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The response to the question below was authored by Marc Mitnick DPM

plantarfasciitis

by J.J.
(Victoria B.C.)

I developed foot pain 1 1/2 years ago. Went to a podiatrist, had custom orthotics made and was told to rest my feet for 2 months, which I did. No relief. Began physical therapy with stretching, exercises, ice, ect. I was told by physical therapist that I may have a ruptured flexor hallucis brevis, but ultrasound was inconclusive. Physical therapist also did ultrasound treatments - no relief. Was seen by a sports medicine dr who did not think it was classic plantar fasciitis -but more of a tendonosis? Recommended cortisone injections, which I refused. I got 2nd opinon on orthodics - had new custom orthodics made. This specialist also felt it was not typical plantar fasciitis - main problem seems to be that the main tendon or fascia that runs from big toe back to heel actually protrudes quite a bit - especially on my left foot, which the pain has always been worse in. As I take a step, this tendon/fascia sticks out and gets irritated with each step, causing inflammation. When I massage the area, it really feels like a big string- very tight and sticks out. I do have pain in my heels when I am standing, but they are not sore to the touch or if palpated. The area that is really sore to touch or manipulation is in front of heal - about in the middle of foot along that fascia. I am told to treat this as plantar fasciitis, even though many symptoms are not really typical for it. I do not have the classic morning pain - never have. My pain worsens the longer I am on my feet. I also have been using a night splint on the

worst foot. I am a 42 year old female. I believe the problem began due to poor fitting shoes and extensive walking on pavement. I am perhaps slightly overweight as well - maybe 20 lbs. Is 1 1/2 years a bit long to be dealing with this? My life has been greatly affected by it. I cannot work, and can barely keep up my house. The pain is very significant. Does this sound like plantar fasciitis? Is there a way to make that fascia relax or soften so it isn't like a guitar string??? What should my next step be? Thank you kindly for any advice.

Hi J.J.
If that "tight guitar string" is the source of your pain, then you have plantar fasciitis. that is the only structure that will protrude like you describe.
I am wondering what kind of orthotics do you have. If they are of the hard plastic variety they will probably worsen the situation rather than remedy it. A softer orthotic might be helpful.
The fact that the heel hurts after you have been on it, rather than first thing in the morning is highly suggestive of a heel bursitis or heel neuroma. (see my section on heel pain).
Since no one seems to be able to come up with a definitive answer, I would consider having an MRI done as I find ultrasounds have limitations in what they can tell you.
If ultimately it comes down to the fact that you have a very tight plantar fascial ligament and if you have enough pain, you might have to consider having a fasciotomy, where the ligament is actually cut at the level of the heel.
Good luck.
Marc Mitnick DPM

Comments for plantarfasciitis

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Apr 28, 2011
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Pain on the sides of my third and fourth toes on left foot..
by: Jessica (In Buffalo, NY

I'm a high school senior who plays and lot of sports and spend a lot of time on my feet. A few days ago it was raining after softball practice and my sneakers got wet. I only had them on for maybe about 3 hours. The very next day my feet kind of felt swollen but since i spend a lot of time on my feet I didnt think much about it. The day after that my feet felt fine except the sides of my third and fourth toes on my left foot felt swollen. They hurt when I walk and put pressure on them. They also hurt when I curl my toes but feel fine when i touch them. I don't know what to do. Its very uncomfortable and kind of makes walking a little hard.

Apr 02, 2011
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What a GREAT site
by: Bre

I have been experiencing foot pain of various sorts and am working to figure out what it is. I found this site and can only say BRAVO!! What an excellent site! The time it must have taken to put all this together must've been a daunting task! I am sure it has helped so many people. Thank you so very much for doing this.

Dec 05, 2008
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Foot pain due to Chicken gunya
by: VY

I was suffering from chicken gunya one month back. My doctor said it will stay for one week. But still my joint pain mainly in foot and leg is more. can you please suggest

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ADDITIONAL REFERENCES

Mayo Clinic

Johns Hopkins Medicine

MedlinePlus

Arthritis Foundation

University of Rochester Medical Center

Harvard Health

Drugs.com

American Academy of Pediatrics

Penn State Medical Center

National Institutes of Health

Columbia University Department of Rehabilitation

ScienceDirect

Stanford Health Care

Illinois Bone and Joint Institute

Mount Sinai Hospital

Institute for Chronic Pain

University of Florida Health

American Family Physician

Cedars-Sinai

University of Maryland Medical Center

MY PRODUCT RECOMMENDATIONS(items I prescribe in the office)

Orthotics for multiple types of foot pain best buy in a pre-made orthotic click link below

Orthotics for heel and arch pain for those who must wear dress shoes click link below

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Hunterville, NC

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NY

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NJ

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Fla

A well organized site containing much information written in a manner that the average reader can comprehend.

