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Dr. Andrew Rynne

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Suggest treatment to relieve severe sharp pain in the sole while walking in a patient with planter fascia

Answered by
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Dr. Kaushal Bhavsar

Pulmonologist

Practicing since :2008

Answered : 14129 Questions

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Posted on Fri, 31 Aug 2018 in Asthma and Allergy
Question: Hi, I am a 75 year old white male of German ancestry grew up on a farm in Northern Iowa 2 ¼ miles south of a small town called “BUFFALO CENTER”. I had 4 siblings a sister was 3 years older than me and died at the age of 70 of metastatic colon cancer (she also had Stein-Leventhal types of overies). Otherwise she just had seasonal allergies like I have.
My two younger brothers have been treated for lymphoma and leukemia but both are now in remission.
My youngest sibling sister has had heart problems and hypertension. As I recall it was a rhythm problem atrial fib.
My foot problem. Bilateral plantar fibromatosis from 2014 summer to present. Right sole developed a 2 cm in diameter necrosis in the middle of the sole after injection of solumedrol. That has healed and does not seem to be a problem now. The toes are very sensitive at the tips and then more proximal are areas that are numb so from spot to spot the sensation can be heightened and then immediately adjacent there is numbness. This is what I would expect to have if plantar fasciitis is due to trapped tiny nerves that are sheared when the arch flattens and pulls on all of these tiny nerves. Another problem is that the joints seem to be more inflamed than you would expect from x-rays and ultrasounds – which say my feet are perfect but maybe for the bunions. However on the right toe which is the most bent at the lateral joint lips and at that site on the skin is an area of red inflammation indicating a reaction to the debris from inside of the joint. I suspect that my body is allergic to this material and maybe the reason I have such a high dsDNA antibody level. I think there is a test for this but I have not tracked it down.
At the age of 10 I developed a fibroma on the sole of the foot about in the middle. Unfortunately I can not remember which foot was the one with the fibroma so it could have been the right foot since that is my worse foot now. About 4 years ago I weighed 185-190 and decided that spring to use ECCO sandals so I did but after about a month I noted that the soles of my feet began to burn more and more. At night it would go away but after walking the burning pain would come back. After 3 days the burning escalated into really severe dull to sharp pain in the deeper tissues of the soles so the initial pain was 1-2 but by day 6-8 etc. it increased to a chronic 6 and an intermittent sharp stabbing 9 pain – on a 10 point scale).
To add some pertinent info on my connective tissue. My mother had some of these same problems but was never correctly diagnosed because of the times in which she lived. I had eczema from birth to about 2 years of age. I would not doubt that it was a milk allergy since we lived on the farm and had plenty of fresh milk to give to a hungry baby. As a little experiment I tried to go back on milk a few days ago and I do think I am worse.
However I went for 6 weeks on nothing but broccoli sprouts and blueberries and lost 25 lbs and but my symptoms did not disappear.
I also had cheilosis –angular cheilitis whenever my allergies were bad. If I had been understress I would get this more and especially in the winter in Iowa I of all the people there was the only one that had such severe cracking of my fissures at the angles of my mouth that I would bleed from these sites- especially in the morning when I would awake. This would return if I were to fly out to Iowa and stay there for no more than one day.
I had an appendectomy after eating lots of Iowa potatoes and another time had a tonsillectory and adenoids removed- both under ether anesthesia at the age of 5.
I had the usual vaccinations for babies of the time and remember my last trip into the hospital must have been at 18 months since I remember my fear of the upcoming needle stick was so great I jumped out of my mother’s arms –up over her right shoulder, down her full length rabbit fur coat to the ground and was one block up the side walk running full tilt when caught.
Child hood was hard – hard work, tough living for me- very sensitive to cold as compared to everyone else.
Always more frail, thin bones from 18 to about 50 weighed 150 and was 6ft tall. My diet as a child was really terrible and I made the worst choices since I was younger than 2. I loved sugar from the get go and was rather addicted to having it but the main culprit was my breakfast of Wheaties and 2 tablespoons of sugar and milk. By the time I was 13 I started to have very sever allergies with runny nose and nonstop sneezing. As I recall though I did have enough allergies to go through allergy desensitization treatments twice like at age 7-8 and another at age 10. In my teen years the allergies made my life miserable and then when I was 18 I went to college and got away from the farm and my nasal problems improved but I had foggy brain syndrome and would fall asleep after lunch to the point I could not stay awake while the prof was lecturing. It took me a while to determine it was post prandial hypoglycemia due to eating a banana for breakfast.
I also am very acidic and have suffered from acid indigestion and gastritis and duodenitis since I was 18 and went to college and started to drink coffee. I gradually became so sensitive to coffee, sodas, carbonated drinks that I have stopped taking any of these for maybe 20 years now. I think my acid condition is why my arteries are free of much calcium etc. This is an interesting thought and I don’t know that anyone has ever looked for this relationship but it makes sense to me.
Today I am back up to 10 mg prednisone in the AM and so far so good. Have a big day tomorrow when I am introducing the world into my office to help me kick off a new “lonely hearts club” which I am calling the “YOUNGERING CLUB”. A few days ago I heard that about 60% of Americans no longer are going to church. Most of these people would like to have the benefits of belonging to a friendly helpful group like a church but it is hard to reconcile a belief in God with the realities of modern life. So we all need help and so I am trying to invent the world’s most perfect self-help you-help, we all help each other type of group to get and stay young and healthy and if you are getting older than help you become a younger you biologically. We will be have a kickoff lecture from a 70 year old lady who has perfected her lifestyle to be about as perfect as you can make it for optimizing your health on a daily basis. If you have any thoughts on how to make this group more friendly and helpful to each other in our mutual goals of becoming healthier and biologically younger. My cell is 949-573-1853. My website is www.stemcellmd.org. I wrote the first book on the use of Umbilical cord stem cells in 2006 with Dr XXXXXXX Payne and have treated over 7000 patients with stem cells.
As to treatments I have have ultrasound, shock-wave therapy (I have this in my office), vibration to the foot, steroids, methylcobalamin, testosterone, topical soaks of a variety of medicaments, stretching exercises, splints, have great shoes (Kubun) and arch supports “Align”. Have good days and bad. If I really push the feet I get lots of pain both chronic and severe sharp pains which can last 4 days and then as long as I stay off of the feet I am ok.
Do you know of a safe method of numbing the nerves? The pain is the major problem. The plantar fascia appears to be swollen at times especially in the AM. I am not having the lupus symptoms much now so hopefully I can continue to decrease the steroid dosages.
Any other suggestions?
Thanks for your time.
Do you know if I bring a lot of people to your group for consultations can we work out a special deal for all of my members? Thank you! XXXXXXX Steenblock, DO

