Hi All - 1st time poster looking for advice.
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Bilateral foot pain on medial aspect of feet - see photos identifying area.
1 year ago pain started after pt got up off sun lounger and stood up. Felt a pain in arch of foot on RF only. Pain persisted to a point where they were having to sleep with their foot in a dorsiflexed position and stretch out the fascia as it was so tight. The pain didn't improve as the day wore on and at night time there was a tender spot on the plantar aspect across anterior border of calc. Treatments of anti inflammatories, ice, rest had little effect although strapping provided some relief.
8 months on pain so severe causing sleep deprivation and depression. Pt had gone from walking regularly, approx 35- 45 miles per week, to nothing. MRI scan showed slight thickening of posterior attachment of plantar fascia into calc and nothing else reported. Pain also started LF approx 8/52 ago. Lumps present over areas shown on pics, painless on palpation, circumscribed, but paraesthesia/neuropathic type discomfort present. Edges can become inflammed and veins prominent. T/t has consisted of; physio, core stability exercises, ultrasound, osteopath (to address L/hip pain), orthotics (bespoke and off shelf), footwear appropriate. Pt has seen orthopaedic consultant who has diagnosed plantar fasciitis even though symptoms atypical!! Pt was offered steroidal injection which they have declined, as the orthopod could not offer any evidence based success rates and did not remove shoes or socks which did not instill confidence in the patient.
Any diagnosis and cure greatly appreciated!
Many thanks.
Julie :drinks
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