Monday, September 24, 2007

Ohhh The Pain!! Could Cost Me. How Much?


Over the past few months, I have had increasing foot pain. After I mentioned it to co-worker and how it came and goes. In fact the morning, I mentioned it, I could barely walk when I first woke up. She suggested it might be heel spurs.

So I came home and looked it up. While, the Doctor writing on about.com, says heel spurs aren't painful, and the painful is Plantar fasciitis. I will still call it heel spurs, because that is what most non-medical people, like myself, calls it, rather then the medical term.


Plantar fasciitis is a common, painful foot condition. Patients, and sometimes doctors often confuse the terms plantar fasciitis and heel spurs. Plantar fasciitis refers to the syndrome of inflammation of the band of tissue that runs from the heel along the arch of the foot; a heel spur is a hook of bone that can form on the heel bone (calcaneus). About 70% of patients with plantar fasciitis have been noted to have a heel spur that can be seen on X-Ray.

Who gets plantar fasciitis?


Plantar fasciitis is most often seen in middle-aged men and women, but can be found in all age groups. Plantar fasciitis is diagnosed with the classic symptoms of pain well localized over the heel area of the bottom of the foot.
Often the pain from plantar fasciitis is most severe when you first stand on your feet in the morning. Pain often subsides quite quickly, but then returns after prolonged standing or walking.

Plantar fasciitis is sometimes, but not always, associated with a rapid gain of weight. Plantar fasciitis is also sometimes seen in recreational athletes, especially runners. In these athletes, it is thought that the repetitive nature of the sports causes the damage to the fibrous tissue that forms the arch of the foot.




Since, it costs money to go to the Doctor, I have not been to a Doctor. I have insurance, once I have paid out the $500 deductible. However, then I would have to pay 20% for a while. So I have been reading up to try to get ideas how to cure the pain without such huge expenditures.



Treatment of plantar fasciitis is with short-term rest and controlling the inflammation. Here are the steps patients should take in order to cure their plantar fasciitis:

Rest

Avoiding the precipitating activity; for example, take a few day off jogging or prolonged standing/walking. Just resting usually helps to eliminate the most severe pain, and will allow the inflammation to begin to cool down.

Since, my job requires me on my feet all day, this one is not an option for me. In fact another site, suggested staying off your feet for like 20 days. Something, they admitted wasn't an option for most people. So I will look at other treatments. However, as much as possible I will stay off my feet.

Apply Ice Packs

Icing will help to diminish some of the symptoms and control the heel pain. Icing is especially helpful after an acute exacerbation of symptoms.
  • A great way to ice plantar fasciitis

    Exercises and Stretches

    Exercises and stretches are designed to relax the tissues that surround the heel bone.
    Some simple exercises, performed in the morning and evening, often help patients feel better quickly.

    Anti-Inflammatory Medications

    Anti-inflammatory medications help to both control pain and decrease inflammation. Over-the-counter medications are usually sufficient, but prescription options are also available.

    Shoe Inserts

    Shoe inserts are often the key to successful treatment of plantar fasciitis. The shoe inserts often permit patients to continue their routine activities without pain.

    Night Splint

    Night splints are worn to keep the heel stretched out when you sleep. By doing so, the arch of the foot does not become contracted at night, and is hopefully not as painful in the morning.

    These modalities alone will cure the plantar fasciitis pain in most patients. Be forewarned that the symptoms will not resolve quickly. Most patients find relief within about three months, and over 90% within one year.

    If the pain does not resolve, an injection of cortisone can decrease the inflammation of plantar fasciitis. However, many physicians do not like to inject cortisone because there are potentially serious problems with cortisone injections in the heel area. The two problems that cause concern are fat pad atrophy and plantar fascial rupture. Both of these problems occur in a very small percentage of patients, but they can cause a worsening of heel pain symptoms.

    A new treatment for chronic plantar fasciitis is being investigated. This treatment, called extracorporeal shock wave therapy, or ESWT, uses energy pulses to induce microtrauma to the tissue of the plantar fascia. This microtrauma is thought to induce a tissue repair process by the body. ESWT is recommended in patients who have failed the previously mentioned treatments, and are considering surgical options. For more information on shock wave therapy treatment:

    After successful treatment, how can I prevent plantar fasciitis from coming back?

