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Plantar Fasciitis or Foot Pad Atrophy?

Discussion in 'Ask your questions here' started by kneman, Jul 5, 2011.

  1. kneman

    kneman New Member

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    I was hoping for some insight. I am a 32 year old male in pretty good shape. About 2 years ago I started running to loose weight. About 1 month in I got plantar fasciitis in both feet. At the time I had no idea what I had so I kept running thinking it was just sore. 1 year later the right one got 70 percent better but the left one hurt like hell. I went to a podiatrist I was referred to and he gave me a cortisone shot, taping, ice, stretching night splint etc. I still had pretty bad pain. 6 months later my friend who is an orthopedist gave me a PRP injection which heped about 40 percent. So I went back to running now I have so much pain everyday especially in the left but also in the right (after standing more than 15 min pain starts in right) The left is always painful. Now 1 year and half in I went to another doctor who put a cortisone this morning and put me in a boot for 1 month before we move to surgery etc. I was hesitant about the cortisone but given the pain I am in I did it anyway. I come home and look up side effects and I read about fat pad atrophy. I called the Dr. immediately and he told me it is highly unlikely less than 1 percent and I had done 2 shots in about 1.5 years and that for people that have done much more.
    1. My question is will the cortisone boot combination help?
    2. How would I know if I have or can get foot pad atrophy. Is it something I can see. I also got an MRI which showed a mild thickening of the fascia.
    3. What is the differnce in pain symptoms between the 2.
    4. Should i think about topaz or full surgery?
  2. I have experienced the same disabling pain for over six months and after much research on the internet and after three visits to a Podiatrist, one visit to a Dermatologist, one visit to the local walk-in clinic, and three visits to a Neurologist (one for an EMG) to determine if I have disabling peripheral neuropathy, I have been diagnosed with both sensory and motor nerve damage in right and left feet. I was prescribed Gabapentin for nerve pain relief. Dosage can be as little as 100 MG or as high as 2000 MG.

    Recent research has shown that I probably have osteoarthritis in my feet and toes. I also have four hammertoes on both feet, toe spread, tailor bunions on bottom of foot near little toes with calluses also. In addition, I believe I have foot pad atrophy.

    I am grossly disappointed that my foot doctor has been of little use. He is not proactive in educating me about my foot deformities or pain. He basically told me that there is nothing that can be done. The only benefit I have derived is my diagnosis of Peripheral Neuropathy so that I can receive callus shaving and toenail cutting every nine weeks because my Health Insurance Provider (Tufts) will pay for it.

    Possible tests are Ultrasound, CT and MRI to determine the biomechanical causes of this malady. That is, osteoarthritis, osteopenia, osteoporosis, hammertoes, fat pad atrophy, calluses, tailor's bunion (near baby toe), etc.

    You might want to schedule appointments with the following type of specialists: Podiatrists, Orthopedists, Chiropractors, Neurologists. Physical Therapists (Yoga).

    Orthopedic Devices: Metatarsal pads, toe splints, custom or over the counter orthotics, callus pads, toe separators, orthopedic shoes, wide toe diabetic shoes (not covered by insurance), etc.

    Some more drastic interventions: Graft Jacket Surgery, Biodegradeable joint implants that provide a scaffolding for stem cells to regrow cartilage.

    I am not a diabetic or overweight. I am active and have typically walked between 2-7 miles per day.
    My younger sister developed the same problem, but she is overweight, has diabetes, cholesterol, and high blood pressure. My sister has already had serious surgery on her feet, toes and ankles because in addition to the problems I have she also had detached foot tendons.

    I think some of the causes of our mutual problems are repeated blunt force trauma, pounding the streets, age,collagen breakdown,etc.

    Hope this helps. Marina
    Last edited: Apr 18, 2013
  3. kneman

    kneman New Member

    Dear Nana,

    Thanks for your reply. It’s been a long time since I posted that. I have since visited a couple more Dr. the latest at UCLA neurology institute. The Dr. Don't has much to say and can't really figure out why this happens or what causes. I have seriously changed some aspects of my life. I was active before but have changed my active to cycling instead of running. The constant pounding was doing more harm than good. I have since ceased taking all medications all together. Although you might want to ask your Dr. About Namenda its used for Dementia but has an off counter use for neuropathy. I have also been my own Dr. seeing what bothers me in terms of food, sleep, time, etc. I have realized that alcohol bothers me. Do I have alcohol neuropathy I don't think so neither do Dr. I don't have diabetes or any other ailments. My family history is clear of anything. I can say have gotten about 20-30 percent better. I can function throughout the day. Obviously some days are better than others.

    I hope my information help you a little.

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