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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Diagnosed With Plantar Fasciitis. Have High Arches And Tight Fascia. Pain In Arches. What To Do?

I was diagnosed with plantar fasciitis in July. I tried over the counter orthotics and they made it worse. I have high arches and tight fascia. After wearing the orthotic for about a week, slowly getting used to it, I had extreme pain in my arches right where that hard ball from the orthotic was and now I have arch pain all the time, even at night and it wakes me up. I have to take pain meds to sleep. It hurts to put pressure on it too. I just sit every day in pain waiting for it to heal and it won't. I also have pain when I walk and can't even work. I have only been tested for arthritis and auto immune diseases and don't have that. Can it be something else? What can I do? I have an HMO and they wont even consider an mri and I only had an x ray of one foot, even thought I have pain in both feet. They just say rest and stretch and sent me to PT who doesn't quite know what to do either.
Mon, 4 Nov 2013
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Orthopaedic Surgeon, Joint Replacement 's  Response
Hi, thanks for writing to HCM.

The conservative management of Plantar fascitis is as follows -

* Relative rest and simple massage of the foot along with stretching exercises. Regular, gentle stretching of your Achilles tendon and plantar fascia may help to ease your symptoms.
* Use of analgesic antiinflammatory medicines like Advil or Aleve as needed
* Night splints may be useful to keep the foot in plantigrade position
* Shoe inserts - Use of MCR (micronised rubber) or silicon heels (orthoses) in the foot wear so as to produce a cushioning effect and taking off the pain
* Maintaining appropriate body weight so as to reduce the load bearing on the heels
* Avoid wearing flat-soled shoes because they will not provide your heel with support and could make your heel pain worse.
* Quit smoking, if you are a smoker
* At times, a single injection of corticosteroid in to the area of maximum pain will provide good pain relief.
* Extracorporeal shock wave therapy- In this procedure, sound waves are directed at the area of heel pain to stimulate healing. It's usually used for chronic plantar fasciitis that hasn't responded to more-conservative treatments.

Hope this information is helpful. Good day
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Diagnosed With Plantar Fasciitis. Have High Arches And Tight Fascia. Pain In Arches. What To Do?

Hi, thanks for writing to HCM. The conservative management of Plantar fascitis is as follows - * Relative rest and simple massage of the foot along with stretching exercises. Regular, gentle stretching of your Achilles tendon and plantar fascia may help to ease your symptoms. * Use of analgesic antiinflammatory medicines like Advil or Aleve as needed * Night splints may be useful to keep the foot in plantigrade position * Shoe inserts - Use of MCR (micronised rubber) or silicon heels (orthoses) in the foot wear so as to produce a cushioning effect and taking off the pain * Maintaining appropriate body weight so as to reduce the load bearing on the heels * Avoid wearing flat-soled shoes because they will not provide your heel with support and could make your heel pain worse. * Quit smoking, if you are a smoker * At times, a single injection of corticosteroid in to the area of maximum pain will provide good pain relief. * Extracorporeal shock wave therapy- In this procedure, sound waves are directed at the area of heel pain to stimulate healing. It s usually used for chronic plantar fasciitis that hasn t responded to more-conservative treatments. Hope this information is helpful. Good day