Hi,
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Apologies in advance for the long winded history. As you have all been so helpful previously I thought I'd pick your brains again..
I have been treating a lovely lady with 'plantar fasciitis' with absolutely no success. This lady initially hobled into my clinic in Oct 2010, was very tearful and in extreme pain. She could barely partially weight bear as the pain was so extreme. She is 42 years old, slim build and previously led a normal active life. It is difficult to assess her accurately as we are limited by pain although I so far have not found any significant joint deformity.
A brief background..
Subdued, constant low level pain around plantar heel (she describes as both central and medial) of both feet began Jan 2010 at present for 6 months.
Mid-July, pain increased in both feet and by warly August the pain had become 'piercing'. During this time no injury was sustained and no obvious explanation for the increase in pain.
Orthopaedic consultant applied a steroid injection into 1 foot which instantly accelerated the pain.
By September she became wheelchair bound and slowly began to walk around the house in January 2011.
She is compliant with gentle stretches and the physio is treating her feet with regular ultrasound with no relief of symptoms.
She has consulted with various well regarded consultants: Orthopaedic, Metabolic and a Rheumatologist all of whom have discharged her as having plantar fasciitis.
Her mother suffers Hypo Phosphataemia Osteo-malacia, a hereditary condition within her family line. Other members of the family of this condition to varying degrees. Her mother is Hypo-Phosphataemic and it's believed her condition lies mainly in the kidney tubules.
The patient recieved a blood test to check phosphate balance at birth although test proved negative. However her mother tested negative for years before being diagnosed as her phosphate levels fluctuated widely.
I wonder if anybody has ever heard of something like this or has any idea how we can help her as ever other profession seem to have given up??!
Many Thanks
Mhairi F
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