doctor
Answered by Dr. Kaushal Bhavsar 6 hours later
Brief Answer:
First rule out diabetes and dyslipidemia.

Detailed Answer:
Hi,
Thanks for your question.
I can understand your concern.
I appreciate your work and thoughts.
I would definitely love to associate with your group.
For your question, in my opinion we should first check for diabetes and dyslipidemia.
So get done HbA1C and lipid profile.
Another important test is arterial and venous doppler study to rule out vascular causes for your symptoms.
I want to know if you are smoker or not.
I will be happy to help you further. Wish you good health. And all the best for your new venture.
Thanks.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Kaushal Bhavsar 14 hours later
No diabetes, no problems with blood flow, circulation is good, hair on toes is normal, pulses normal, blood vessel dilators like trental or Cialis no effect. Like I said this is due to trapped small fiber nerves as they pass through the plantar fascia. Need nerve regeneration electrical stimulation parameters, methods to dissolve fibrous tissue, and to stop the entrapment pain. Thanks
doctor
Answered by Dr. Kaushal Bhavsar 24 hours later
Brief Answer:
There is no such 100% effective method.

Detailed Answer:
Thanks for your follow up question.
I can understand your concern.
Sorry to say but there is no such 100 % effective method.
You can try Pregabalin or Gabapentin.
These are painkillers specifically used for nerve related pain.
Hope I have solved your query. Let me know if I can assist you further.

Wish you good health.
Thanks.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Kaushal Bhavsar 9 hours later
Where did you get the idea I was asking for a 100% effective answer? I tried gabapentin and no help but made me a little more dull minded. What painkillers are used for neuropathic pain? No you did not answer my questions well.
doctor
Answered by Dr. Kaushal Bhavsar 22 hours later
Brief Answer:
You can try these drugs for nerve regeneration.

Detailed Answer:
Hi,

I can understand your concern.
For nerve regeneration, Pirocetam, Riboxone and Xymedon are available.
You can try any of these drugs after consulting your doctor.
For neuropathic pain, Pregabalin, Gabapentin and Amitryptilline are effective.
There is no drug for dissolution of planter fascia.
And you can also try physiotherapy to improve nerve functions.
Hope I have solved your query. Wish you good health.

Take care
Dr. Kaushal Bhavsar
Above answer was peer-reviewed by : Dr. Kampana
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