Yesterday I went to see the orthopedic surgeon. I was really hoping he would have some miracle insight as to why my pain has lasted so long and been so bad, but he just said sometimes plantar fasciitis is 'recalcitrant' and instead of responding to prescribed therapy, worsens. He took x-rays and could tell by how much 'weird calcification' he saw in various areas that this has been going on for a long time. He said a couple of things that I didn't expect.
First, he said I would probably need one of two options. First option is cortisone shots in both feet but with casting immediately after the shots... as in, no walking or weight bearing or even crutching AT ALL for 6 weeks. Option two is full surgery where he said he would go in and completely sever both fascia, which also involves no weight bearing for several weeks after. I am trying to get my mind around how either option would be feasible, since I have to go up a full flight of stairs to get into my house. I would only be allowed to use a wheelchair. My house is not wheelchair accessible. I have no idea how to make this work. Thinking that eventually I am going to have to move into a one level house anyway. Not sure that can happen immediately though.
Next, he told me that he thinks physical therapy is a waste of time. He told me to stop lower body strength training, such as calf raises etc that I have been doing. I was really shocked at this; it is the opposite of what all the PT's have said. But he said my muscles in my legs are entirely too tight and that I need to ONLY stretch them and not continue the other exercises. He said the muscles need to "relax." I asked him what to do over the next several months while I try to figure out the surgery/shot thing and he said:
1) Buy a ProStretch and use it 4 times a day, doing some different stretches for 60 seconds each, 5 repetitions. NO leg lifts, toe raises, etc. Just the stretches, which he demonstrated on the ProStretch for me.
2) Bike as much as I can on my recumbent exercise bike. He wants me to focus on biking as often as possible, for as long as I can without pain each time, and then stretching afterwards.
3) If I *want* to, I can continue going to PT just for ultrasound and walking in the pool, but no other exercises. But he sort of shrugged about this, like, "eh, do it if you want, it won't hurt anything, but it's a waste of time." Actually, I do want to continue, it is very freeing to be able to "take walks" without pain.
4) Start wearing the night splints again on both feet all night. I hate this... it keeps me awake and they clang together and wake me up if I do fall asleep... but I'll do it. I have done this before without success but hopefully as part of this whole regimen it will make a difference.
5) He wrote me a powerful NSAID prescription to take for 6 weeks. This one I am a little worried about. I told him I have high blood pressure and he seemed rather indifferent about it and said yes, NSAIDS can/do cause high blood pressure, possible heart attack, and stroke, but it is part of what I need to help my feet if I don't want surgery right now. I filled the script but am going to talk to my primary care doctor next week before taking it.
So, that's where I am right now. Trying to process the info, waiting for the ProStretch to come in the mail, following his directions and waiting for my regular doc to okay the new med.
6 hours ago