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I have been dealing with heel pain for the past 9 months. Much of the pain now has moved toward the toes on the bottom that are at the big toe area and small toe area. No heel spurs no broken bones via x-ray and two orthopedic surgeons. Now what is the steps before we get to the custom insoles. Would a cortisone injection be good for the plantar area near the heel? 8 months of stretching has provided no help. PS the right kind of stretching. I can take 2 50 mg Diclofenac NSAIDS twice a week and keep things in check. The foot really responds to the NSAIDS. I really am ready to get this right foot as well as my left foot which is fine. What are my options well before the custom insole? I do appreciate the feedback Can a ultrasound of the foot provide any diagnostic help?

 

One of the more interesting pieces of information you provide is the lack of pain in the heel area now, and that "it has moved" more distally towards the toes. The presence or absence of a plantar spur has no bearing on the diagnosis...probably information given to you by the orthopods. Maybe you don't need custom insoles and generic supports might suffice. It is entirely possible that after 9 months of having heel pain, you've developed a neuroma, or neuroma-like symptoms. Without plain film, weight bearing radiographs, it is difficult to make online suggestions or a definitive diagnosis. I instruct my patients to freeze a bottle of water, and press/roll the plantar fascia origin every night for 15 minutes. But the reality is, ice massage, cortisone injections, stretching and NSAID's only treat the symptoms...it's the arch support, (generic or custom) that treats the problem. Best to find yourself a Podiatrist.