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Incidence of permanent Plantar fasciitis?

Discussion in 'General Issues and Discussion Forum' started by alexb, Oct 28, 2010.

  1. alexb

    alexb Welcome New Poster


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    Hi,
    Have a 24 year old patient with bilateral plantar fasciitis. Patient has had PF for 14 months now, which has failed to respond to conservative treatments like stretching, orthotics, night splint, etc.

    The orthotics the patient was using were 'off-the-shelf,' and I prescribed custom orthotics for the patient. However, during the evaluation the patient asked me what % of patients in the general population suffer with permanent fasciitis. He also asked how many are permanently disabled.

    I gave him the standard figure of approximately 95% of patients respond to custom orthotics. In your experience, how many cases of persistent/permanent PF have you seen? Can the patient still walk/ perform job duties?
     
  2. psturdy

    psturdy Member

    I, too have been asked the same question by a chronic sufferer who has had the problem on and off for three years. So I would welcome anybody else's comments and experience on the subject. My client is an amateur tri athlete and really hoped I could give him a positive reply but I evaded commiting myself!
     
  3. I would assume it´s all about how far the patient is willing to go with treatment rather than permanent.

    ie if a surgical plantar fascia release is performed the pain in the fascia from tension will be removed - so it´s not permanent.

    If this release is good thing or not is another question but the fact is alot of people will say no to surg so it´s not the treatment steps that mean chronic sufferers have pain the whole time it´s the patients themselves .

    Hope that makes sense.
     
  4. JB1973

    JB1973 Active Member

    hiya,
    also have you got the correct diagnosis? could it be something else?
    have you tried acupuncture or steroid injection or anything slightly more invasive like that.

    cheers
    JB
     
  5. alexb

    alexb Welcome New Poster

    yes, we used ultrasound to confirm presence of PF.

    I offered steroid injections to the patient, but he refused. He is being treated with more conservative techniques, although I told him ESWT is a definite possibility in the near future.

    While I am fairly reluctant to give him a straight answer on this, as there really are no definites, I have yet to see anyone confined to a wheelchair out of necessity over PF. What about in your experience?
     
  6. Roadrunner

    Roadrunner Member

    Hi there, Ive been Chiropodist for 14 years now and have found that all patients have been cured or there PF, Of course there different degrees of the condtion and some cases go on for up to a yr before going, Patients weight and lifeyle must be taken into the equation. I find rest with stapping and good orthotics works best, some patients need injections. :morning:
     
  7. JB1973

    JB1973 Active Member

    Hiya Alex
    I too use strapping quite a bit for PF and it does help in my experience. It's quick and easy and patients seem to respond well to it but it is quite short term. Calcaneal pecking with acupuncture needle is also something I have had a little bit of success with and of course steroid. I have only had one patient so far (that i know of anyway) that hasnt responded to absolutely anything and she's had surgery. Why is he so reluctant to try steroid. You are trying to help him!
    Cheers
    JB
     
  8. Ian Linane

    Ian Linane Well-Known Member

    Hi Alex
    I've had people with various soft tissue conditions, some of which stem back some 15 years. Recently had a chap with bilateral PF for 7 years that responded well to soft tissue work (6 treatment sessions in total with a pair of slimflex insoles thrown in half way through the treatment). For me, the thing is not to think PF alone but to work on the neighbouring tissues as well. After 7 years it is likely that other tissues were affected, I dare say this could be the case even after 14 months.

    Ian
     
  9. jerkygirl

    jerkygirl Welcome New Poster

    Hi there

    This thread interests me - I've had bilateral PF for coming up 5 years now and while it is by no means chronic (yet, touch wood), I just can't shake it so I can resume normal exercise and activity without it returning.

    I have custom orthotics, I've had bilateral PF release surgery, I ice after any strenuous impact/activity, I've tried acupuncture, cortisone injections (ultrasound guided), home ultrasound kit, strapping, stretching, heat boot treatment.....I think that's the end of the list...? I've been through 5 podiatrists - giving each a fair turn before my frustration moves me to another. I've even gone so far as to take dietary supplements for things that are supposed to assist with inflammation, such as fish oils, tumeric and some chinese herbal medicines to boot.

    I'm 34, weight is healthy (~76kg for 178cm), and I keep activity on my feet to a bare minimum - I work an office job, exercise by swimming, avoid standing for more than a minute or 2, and use a bicycle for transport instead of walking as much as possible. It just doesn't seem to heal.

    I'd be interested in any suggestions from this forum - I'm almost at the point of offering a reward for solution, dead or alive (preferably alive..)!

    JB1973 mentioned "Calcaneal pecking" - I haven't heard of that, what is that...?

    Thanks in advance,

    Dave.. (this is actually my girlfriend's account, that she created while researching stuff for me, we're both at the end of our tethers!) :)
     
  10. Griff

    Griff Moderator

    Dave,

    Just incase your girlfriend didn't read and pass on the rules when she created her account: http://www.podiatry-arena.com/podiatry-forum/faq.php?faq=about#faq_not_podiatrist
     
  11. JB1973

    JB1973 Active Member

    JB1973 mentioned "Calcaneal pecking" - I haven't heard of that, what is that...?

    Hiya
    Its when you get a two inch acupuncture needle and go through the skin at the heel ( I go in plantarly shallow so I don't go through the fat pad) and ' peck ' the calcaneus , which means that you tap the calc 5 or 6 times with the needle and remove. I don't have any evidence to support how this works but I've had decent results with it
    Cheers
    JB
     
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