In highly exciting news, I have recently had occasion to visit a podiatrist for the first time.
Relatedly, I want to talk about my foot. The thought of doing so bores me almost to tears, so I feel deep empathy for YOU, whose foot it is not. The thing is, it has been causing me enormous grief for months now and I better just talk about it and get it over with.
Sometime in December of 2021, I started having heel pain when I woke up. It would be worst when I first got out of bed, then would gradually subside throughout the day. My runner friend told me it sounded like plantar fasciitis, which is a term with vowels that look incorrect even when I know they’re in the right places. I looked up plantar fasciitis and found some stretching exercises to do; I did them; they seemed to work.
But then after maybe a week or so, the exercises stopped being effective. And the pain got worse and worse, so that any time I sat down (and as a person who writes for most of the day, I sit a LOT) and then tried to stand, I would hobble around with serious pain. It started waking me up in the night. It started affecting my ability to drive (I would get sharp shooting pains in my arch when I pushed on the gas or the brake). It made it difficult/painful for me to do my preferred type of exercise (walking).
I went to a podiatrist, who seems very knowledgeable and who came highly recommended. But it seemed to me that the podiatrist relies a little too heavily on ME and not heavily enough on measurable facts. I suppose that’s how most of medicine is, isn’t it. If I say I have sinus pain and I’m miserable, and the doctor presses on my forehead and under my cheekbones and asks if it hurts, she has to take my word for it that it does. A gastroenterologist has to rely on your report of stomach/intestinal pain. But I hate that. I do. I want to be able to go to a doctor and say, “I am in pain” and for them to be able to VERIFY that, scientifically. I want them to have calipers that measure the pain so they can nod and say, “Yes, I see, this is clearly a Level 5 pain.” rather than making me the sole reporter of painfulness. For one thing, I feel like I have a low threshold for pain, so that what might be excruciating for me would be just a little twinge for you. And I don’t want to overreact to pain, or come across in any way like I am overexaggerating. I want it to be quantifiable. It’s NOT, but oh well.
The podiatrist did press on my foot to see if I reacted, which I did. And he used an ultrasound machine to check… something. I’m not sure, but he did measure something and record those measurements. (He also took an X-ray, to ensure I didn’t have any fractures or cancer.) (Brief digression: I have been having pain in both feet, but one is much more severe than the other. When I checked in, I explained this. The receptionist said she would send me for an X-ray right away, and did I want X-rays of both feet or one? Um. I don’t know? I feel like that is not the kind of decision I, the non-doctor, am qualified to make? I did say that I would do whatever the doctor recommended, and the receptionist said, “It’s really up to you.” So I told her we could focus on just the one because the pain in the other foot is – currently – livable. But then the whole time I was getting my foot X-rayed I was feeling panicky that I had made the wrong choice, and what if I needed to come BACK in a few months and do it all again, and pay extra to get the other foot X-rayed when I could have gotten it all done at once? I had to use some coping thoughts like, “less radiation NOW is better, when I may not ever need a X-ray for the other foot.” And, “I made the best choice I could in the moment, and there is nothing I can do now.” And, “maybe it would end up costing the same anyway; I don’t know if they charge per foot or per visit, so who knows.” And, “I am fortunate to have health insurance and a health savings account, and this is what those things are for.” I had a good hearty wait before the X-ray technician was ready for me, so I got a chance to repeat these coping thoughts several times. (And panickedly wonder whether I could ask the X-ray tech to do both feet, or ask if I could call up to the doctor and alter the order.) It turned out okay, and if I need another X-ray of the other foot at some time in the future, so be it. But I really wish that the DOCTOR would have said, “Well, I really think that we should focus on the one foot that’s causing you the most trouble.” Or “Well, this thing can develop quickly so if you are having even a little trouble, let’s treat the other foot too.”)