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Ontario, Canada

I found your website and articles most interesting.

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Fla.

Thank you for a quick response. I think your site is the best information site on foot pain and I have viewed many.

Judy

(location unknown)

I came to your website, footspecialist.net via www.foot-pain explained .com which I think is also your website? I thought explanations for different types of problems were well addressed and thoughtfully stated for the patient in mind.

L.W.

New York

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Yvette

Memphis, TN

Thanks again so much for the information in the article. Very interesting.

Anna

Scotland

Great article. I have had plantar fasciitis since I was in high school……..

J. Simmons

(location unknown)

Dear Dr. Mitnick, The orthotics arrived four days ago and I slipped them into my shoes immediately. I was skeptical as to the usefulness of the item, they really didn't look very exotic. I have to say though, after using them for just four days, I have experienced grand relief from my foot pain. Even the very first day, I was able to do a lot of work while on my feet with at least a 75% reduction of pain. It has only gotten better every day, and I go nowhere without my shoes with the orthotics. I had been experiencing extreme heel and sole pain for about six months and had to take extended breaks off my feet many times a day as well as regular doses of Ibuprofen. Since getting the orthotics, my life has returned to normal and I feel good again. Just wanted to say thanks for the recommendation for a very effective item, I had no idea what a change this item could affect.

Yours truly,

J.C. Forbes

Tennessee

Thanks for the Response, you hit it on the head.

Steve

Redondo Beach, CA

Thank you for your time and expertise in answering my question…..

LH

(location unknown)

First, thanks for putting together this website. Its the most informative site I have found dealing with foot problems. Last June I started having pain and swelling at …….

Joe

(location unknown)

First of all, thank you for having all this useful information available in one place. I've been through most of your website and based on my research, pain and evaluations I think I've narrowed things down quite a bit.

Pete M.

(location unknown)

Thank you for the best site I have found when researching foot pain.

Glenda B.

Madison, Alabama

Thanks for replying so quickly. I was a bit concerned. I think your website is great, and chock full of info.....

Carol

Denison, TX

Dr. Marc, Thank you so much for your reply which seemed to be right on. I have researched many sites but you put me on the right path to the possible answer. My foot pain may not rule the rest of my life after all! I believe I'll make a sign that reads, "THE END IS NEAR!" Thanks Very Much,

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West lafayette, IN

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Tampa, Florida 33624

Hi. This is a great site! I'm a healthy middle aged woman who is in good health, but.....

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Texas

Just a wee word of thanks for your wonderful website...It is a terrific service...Thank you for providing your knowledge and help...With highest regards, m ebeling

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Tampa, Florida 33624

Thanks for a most interesting website, which has helped a lot.

Steve

Dear Dr.Mitnick

I usually do my research on the Mayo clinic website. I think your website is the most informative site I have found when researching foot pain.

I thank you for putting together this incredible website.

Regards,

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Edmonton,Canada

....I have been told that it is not hard enough to be cut off. Please help, I am not sure what to do now! THANKS FOR A WONDERFUL AND VERY HELPFUL SITE!

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South Africa

You have an unusually clear, informative and well-written website for laypersons. Thank you for that.

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Mansfield Ctr, CT

First, I'd like to thank you for all the information that you provide on your website and the opportunity to write to you.

Steve

Placentia, California

First, I want to let you know that you have the best web site I've found related to foot issues. (The only thing I had difficulty finding was the "ask a question" page.)

Unknown

Unknown location

I received the orthotics Monday afternoon and began wearing them Tuesday. After two days I would say that I have noticed a huge improvement in the discomfort I have been experiencing. My foot feels better than it has in months.

Ric J.

Unknown location

I greatly admire someone like you who would donate and dedicate so much time and effort to helping strangers with no compensation. Truly, it is uncommonly kind. And your site is so intelligently arranged.