    To prevent the recurrence of plantar fasciitis after treatment, proper fitting footwear is essential. Many people use shoe inserts to relieve pressure over the tender area. Custom orthotics can also be made if there appears to be a problem with the mechanical structure of the foot. It is also important to continue the stretching and exercises. These simple exercises will help maintain the flexibility of the foot and prevent the plantar fasciitis pain from returning.


  • One thing I did is went by a business called, Foot Pain Solutions. This business makes custom orthopedic inserts. They in fact do the inserts for all the athletes at KU (Kansas University) in Lawrence and Washburn University, here in Topeka.

    He connected me to a device, he inserted into my shoe and strapped around my leg, then had me walk around for a couple of minutes. When I came back, he connected the device to the computer and we could see images of where the pressure was.

    It seems I have no support whatsoever, on my right arch. For my left foot, I have absolutely no support anywhere on the middle part of my foot. All the pressure is on the heel and toes.

    He suggested two things:
  • Proper foot wear
  • He said I need to wear quality foot wear. Shoes that are better quality then the $25 Payless Shoes that I currently wear. He suggested a shoe company in town that actually takes time to measure your foot (both width and length) to find a proper fitting shoe. They also will look at your feet and if are like me, and you kind of walk on the side of your foot, they have shoes that force you to walk on your entire foot. They even have a treadmill, and they might even have you walk on it, to make sure you get the correct shoes. The cost of these good shoes are in the neighborhood of $100.

    I have known for sometime, I needed to get better quality of shoes. However, with my budget, I always went to budget route. Now, as I am developing (and the images seem to indicate, it's the early stages of my condition) foot problems, it has come to be more mandatory.

  • Custom Made Inserts
  • Of course the Free Evaluation, was to try to sell me the custom made orthopedics. Inserts specifically designed for my feet, to correct the problems that I am faced with. The cost of these things are $195. Certainly outside of my price range. However, they do come with a lifetime guarantee that they will work or they will refund my money. They are about 1 weeks take home pay.



    However, coming up with the funds for these two things will greatly help correct and prevent future occurrences of my foot problems. So I need to find the funds. In the mean time, I have bought some "cheap" $8 gel inserts to help pad my feet some. While I can still feel the pain, I notice a big difference in the pain, when I walk.

    I probably should visit the doc also. Seeing as they can take care of the Anti-Inflammatory Medications, if that should be needed. Of course do I visit my family doctor? Or do I find a podiatrist?

    Whatever, this pain will cost me. Not only in the treatment, but also in my enjoyment of walking to nearby places. I love walking to church (4 blocks away), to events, I might go to at the arena (2 blocks away) and even things at Washburn University (5 blocks away). However, now because of the pain, I will have to drive to these nearby locations.

    Hopefully, I can get this problem fixed quickly.

    11 comments:

    1. That's a pretty good and well thought out post you have here, Kevin.

      The word "Plantar Fasciitis" in and of itself is a descriptive term. Plantar meaning the bottom of the foot, fascia being a kind of tissue, and 'itis' being a suffix that means inflammation. Taken together they describe a condition of inflammation of the tissues on the bottom of the foot.

      I had this condition one time, and I did NOT go to a dr.
      I couldn't see spending the money just for him to tell me to take it easy and give me a prescription for Motrin.

      So I called Dr Mom.

      Dr Mom told me to not walk on tile or concrete in bare feet, take Motrin (or generically, ibuprofen) two or three times per day, and to throw away the shoes that I had, because they are likely what caused it. So I went and bought a big bottle of ibuprofen for eight bucks and some new shoes.

      I didn't get the $100 shoes. Just a different brand than what I had been wearing. I also got a pair of cushioned sandals for wearing at home so I wouldn't have to walk on the ceramic tile in bare feet. And since there is concrete under the carpet and my carpet is cheap, I used the sandals there, too.

      Sure enough, the pain went away. But not all at once. It was just like you said. Over the course of a month or so. After that I would still get a pain every now and then, and then I would just take some more ibuprofen and rest my feet some.

