Question
QUESTION: I have had plantar fasciitis for 5 years.  I had the normal relapse but was able to stretch and ice on my own to take care of it.  This past April i had my prescribed orthotics in my tennis shoes and went shopping for the day.  I stood to long and felt pain on the lateral column of my left foot the padding where my pinky toe goes to my heal.  I ended it up at podiatrist office who gave me a cortisone shot.  that where things got bad.  The shot gave me a dead foot i did not have free range to walk... horrible so pain never went away and i was placed in a cam walking boot.  i wore this for two weeks only because my right foot started hurting.  I had MRI done last week and i have bone marrow osseous of the pinky toe 5th metatarsal and stress of the soft tissue on my right foot. :(  i was told i have to wear the walking boot on my right foot... i cant i am still in pain on my left foot.  I saw chiropractor yesterday who said this is not the normal PF pattern of pain.  She did acupuncture on both my feet to help with pain and blood flow.  I am at a loss and i don't know who can help me.   if you or anyone has any suggestions it would be greatly appreciated.

ANSWER: Hi Sherry,

I am sorry to hear about your problem.  Hard orthotics can some times increase plantar fasciitis symptoms if the correction is too drastic.  Soft orthotics may help reduce some of your acute pain.  Stretching is very important.  There are a few therapies to help control the pain and improve healing.  One is class 4 laser therapy.  This is different than "cold laser" therapy.  To be successful, I have found that treatment should be directed at your calf muscles as well as your feet.  The next therapy worth trying is shock wave therapy.  This is a type of acoustic percussive treatment for your calves and feet.  Finding a practitioner with the equipment may be challenging.  I would like to know exactly what the MRI report stated.  Was it bone marrow edema?  Localized pain or increased burning pain is a frequent side effect of steroid shots.  A dead foot sensation is very unusual and may require additional investigation.  Class 4 laser will help promote healing this is a definite benefit, although the pain relief may still be temporary, there are no side effects.  Chiropractic treatment for your spine and extremities is also a common sense approach because the basis of chiropractic care is to correct biomechanical abnormalities that cause joint/muscle/tendon/ligament injuries.  Let me know if you have any questions.

All the best,
Dr. True

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QUESTION: Findings on MRI - Nonspecific marrow edema is identified within the distal fifth metatarsal.  Given history I suspect this to represent a grade 3 osseous stss reaction/micro trabecular  fracture.  No macro fracture is noted.        I went to chiropractor last week who stated my gate is fine.  I ended up with two sessions of acupuncture.   I live in Phoenix Arizona and I am going to research therapies you suggested above.  I have been using heat and ice and now have incorporated a tens unit to increase blow flow.    I appreciate your time.  Thanks Sherry B

Answer
The MRI clearly demonstrates injury to metatarsal in the foot. This will heal but you have to avoid additional injury during healing. Wearing the boot helps promote a faster recovery. After the foot heals, stretch every morning and night with towel by pulling the fore foot and stretching the calf. Drink plenty of water, you live in a desert climate and take minerals such as magnesium malate 200mg.