This is a very complainy post about my podiatrist, when really he seemed very nice. I guess I just get very anxious about doctors’ visits. I don’t want to waste the doctor’s time, I don’t want to overestimate the problem, or make A Big Deal when it’s not a big deal, I don’t want to spend a lot of health savings account money when I could really just be at home icing my foot, you know?
Anyway. After the podiatrist evaluated my foot, he gave me a little mini lecture about what plantar fasciitis is, using a plaster foot as a visual aid, and I thought it was very useful and interesting and then promptly forgot everything he told me. He then gave me a splint to wear on my foot while sleeping (“gave” – it cost $75; it is possible I could have bought one myself elsewhere for much cheaper, but I did not) and a prescription for a steroid/anti-inflammatory drug, and scheduled an appointment for me to come back in just over a week.
The first day of the steroid, I had excruciating bone pain in ALL my bones. That was deeply unpleasant. But on days two and three, the bone pain had subsided and I had almost NO PAIN in my afflicted foot. It was MIRACULOUS. Then, as I “stepped down” the dosage of the steroid over the next week, the pain returned. It was dispiriting, to say the least.
Not to mention that the splint for my foot is not… super. It wraps around the ball of my foot and then has a stiff arm that goes up the outside of my shin, and tightens around my calf. Kind of like a shin guard, only a bit more flexible. It keeps my foot in a slightly flexed position, which is not uncomfortable. The edges of the Velcro closure scratch my toes though, and I find it very difficult to sleep with the thing on my leg. Plus, I absolutely cannot walk on it, so I have to remove the whole splint every time I get up to go to the bathroom which is at least twice per night. (Each time, I try to undo the Velcro as quickly as possible, so that I don’t wake my husband. I feel like the sound of Velcro reluctantly parting from itself would be a highly unpleasant way to wake up in the middle of the night.)
When I went back to the podiatrist, the medical assistant asked me how things had gone, and I told her: my foot was definitely better than it was before, but it was not great. She said, “What percentage has your pain been reduced?”
What? Ugh. While I was just whining a few paragraphs ago about wanting quantitative measurements of medical issues, I do not want to be the one who provides them. I am at a loss for how to evaluate things like this. If you ask me to rate my pain on a scale of 1 to 10, I usually have NO IDEA how to do that. Like, I have in my head the worst pain I have ever experienced, so I assign that a 10. But then… it’s very difficult to know where other things fall. Primarily because pain is so immediate, and because the perception of pain fades with time. Right now, it HURTS, and it’s bearable or not.
Anyway, I told her that maybe the pain was 20% better – which was a wild guess on my part – and she said, Wow, okay, that’s not good. If you had said it was a 70% improvement, maybe we could give you another round of the steroid, but the next step is usually an injection.
Now, I had heard about the injection before I ever made my first appointment with the podiatrist. The person who recommended him had had an injection for my exact problem, and it seemed like that was the treatment, so the steroid/splint treatment I received was a surprise to me. I’d been prepared from the get go for an injection, and the podiatrist had mentioned at my first appointment that if the steroid/splint didn’t work, I would probably need an injection. So I was anticipating an injection.
The medical assistant left and when the doctor came in, he said, “I hear you were begging for the injection.” Which made my eyes go all wide until I realized he was joking. THEN he told me that a lot of people say the injection is the worst pain they have ever had; that women who have delivered multiple children say it’s much worse than childbirth. (Not the most reassuring way to begin the injection discussion, Doc!) But, he went on, he has never had any patient say that to HIM. HIS injections are painless, and he uses a specific method that makes them so.
So now I had two things to hold in my head: 1. That some people find this injection to be excruciating and 2. That I could not in any way tell this guy if it WAS, because he would not believe me.