      And it worked like a charm for me.

      Not to say that it would work exactly the same for you, but I just thought I would share that with you.

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    2. I have a friend who has this, and she got the inserts, since they were prescribed by a doctor, her insurance covered it. Do you have to pay your deductible up front? My insurance has a deuctible, but we also have a co-pay for doctor visits which would cover your office visit...
      You need to decide if your feet are worth spending the money to fix. And, if your job reqiures you to be on your feet, then it seems like this would be very important, what happens if it gets worse and you require surgery or can't work? You can't ignore a medical problem because you "think" you cannot afford to go to a doctor, some things are more important than getting out of debt in 6 monhts - your health being one of them. If you had an kind of an emergency fund, this would be used for your inserts, or the doctor visit. I have been reading your blog for a long time, and you talk a lot about getting out of debt, being free of debt, and having money saved....and each time you have a financial emergency, you never seem to have the dollars to cover it. Not judging, it's just an observation...mybe this is a wake up call that you need to be more diligent about saving up for such things?

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    3. Jagular -
      Thanks for your comments. It is good to hear a nurse make these suggestions. As I have said I have known for a long time (years) that buying a better quality of shoe ($60-$150) lasted longer then the cheap $20/$25 shoes I get from Payless. Now, there are medical reasons to buy the better quality shoes.

      The inserts, like you said I might be able to get along with a store bought insert.


      Cheryl -
      Thanks for your comments. You are so right. I appreciate your thoughts and I look forward to the day I can keep my emergency fund as my baby emergency fund. I tend to get it built, either partially or in full and then shove that money towards my debts or taxes and it leaves me short for true emergencies.

      Right now, I am trying get the car tags paid.

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    4. I wouldn't bother with ibuprophen. Why? Because you're taking more and more every 4 hours. Spend the extra dollar on generic Naproxen Sodium (Aleve). It lasts a LOT longer and therefore will save you money in the end. I also find it much more effective and for most people easier on the stomach. This will sound weird, but also try soaking your feet in a hot tub (or just take a hot bath) and Icy Hot at night. Foot massages (which you can give yourself) will be of great help too. But you do need to stay off your feet as much as possible, but even more importantly, hard surfaces. And go back to the shoe store. Just check for arches. You should have one on each side of your foot and a slope down from heel to toe to help even out the pressure. Shoes need to be replaced when the arches go out and, considering how old your shoes probably are as the way you put it that you had no arches, some new shoes period should help. Just make sure you have plenty of padding in there. Good luck, and email me if you need any extra help.

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    5. Lynx217 -

      Thanks for your comments. My shoes are brand new. Just bought them a month or so ago, to replace my boots. Thought my pain, that was just beginning. It helped for a couple of weeks, then was worse then before. Woke up one morning and could barely walk. Going doorway to doorway for support. It is the way I walk, that i am not using my right arch and only using my heels and toes in my left foot. What the guy at the orthopedic store said was that in part I needed shoes to and inserts that forced me to use my entire foot, so that the legitimate was used properly and thus relieve the pain (over time) that is being caused.

      Arch support is certainly something I need.

      ReplyDelete
    6. I had the same problem when I turned about 21. If you can wear tennis shoes to work, Try to go find some that are fit for your feet. Check out running sites for a guide to fitting your shoe. I have extremely high arches and all the pressure is on the ball/heal/outside of my foot. I bought a pair of cushioning running shoes. As soon as I put them on I was like WOW! These fit my feet. I never knew such a thing existed!

      http://www.zappos.com/runningfitguide.zhtml is a good guide to fitting your shoes.

      I found a pair for around $50. Being able to walk is well worth it to me--and yes, I had to do this while I was on a college student budget.

      This is the only body you have and you have to use it for the rest of your life. I've come to the conclusion that it's worth taking care of because I do need it for a while.

      1) get proper fitting shoes. This will probably cost around $50 or 60. If you can wear tennis shoes you might be able to get them on sale now as the running season is ending. If you can't buy new shoes buy good arch supporting inserts--not all inserts are created equal. Super feet is supposed to be a good brand, but they will run you $25 on their own.