Ron R.

Pacific Grove, CA

I used to work for a podiatrist (front desk) back during summers in college years ago, so I know the benefits of good care. Again, I want to thank you for an EXCELLENT website. It was so great to get to your site (top of google search) and actually find all the answers I needed EASILY and QUICKLY! Clearly you put a ton of work into it and I really appreciate it.

All the best,

Victoria

Alameda, California

By the way, millions of websites could use yours as a guideline on how to organize information and make the site user-friendly. Kudos to you!

Anonymous

Thank you for your very interesting and informative site!

Anonymous

Hi. I come to your site often looking for information. It is really informative and I appreciate it very much. I have RA and have been having considerable amount of foot pain...... Dee RN

Thanks very much for the wonderful informative site.

Catherine

New Zealand

Thank You for my answer! I have been schedule for a bone density scan, allingment, and I am in the process of getting orthotics made, and checking out the natural remedies. Thank again! What a great web site!

Sincerely

Josette

Yes I want both pair of orthotics. You don't have an option of ordering 2 at one time so I had to place the order twice. Thanks. My husband likes these and wants to put them in all of his shoes. (referring to Superstep orthotics)

Cindy H.

Arizona

I searched the internet everywhere for a clear description and illustration of my symptoms/problem. https://www.foot-pain-explained.com/ was where I ended my search with answers. If I lived in Jersey (left 30 years ago) and didn't live in Florida I would definetly make an appointment with Dr. Mitnick.

Thanks, Kathy

Florida

1st of all THANKS A LOT for your great site......

Anna

Poland

Thank you so much for your response. I will let you know how I am doing if you would like. Your website is awesome!

M P

South Carolina

Hello! I want to thank you for such an informative website! I found you based on my ankle pain search and am happy to realize that there may be a relatively simple cause and solution....

Natalie

unknown location

...Thanks for your fantastic service.

Gary

Arlington, VA

Thank you so very much, that would be much appreciated. I love those insoles, by the way. (referring to Superstep orthotics)

Kelly W.

San Clemente, CA

Dr Marc is fantastic...He seems to know exactly what you are feeling with the problems you are having. I wish he was in my home town so I could go to him with my problems!!!!!!!!!!!!!

Pam

location unknown

Great insights! Thanks Doc, you're the best.

Glen

location unknown

I have been experiencing foot pain of various sorts and am working to figure out what it is. I found this site and can only say BRAVO!! What an excellent site! The time it must have taken to put all this together must've been a daunting task! I am sure it has helped so many people. Thank you so very much for doing this.

Bre

location unknown

Dr. Mitnick, Thank you so much for your reply. I did let my physician know and they took an x-ray - all is well! Also, thank you for providing this wonderful site, it is very helpful with lots of useful information! I appreciate your gift of time! God bless.

anonymous

Dr. Mitnick, Thank you, you were 100% correct. The pain finally brought me to the ER. I spent 8 days in the hospital. The Doppler you spoke of was able to show that there was no pulse in that foot. This was an arterial clot that split and traveled throughout my leg. My leg was almost amputated. I am in rough shape but have all my parts intact!! You certainly know what you are talking about. Thank you for taking the time to answer. Yours Truly!

anonymous

Staying at home after hallux surgery I spend quite a lot of time seaching info useful for avoiding problems which might come back. Today I found your site and I am .... delighted it happened. It's one of the best site I found last days.

Anna

Poland

Thanks for taking time to read and answer so many questions. It is truly a public service!

Esh

Seattle, WA

I just wanted to say that I am very greatful for this website!!

Bonnie

location unknown

Also, and importantly, just want to praise this web site. Thorough and thoughtfully presented, it certainly must be of considerable assistance to anyone with a foot problem. Terrific -- and very interesting.I trust the address comes up easily for those seeking information.

Bill

New Jersey

Thanks so much for answering my question. You've been more help to me than my own Dr. has been lately. Thanks again....I hope to be able to walk without pain someday.

Debbie

location unknown

Wow, that is exactly the information needed!!! thank you thank you thank you!!! I appreciate this help so very much from Marc Mitnick DPM. Excellent information and help to improve One's life.