He put up a little curtain, separating my eyes from from my foot, which is a weird way to phrase that but I am leaving it, and sprayed my foot with what he called a “cold spray.” THAT was pretty uncomfortable, but bearable. And then he started the injection, which took several minutes and was also fairly uncomfortable but bearable. I had to do some deep breathing, and had to clutch my arms across my chest quite tightly to get through it, and there was some tear-prickling at my eyes, but no actual tears. (At one point, he asked if I was doing Lamaze breathing back there, which made me feel quite embarrassed. He went on to say if I left with a baby, we’d each have a lot of explaining to do, har har har, and as I mulled THAT ONE over for awhile, while trying not to breathe so audibly, I came to the conclusion that I probably wasn’t breathing THAT hard, and that instead the Lamaze thing was probably a bit he does for lots of his patients.) (I feel as though, in describing this to you, I am describing this doctor quite unfavorably. I definitely do NOT jive with his sense of humor, although I can see how many patients would find him hilarious and delightful. But I did feel that he was a good listener, and that he cared that I was in pain, and that he wasn’t judging my particular level of pain tolerance, and that he was determined to resolve the problem. AND that he was an experienced and knowledgeable practitioner.)
Anyway. The injection was FAR from the most painful thing I’ve endured. Dental procedures are much, much worse. But afterward, my foot was sore and I kept getting these little shooting pains in my heel and walking was about as uncomfortable as it had been before I saw the podiatrist.
The injection did HELP, for a while. The next day, my foot felt significantly better. But I am nearly a week out from the first injection and I am back to hobbling around when I wake up/stand up after sitting for awhile.
And yes, I said “first injection” because the podiatrist mentioned that, for a LOT of people, one injection resolves the issue completely. But for some people, it doesn’t. And that we needed to resign ourselves (he didn’t say resign; I think he said “commit.” Resign feels more accurate for me, though.) to THREE injections before we pursued a different path. He didn’t even mention what the next path would be, so I’m trying to borrow some of his confidence that the second or, gulp, third injection will do the trick. I am NOT looking forward to another injection. Last time, I had the added anxiety of not knowing what to expect. But now I have a different type of anxiety because I DO know. And it’s hard to go into something, knowing it will result in pain.
This feels like the kind of thing I had better get used to, as I age. More and more parts of me are going to fail. More and more parts of my body are going to experience pain. I am not pleased about it, but I recognize that this is just A Part of Aging. And I’m really very lucky. I can still walk. I can still exercise, even if doing so is slower and causes residual pain. I can afford to treat it. Hopefully my marriage can withstand my ongoing crankiness/hobbling.
I’m sorry. That sounds quite unpleasant, the original problem and the treatment. I think I may have PF, too, but a considerably milder case than what you describe. It’s more of an annoyance. I was just starting to talk to my doctor about it when I got the diabetes diagnosis and we sort of shifted to focusing on that because I didn’t have the bandwidth to pursue my various aches and pains.
Yes, I can see how you would want to triage the issues and focus on the most pressing one first! I’m sorry if you have PF, but glad it is mild!
I have had foot pain similar to this! But I went to a podiatrist that I did not like AT ALL — he was even more vague and wanting me to inform HIM what’s wrong than yours was. Seriously, I felt like the doctor looked at my foot, “hmmm’d” and scratched his head, and then basically told me NOTHING. I didn’t get a splint or a shot. He truly seemed like he didn’t know what he was doing. So I stopped pursuing it. I still wake up in the middle of the night and can’t walk well, but it doesn’t stop me from driving or anything like that so I’ve just learned to live with it. I hope yours gets better from here!
WHAT? That sounds awful! I hope you can find a different podiatrist if you decide to pursue treatment again.
