or didn’t work. I have had laser and shockwave together with no effect to the extent the physio I was seeing at the time gave up and discharged me. Do you mean you had them at the same session or actually at the same time sleep?

[alphabill]

My DH has suffered with PF, for years has paid a fortune with podiatry and shock wave therapy. You name it he had tried it. He could barely walk a year ago. He started one to one Pilates and he is hundred times better and has recently started playing football again. Hope that helps.

[Blutopia]

According to the surgeon, I have unusually short calf muscles and very inflexible ankle joints. I have tried icing, yes. When I try to perform the heel stretch, I generally feel tightness in the calf. Heels do indeed make it much worse!

Interesting that you've had the same combined issues somewhere, they must be linked (although for me it was the SIJ pain that came first). I've seen the Bowen technique performed on horses...tbh I'll try anything at this stage! Thank you for the link, I'll do some research.

I'd forgotten about ibuprofen gel, that's a good reminder thanks. I used it when it first started. You've had your SIJs pinned, blimey! What brought that about? I seem to have chronic inflammation in one of mine, I've had loads of different treatments. The pain last time was so deep, intense and sickening, lasting for several weeks even with physio, that I got quite spooked. Was on the verge of asking for a scan (I'd have used my insurance) to see what was really happening in there, when it eased off again so I left it.

I guess there could be a bone spur but I don't think they do anything with those anyway do they?

[Blutopia]

Oh sorry, loads more responses since I started typing my last post.

I've been to two sports physios, one in the city recommended by the surgeon at £85 a pop. He just put me through the agony of rolling the calf muscles, nothing made any difference. I'll have a look at that thread Stressy, thanks!

That might have been the surgery mentioned to me lindy. I'm a bit reluctant as it'll mean time off work - but I'm sure I've exhausted the majority of treatments involving stretching, icing, orthotics, wedges and inserts, shock wave therapy, massage, and steroid injections.

If I thought an op would fix it I'd have to go with it. I'm laying here with my foot up and relaxed and it feels like I have needles going through the base of my heel.

[somewhereovertherainbutt]

Bowen Technique costs £35-40 depending where you are in the country. Worth one go surely?

[Coffeeandchocolate9]

Have you had an xray or MRI on it? I'd be looking for a bony spur, which is operable.

I'm sorry you're going through this, it's hell.

My story is that I had mine for 2 years until I broke my ankle and was forced to be non-weight bearing for 6 weeks. Nobody ever takes rest seriously with PF unless like me they are forced to.

[Sarcelle]

This is probably not helpful to your bad situation but I had this for about a year. It took me a year to go to a GP. They told me to take 6 ibuprofen a day for 3 weeks. It worked.

I still get the occasional warning twinge if I wear too flat shoes, but nothing like it was. You have probably investigated all the simple cures and my solution is laughingly naive but thought I would mention it,

[ProhibitedRodent]

I'm wheelchair bound due to PF. Putting my feet in a bowl of hot water for 10/20 mins helps a lot. Nothing else does though hence the wheelchair

[Wilmalovescake]

Things that help me (but don’t cure it):
An L shape night splint
Stretching my calf muscles and hamstrings religiously.
An air boot during the day when it’s really bad.
Anti inflammatories
Resting as much as I can in the splint.

[Bettertobehealthy]

hello ... Op and others here

This may or may not be something you have considered . However , just in case this is helpful I wonder if you have considered the impact of Low Levels of Vitamin D , and its cofactor magnesium. Journal of the American College of Nutrition, 36(6):455-461 (2017)

That research ( 2017) in the US , shows that myofascial pain is associated with these factors.

IF, you have not had these things looked at , it may prove to be a good thing to investigate. It is quite straightforward to measure your vitamin D level. Not quite so easy for intracellular magnesium. Vitamin D researchers now consider that a blood level of over 100 nmol/L is appropriate for optimal health. Here in the UK, many people are lucky if they reach 50 nmol/L of vit D. In winter , it is worse, whereby sunlight does not contain UVB radiation , and so it cannot be manufactured in the skin.
You can ask your doctor for a test. Some are reluctant to test , because so many people are found deficient.

IF , he won't do it , here is an NHS lab that will test a sample on blotting paper , that you send by post. Results are emailed to you within a week. www.vitamindtest.org.uk/

Your aim should be to supplement with Vit D , to maintain a blood level, over 100 nmol/L over the long term. In other words , don't stop some supplementation , if it is shown that you are low now, it is very likely that your level will drop to its original level , after you stop supplementation.

Hope that is maybe useful. I have explained quite a bit here on Mumsnet , about Vitamin D , have a look at some of my posts in General Health. .. ! ,

BTBH.

[Blutopia]

Thanks everyone for responding, I did type out a long reply name checking everyone but lost it (got distracted and the page refreshed).

But I do appreciate you all taking the time to respond and I am heeding the advice. I've done virtually all the things mentioned apart from the Bowen technique and the hot water idea!

Wheelchair bound?! Jeez, is that temporary?

[123976535ng]

Hi there - I will second the recommendation for Bowen therapy. I am actually a Bowen therapist myself and plantar fasciitis is something that I treat fairly often. Many people without realising are walking around with one leg slightly shorter than the other due to muscular imbalance. This causes uneven pressure on the feet and often causes pain, either in the feet as plantar fasciitis or in other areas such as the back or hips. A Bowen therapist will check for this and correct it. A very small percentage of the population has an anatomical short leg but the majority of cases are easy to correct by releasing those muscles that are holding the body out of alignment. It is also possible to tape the foot with kinesiology tape in a way that relieves pressure and allows the foot to heal. So a combination of balancing the pelvis and taping the foot usually completely resolves the problem. (It is important to check whether the Bowen therapist has post graduate training in assessment and knows how to correct pelvic imbalance).

[Bunnybaubles]

I could've written your post myself! Including the charity sales job. Except I was the pest people tried to sneak past on their way out the supermarket

I've had PF in both feet since 2012 and the combination of years of limping, over compensating etc I've now got shortened calf muscles, reduced flexibility in my ankles, very painful heel bones as well as the typical PF pain.

Ultrasound showed both my plantar fascia are thickened with scar tissue and I have heel spurs on both heels too.

I've also tried everything, although never heard of the Bowen therapy!! But was warned against the surgery due to possible complications and to try manage the pain with medication and lifestyle changes.

I haven't found anything that helps, I've had 2 referrals to the pain clinic and I'm on tramadol.

@Coffeeandchocolate9 I broke my foot and dislocated my toes in 2016. I had to wait 2 weeks with my foot bandaged, so the plantar facia was stuck in its shortened position, before I got the boot fitted (instead of a cast). The nurse wanted me to put my foot at an L angle so he could put the boot on. Told him I couldnt because my plantar fascia. So he bloody grabbed my foot, telling me its nonsense, and forced my foot upwards. The pain was incredible and I felt tissue tear off my heal bone!!

I was meant to be able to weight bare with the boot but the injuries I got because he forced my foot up meant I couldnt for 2 months.