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Foot/Heel Injuries Heel Pain that is not Plantar Fasciitis

Heel Pain that is not Plantar Fasciitis

Why do I have Achilles Pain?

Why do I have Achilles Pain?

 

I am not a runner, however I do run as part of some cross training and while playing softball.   My foot problems began with planters fasciitis which I had in BOTH feet,  I had surgery on both in 2014 after all other treatments failed,  After several week of physical therapy I still experienced pain but in a different location, the subtalar bone around my heel.  My podiatrist told me to be patient, all would heal, was just taking longer than anticipated.  More than 2 years later I still have pain around heel and on inside and outside of both feet.  I have tried acupuncture, shots and nothing has really worked.  X-rays did not show any fractures.  My podiatrist basically said he was stumped.  My family doctor referred me to a rheumatologist because he thought it was inflammation,  Blood test showed no arthritis, rheumatologist ordered an MRI.  He stated MRI did not show inflammation.  He said only thing he could do is recommend something for pain to give me some relief,  He ordered Gabapentin which does help as long as I take it 3 times per day (300 mg).  Does not alleviate the pain though.  On scale of 1-10, my daily pain is easily a 7.  I ‘m at  my wits end with this pain.  I recently asked my family doctor to review all tests.  He advised my MRI    DID show inflammation – bony edema on inside of BOTH feet (which is where they hurt the worst, like a burning pain).  He said to see another podiatrist or an ortho doctor.  My question is – how would YOU treat this condition?  Should I see a podiatrist or an orthopedic doctor?  Some things to note – I only have 1 kidney and cannot take anti inflammatory drugs.  I am taking turmeric curcumin.  Have tried cherry juice, niacin and many other “natural” anti- inflammatory supplements but nothing seems to work.   Also, I have always had cold feet.  I do ice them for pain and it takes hours to get them warm  Have had thyroid checked.  I am wondering if vascular issue.  Your help is greatly appreciated!

I am sorry to hear about your issue.  It is difficult to say without seeing the MRI and examining you exactly how we would treat

Pain around heel and subtalar joint

Pain around heel and subtalar joint

it or what therapeutic interventions I may advise.  Accurate diagnosis is critical to effective treatment.  I can guess based on your anatomical description that what you are experiencing is the effects of a chronically shortened and tight Achilles insertion on your heel bone (calcaneus).  This can be called Achilles Tendonosis or Achilles Tendnopathy.  If that is the case I have the fix for you!

I can tell you that it is not uncommon for me to see things on MRI others did not….you have experience with this as two different doctors had differing opinions on your MRI!

We use various treatment strategies for people depending on what the underlying pathology is.  Some interventions we use are

Ultrasound combined with something called Gua Sha to eliminate scar tissue (if it exists) Ultrasound Therapy

Joint Manipulation/Mobilization if the muscles and joints are restricted.

Taping in the event the muscles and joints are hypermobile and need support or stabilization.  Tapingforsupport

Alter Gravity Treadmill rehab to strengthen bones, tendons, muscles and ligaments safely by allowing them to slowly accommodate to increased stress  AlterGravityTreadmill

PRP (Platelet Rich Plasma) injection to stimulate healing in tissue with little blood flow like tendons  PRPTherapy

Custom orthotics or modification of existing orthotics to improve their design CustomOrthotics

Do you live in San Diego?  If so follow the below instructions and we can help you.  If not and you prefer a phone consultation send me a picture of your MRI report.  Please let me know if you have any questions

COST If you are a cash paying patient … or have an Insurance Deductible still to meet … the cash fees are as follows:

New Patient Visit = $236 (Includes, Exam, Diagnosis, Treatment, and Dr.’s Recommendations. Plan to be here about 1 hour.)

If you need future Treatment or Rehab after your 1st appointment it will be $69 per visit for a 30 minute appointment, and can include ultrasound, electrical stimulation, muscle work/ART, Kinesio-taping, manipulation, manual therapy, inversion therapy, rehab therapy, home exercise instruction, sport-specific training plan, weight-loss plan.  (If you have insurance coverage, this is typically just a copay.)

There is a 3% credit card fee if you pay by credit card, debit card, or HSA card.  There is NO fee if you pay in cash. We do NOT take checks.  We do supply detailed Receipts for HSA & HRA Plans.

IF YOU HAVE INSURANCE:  And want us to check to see if you have coverage, do this asap. (Sometimes insurance takes a full day to get back to us.)

  1. Take a picture of the front and back of your insurance card and text/email it to our owner:  DrAllen@SDRi.net
  1. Include your FULL date of birth in that text/email.
  1. Lastly, give potential days and times that you can come in for your 1 hour New Patient visit (or Re-Exam.)

Dr. Allen will verify your insurance copay, email you back, and hold your appointment spot until you confirm if you want the appointment.

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