I HATE when medical professionals want me to rank pain or make decisions. I have been having knee pain, and I brought it up at my recent physical, and the doctor ASKED IF I WANTED AN X-RAY. How, HOW, would I know?? She also asked things like was the knee STIFF in the morning. Well…is it? I experience it as soreness, but is the temporary hobbling because the knee is stiff? And then she wanted a 1 to 10 for pain. I just can’t. I never answer with numbers. I always have to say things like “Well, it hurts enough that it is on my mind whenever I am moving around, but not so much that it keeps me from moving around.” And then she says, “So…a 2? a 4?” DOC, I AM EXPLAINING IT BECAUSE I CAN’T PICK A NUMBER. Also, I think OTHER patients might be choosing higher numbers, because they are thinking “Well, it HURTS, so, like, EIGHT!!” and so then when I am carefully thinking of “getting my arm ripped off” as a ten, so this is probably only relatively speaking a TWO even though it HURTS QUITE A BIT, but on the other hand I am not screaming—then it looks like I have only a very minor problem, since most patients (remembering that these are imaginary patients I am imagining) would have said eight for that level of pain.
I always wonder that, too! Do other people rank their pain the same way I do? Keeping in mind that I feel like I have a low pain tolerance, I always try to compensate for that. But what if other people are out there doing the opposite, and saying, “Well, I’m not going to get the doctor’s attention if I say it’s a 3, so I’m calling it an 8!” UGH. This is not a good system!
Aw man, PF sucks. I’ve never had it but my husband is quite the veteran. I’m not telling you anything that you don’t already know, but yes it’s normal to cycle through all of the treatments until you find the magic combination that’s right for you. Good luck!
Well, that is useful to know. I am hopeful that the right combination is right around the corner.
Oh, I am sorry. I’ve also been dealing with plantar fasciitis for several months. My doc referred me to a podiatrist, who scheduled a phone meeting with me. We relied heavily on my descriptions of the pain and my imprecise vocabulary for my foot.
I’ve gotten some relief from YouTube videos by physical therapists that had helpful stretches. Google YouTube, “Bob & Brad”, and “The 5 things anyone with plantar fasciitis should do every morning.” You could also look at bobandbrad.com/programs for specific stretches and exercises since the doctor didn’t give you written notes (which was a major fail on his part!). Take good care.
THANK YOU! I will look them up!
PF Is terrible. I can really only wear a handful of shoes at this point without serious pain. I have always found physical therapy to be more helpful than actual doctors in figuring out what my pain is. For example, earlier this year, I was having back pain that was preventing me from exercising and sleeping, so my doctor referred me to PT and the therapist was the one who actually figured out that it was a muscle in my glute that was locked up and I was compensating for it and that led to the back pain. ANYWAY, I saw a PT when I was first diagnosed with PF and they gave me lots of exercises and advice about shoes/insoles, and if I stay pretty vigilant, it’s under control. But, obviously, my PF is not the same as yours!
That’s good to know — I will definitely pursue PT if this injection treatment doesn’t work. I am so interested to read all these comments about it going on and on… the podiatrist seems very confident that he will ERADICATE it. Well. I’m glad to have different expectations now.
My 11-year old, who is quite prone to hurting himself and therefore very used to answering a doctor’s 1-10 pain scale question, usually sets the parameters when he answers. The examples he uses change all the time, but he will say something like: “if 1 is a mosquito bite and 10 is someone chewing my arm off, I’m a 5” or “if 1 is you stepped on my toe and 10 is I’m about to start screaming, I’m a 7”. I find this strategy both charming and useful, so have plans to deploy it if I’m ever asked to rate my pain.
That is adorable and awesome!
Not boring at all! Sounds awful though, you poor woman. I’ve heard it described as like stepping on lego. Urg! I hope it will be better soon. I’m not acquainted with pf thus far (touch wood) but both shoulders have frozen and fwiw I concur with the others, my experience is that a physical therapist is much more helpful.
^_^
Stepping on lego! That is such a good description!
So sorry you are going through this. PF is very painful and difficult to resolve. A lot of my runner friends have dealt with it and it can be frustrating. I’ve heard icing the bottom of your foot by rolling on a frozen water bottle helps, plus stretching and of course resting it as much as possible. Good luck
I love the icing tip! I haven’t tried that.
I have foot pain as well but not debilitating so I just live with it, for now. The treatment sounds unpleasant! However, we do need our feet for just about everything, so we have to try the various fixes. Hope that something works for you!