      2)Always wear shoes.

      3) put a tennis ball on the floor and roll it around with your foot. Keeping the ball under the arch. This will act like massage.

      4)clinch up your toes and hold it for a while then release and repeat. This will work the muscles/tissue on the bottom of your feet.

      It took me about 3 years before I could go barefoot again. I still buy good shoes (except for dress shoes it's impossible to find a woman's dress shoe with arch support) and wear shoes most of the time. It was nice to be able to go barefoot again this summer.

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    7. Ouch. I am so sorry you have this problem. I have had this in the past when I worked as a waitress, and it was terrible. I was told a couple of things that really helped. Some have been already listed.
      1. Wear shoes with good support.
      2. Do not wear the same shoes everyday. Switching shoe types daily causes your foot to not get into the same rut of the shoe everyday. This can even change your posture for the better.
      3. Hot foot soaks, followed by cool foot soaks, then hot, then cool. I was told to spend 30-40 minutes at least once a day (twice was even better) soaking my feet in hot warm/then cool (back & forth) for about 5 to ten minutes in each tub for up to 30-40 minutes a session. The purpose is to get blood flowing to the area, which promotes healing. Follow with a light foot massage.
      4. I also have the name of a company that has reasonably priced items to help. It is Footsmart.com, and I have did business with them for years.Even going to their website can maybe give you ideas on what you can do yourself. Good luck

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    8. 09/25/07
      Since this happens when you get up in the morning, it could be problems with your Achilles tendon. Get the inserts; it's cheaper than surgery. My husband cannot walk without inserts; they can make your life livable. Go to a good orthopedic doctor for a diagnosis. You only get one pair of feet and they need to last.

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    9. i'm a believer in learning stretches, and i have healthier feet after learning some stretches that i try to do every day. but maybe first try a hot epsom salt soak, and then hold the whole foot in your hands and move it around gently. pay attention to what parts feel injured. maybe a nightly long, hot soak would be useful in other ways.

      shoes are tricky because buying new ones it always hard on your feet, even for good shoes. but the way i see it, shoes costing under fifty dollars might be a wise investment. i personally do not believe good shoes cost $100, as I pay around $40. if there's a college nearby, look around it for a sporting goods store. "you get what you pay for" only goes so far... at some point, the "good shoes" are just more fashionable, not better. hmm, my opinion.

      i'm glad you bought some inexpensive inserts. great approach. why not try the other brand too if you feel like it? cuz face it, that idea's inexpensive. when i face things like this, i make a long list of what i could try... and i start by trying what's cheap or free! for example, i recently learned a technique of standing properly. all these years i was standing wrong. ;) it's free, but it has been very valuable knowledge so far, as i feel some improvement in my knee problems. i bet many of your best treatments are just changes to your lifestyle, and that's often free, so treasure it!

      also: anti-inflammatory medications like ibuprofin can be useful. take one after the soak, perhaps, and let your muscles relax. when muscles and bones are inflamed, it's a lot harder for them to heal. i bet you can try ibuprofin without a doctor's supervision. they happen to make me feel sick so i don't take them.

      i hope you do get past this current situation, where you struggle to cover 4 blocks! do you have a bicycle, kevin? at times like these, i try to focus on being creative and clever. necessity is the mother of invention. i understand about the job duties. maybe there are other duties at work you could focus on for a while? perhaps even a second career. ;) it doesn't hurt to inquire at work about this.

      p.s. crutches, when properly used, might be yet another darn-cheap idea.

      try a lot. try all the cheap ideas first. then you might not even need the pricey ones.

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    10. I've had this problem in the past. It went away when I started wearing Dr. Scholls arch support inserts (which I think are different from their regular gel or padded shoe inserts). They were less than $10 and the pain when away within a couple days.

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    11. i had the same problem for years... i bought the shoe inserts, gave up the high heels, did the exercises, took the anti-inflammatory ---- nothing worked. I have since had 1 shot of cortizone --- no pain for 2 years now. NONE. so if none of the recommended stuff pans out --- go for a shot. it works wonders.

      ReplyDelete