Chrissy

location unknown

Thanks so much for this website Dr. Marc! It is so nice that you have this ask the doctor feature..I'm sure I'ts been helpful for alot of people. I will try what you suggested and see if it helps...thanks again!

Tracy

Evansville, IA

Dear Marc

I just want to say thank you for the quick response and the good info. I find it amazing and a super nice thing that you do here by answering medical questions at no charge.

Russ W.

location unknown

Your website is full of a lot of helpful information, and I am very impressed with the time in which you responded to my post. Thank you again for your time and consideration in your response.

-Sunny.

location unknown

Thank you very much for the information, I will consider it. Excellent web site.

Jackie

San Diego, CA

Dr. Mitnick, Just want to say thank you so very much for your quick response and very informative reply! After reading what you had to say, I called the doctor's office and was able to get in and see him the same day as my injury. Toe was x-rayed and luckily, it is not broken or fractured. Very badly bruised and will probably lose the toe nail. And although my toe and toe nail are still very black and blue and very sore, they ARE both starting to feel a little better. So again, thank you! I am so very happy that I came across your website. The service you provide is outstanding and immeasurable!

Rivi,

Albany, NY

Thank you so much for all of your advice. In searching the web for people dealing with this same issue i can tell you that you are a Knight In shining Armor! If I lived in Jersey I would gladly be your Spokesperson. Hopefully next time you hear from me it will be good news. God Bless,

Jill S.

location unknown

THANK YOU SO VERY MUCH FOR YOUR TIME AND EFFORTS, YOU ARE SO VERY APPRECIATED. THANK YOU FOR ALL YOU DO.

Jackie

Whichita, KS

thanks again, this site is very helpful.

mark

Boston, MA

Like others have stated...This site is amazing and I am so thankful that it was created.

....Keep up what your doing. Your a life saver.

Michelle

Colorado

Thanks again for the information provided on your site. It's easy for non-medical folk to understand your writing, and helps provide better communication between patient and doctor.

annielou

Colorado

Wonderful advice

by: Anonymous

This is the best site for foot problem info.

Thank you for this information. This description fits my pain and inflammation behind my 2nd toe perfectly.

by: Max

location unknown

Again, I really appreciate that you responded to my inquiry, and that your mention of Parkinson's helped me to find my way to a diagnosis of this difficult to diagnose disease. Most patients see on average 16 doctors before they are diagnosed. I hope that you can help other people that ask for your expertise in the future.

Barb D.

Canada

I just wanted to say that I am very greatful for this website!! I have had a fusion in my rt foot and am finally getting a little bit better......

Bonnie

location unknown

Again, Thank you from the bottom of my heart for taking the time to answer my question....your an angel!

Nancie

Wisconsin

Thank you for your response. You have provided some great insight (to my question)....

Julie

location unknown

Thank-you so very much for responding so quickly and in such detail to my question!! I will give my surgeon a call today!! This website is terrific!!!! Thank-you again!

Renae

North Carolina

Many Thanks Dr Marc!
Thank you for your response. It sounds like a good plan to me. He did not cut the wart out first ...

KG

location unknown

Thanks again doc for having this website and we STILL need qualified Podiatrists in beautiful sunny Tampa Bay (Bradenton) Florida.

Bessie Mae

Florida

Dear Dr. Mitnick, Thank you so very much for taking your time to answer my question. You have greatly relieved my anxiety related to the continual tingly I feel in my feet. I will share your response with my podiatrist next week. God bless you for having this question and answer page on your website! Most gratefully,

Lynne T.

location unknown

Your webpage is excellent, I commend you on sharing your knowledge to the public.

Robert

New Jersey

Thank you. you were more detailed than what others have told me they finally called from the last xrays and my son is now in a cast for 2 weeks he did have a fracture that was not noticeable.

a mom

location unknown

I have read your website and I have to admit that I am amazed at all the information that is on here. I have learned more than the three years I have been going to several doctors that I have seen!!

Melody

Lenoir, NC

Thank you so much Doc for a quick and thorough response!

Rustam

Bellevue, WA

I cannot thank you enough for your response, opinion, and suggestions! I want you to know how much it means to me, and I'm sure everyone else who has ever asked you a question! I feel like you're a lifesaver and have empowered me to take a stronger role and stand up for myself and my feet!

Jodi

location unknown

plantarfasciitis

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