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I have had heel pain for almost a year now, i got an xray

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I have had heel pain...
I have had heel pain for almost a year now , i got an xray but the doctor said nothing was unusual so he diagnosed me with plantar faciitis so i did physical therapy , custom orthodics and cortizone shot ... finally just this past month i went to get an MRI and the MRI results say that i have a "bone bruise" on my calcaneus and plantar faciitis ... now my doctor says to wear this camwalker boot for six weeks and the pain will magically go away , well i wore the boot for 3 weeks but it seemed like my pain is still there when i test and try my heel on hard floors .... i decided to continue physical therapy while also wearing this boot because i think that maybe my rising pain in the morning is caused by inflamation from my bone bruise ... im going on my 4th week now with this camwalker that i pump full of air before i stand up , i still dont feel different .. WHAT SHOULD I DO ??? - BRUCE
Submitted: 7 years ago.Category: Medical
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Answered in 13 minutes by:
3/2/2010
Doctor: Dr. Amir, Doctor replied 7 years ago
Dr. Amir
Dr. Amir, Doctor
Category: Medical
Satisfied Customers: 8,865
Experience: Master of Internal medicine & Gastroenterology with six years of experience (London). MBBS
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Thanks for your question. I would say that first of all that bone bruise can occur due to injury or compressive force on the bone. This can take some time long to heal in months. Your heel pain is mainly due to plantar fasciitis and for that you have tried most of the treatment modalities including steroid injections, physical therapy and foot wears. There are limited options remaining but worth trying can be beneficial for you in getting relief from this notorious pain. The one important option is extracorporeal shock-wave therapy in which a device is mainly used to deliver high-energy sound waves through your skin to the painful area and in your case it is plantar fascia. It can be very helpful for you. The other treatment which is not very common but still can be given is Such treatments include injection with botulinum toxin. The last option if the above don't work is surgery which is advised if the pain is persistent due to plantar fasciitis for more then 12 months.

Do ACCEPT the answer if you find it useful in this way I will be rewarded for my work and time here.

Best of luck and keep in touch
Regards
Dr. Amir Javed
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Customer reply replied 7 years ago

just today i went to physical therapy and they put this iced towel on my foot while putting electric shocks to my feet , is this the shock thereapy your speaking of ? ... and my original question is will this camwalker actually help me with my problem ?

Doctor: Dr. Amir, Doctor replied 7 years ago
its pretty the same but in that one which I am telling sound waves are used. The concept is the same in order to get relief from pain. I will now shed some light regarding cam walker which you are using. Ideally, it should give relief with in four weeks from pain in plantar fasciitis. But still I will advise you to use it for two weeks more. They are usually advised for 6 weeks in such kind of foot pain.

Do ACCEPT the answer if you find it useful in order to give respect to my time and work here for you

Best of luck and keep in touch
Regards
Dr. Amir Javed
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Customer reply replied 7 years ago
ok , final question...now should i ONLY leave it for my camwalker to take care of the job ? Should i continue to do physical therapy while im in my camwalker or is the physical therapy decreasing my healing time or making it better???
Doctor: Dr. Amir, Doctor replied 7 years ago
You should continue both camwalker and physical therapy as well. Because these are the mainstay of treatment for getting relief from plantar fasciitis. Healing in some cases is slow a process but persistent and continue medical and physical therapy should be taken in order to avoid surgery. Remember physical therapy is helpful and initiate in healing process. You should also discuss the other possibilities which I mentioned above with your doctor regarding treatment. The last resort is surgery if the pain don't get better or persistent.

Do ACCEPT the answer in order to give respect to my time and work here for you.

Best wishes and warm regards
Dr. Amir Javed
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Customer reply replied 7 years ago
im sorry maybe you misunderstood my question ... i understand that camwalker and physical therapy will make plantar faciitis better , but my goal is to make my calcaneus bone bruise heal faster so that the plantar faciitis goes away permanantly ... i have had this problem for a year now so forgive me for being so persistant with my questions here today
Doctor: Dr. Amir, Doctor replied 7 years ago
I already told that bone bruise can take long time to heal in months and in very some cases in years. I know about your goal and I didn't misunderstood your question. Both physical therapy and camwalker will help in healing bone bruise and plantar fasciitis as well. Because remember bone bruises are not fracture and these are superficial minor injuries to bone which heals slowly usually in months. Best wishes

Regards
Dr. Amir Javed
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Customer reply replied 7 years ago
Relist: Answer quality.
Doctor: Dr. Amir, Doctor replied 7 years ago
I am going to OPT out so another expert help you in this.
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Customer reply replied 7 years ago
Relist: Answer quality.
Doctor: DrRussMD, Board Certified Physician replied 7 years ago
DrRussMD
DrRussMD, Board Certified Physician
Category: Medical
Satisfied Customers: 65,548
Experience: Internal Medicine--practice all of internal medicine, all ages, family, health, prevention, complementary medicine, etc.
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Hello from dt

I am not sure if you are still working with another expert or not; it looks like an opt out and a relist.

If so...

Can you copy the exact wording of the MRI summary for me and I will try and help

dt

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Customer reply replied 7 years ago
THERE IS MILD THICKENING OF THE ORIGIN OF THE PLANTAR FASCIA ON THE CALCANEUS WITH SMALL AMOUNT OF ADJACENT BONE MARROW EDEMA AND ENTHESOPHYTE. ... = CONCLUSION : PLANTAR FACIITIS ..
Doctor: Cosmetic Doctor, Doctor replied 7 years ago
Cosmetic Doctor
Category: Medical
Satisfied Customers: 678
Experience: Has been serving the Beverly Hills community for over 10 years.
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Hello,

I will try to answer any more specific questions you may have.

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Customer reply replied 7 years ago
you didnt answer anything .
Customer reply replied 7 years ago
Relist: Incomplete answer.
Doctor: DrRussMD, Board Certified Physician replied 7 years ago
The enthesophyte mentioned is a bone spur. This means that you have more than a contusion; there is actually a projection of bone that is pressing into the soft structure of the heel.
What they are attempting to do with the boot is to take all there pressure off of the affected area to allow the inflamed tissues to heel.
At this point, I would suggest a specialist. Podiatrists, good ones that is. are trained in all aspects of the feet, including specialized surgical procedures, many which generalists do not do.
This is a very specific problem. Podiatrists are also, if they focused on this, specialized in the extensive use of orthotics to relieve problems, making them for both feet and addressing a number of factors to relieve stress.
I would continue the boot, but realizing exactly what the mechanical problem is, and get the specialist opinion. We have had good success in our medical centers using this specialty.
dt
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Customer reply replied 7 years ago

arent you a podiatrist ? I have two doctors claiming i have a bone bruise , ... if i have a bone spur , doesnt it have to be sugically removed ? whats the point of me wearing this cam walker boot and going to physical therapy ?

Doctor: DrRussMD, Board Certified Physician replied 7 years ago
My understanding is that if all pressure is relieved on the spur, things can sometimes get better.
Podiatrists are not MDs. They go to a college of podiatry. We just started welcoming them into our system about 10 to 15 years ago, when we noticed that some had extensive and unique surgical training.
Some will be able, also, to help you with the release of pressure concept in its application in a more sophisticated way than what you have been doing, from what I have seen.
Good Luck
dt
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Customer reply replied 7 years ago
i dont mean to challenger your expertise , but id like a few more opinions before i choose to ACCEPT ANSWER , preferably from specialized podiatrists since your telling me that thats their specialty ... ive been trying to treat this for almost a year
Customer reply replied 7 years ago
Relist: Incomplete answer.
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