Yes! We need our feet!
I’m here with another vote for you to find a physical therapist! I’ve had good luck with finding a physical therapist that I like by doing my research and scheduling my first appointment, then calling my doctor’s office to inform them that I need a referral to that particular physical therapist so that insurance will cover it.
Smart!
Ugh ugh UGH. This all sounds awful. My husband had PF about 22 years ago and it was quite painful but eventually managed with stretches, orthotics, and something I am going to tell you about, which might sound weird but was really effective. What he did was put a washcloth on the floor of the shower when he was showering, and then pick up that washcloth with his toes, working up to picking it up ten times per shower. That strengthened the muscles in his foot and it really helped a lot. I mention it because maybe it will help you and it certainly can’t hurt/ cost anything. Or, hopefully, not certainly.
In terms of ranking pain: when I was defending my master’s thesis, one of the committee was a sociologist, and he thought I should have included something about people’s pain in my equation (long boring econometric story). My response was that pain is not measurable in any empirical or quantifiable way, and I stand by that statement, 25 years later. Pain is SUBJECTIVE. END OF SENTENCE. How are you supposed to know if your pain is 50% better or 25% better? The only possible thing you could say is it would be 100% better, if the pain was completely gone. Other than that there is no way to quantify that, and I did a master’s degree in economics and econometrics where we quantified everything.
Also also ALSO. There is no morality in having a high/ low pain tolerance. If anything, pain is your body telling you something is wrong. I have a girlfriend who has an extremely high pain tolerance and was an amateur athlete in her youth, and that high pain tolerance has caused major issues. In other words, she has caused more damage to her body because she kept going with some pretty significant injuries, and this has led to a lot of problems. So having a low pain tolerance is probably better, in my opinion.
Is this the longest comment I have ever written? Perhaps.
NICOLE, I just read about that same exercise today, but it was meant to help some other issue, and I thought, Hmm, I wonder if that would help? And here you are, saying it DOES! I will try it!
I have advice based on personal experience but feel free to completely ignore if you do not want advice. I had/have PF and experienced pain very similar to you and ignored it for a long time. Finally I went to a podiatrist and got x-rays, custom orthotics, a stretching regime, ultrasound therapy, electricity therapy (I don’t remember what this is called) and they finished off with whirlpool each time. Also a night splint that I was to wear every day for at least 30 minutes. I was upfront with the doc that I was not going to wear it to sleep. He did give me a cortisone injection before I had to go work at a conference and it was super painful the first day after the shot, then I got through the conference without pain, and then the shot wore off. For me, the stretching and therapy were key and years later I still stretch every day, use the orthotics, and use the night splint when my calves feel tight. I never got any more cortisone injections. I thought the ultrasound etc therapy, stretching, orthotics, splint were the standard practice and the shots are only if you have extreme need for them, but that may have changed or this might be a different type of shot.
Oh yes, and icing! Freeze a 20 ounce or similar bottle of water and roll under the foot for 15-20 minutes.
This is so bolstering, in case the shots don’t work!
I have no helpful advice but so much sympathy! I had to have something else treated on the bottom of my foot and after the second treatment, I was in so much pain for three days straight, and yet if I had been asked to rate the pain, ugh, I don’t know. It hurts! I hope you are able to get some relief.
Oh MAN is plantar fasciitis no fun and terrible to spell. I found I had to change my gait and do some INSANELY painful deep calf massages to finally be done with it. My gait had changed because I was trying to “protect” my foot, and this eventually ended up making it worse and the calf muscles kept pulling everything out of wack in my foot- I used a tennis ball and really rolled hard on the calves and it was so damn painful but helped me.
And that whole Lamaze schtick is NOT okay- what the f*ck is wrong with him?! Your husband is a doctor- if you found out he was using that line with female patients I bet you’d smack him on the back of the head!
Hello! I work for a podiatrist and also have PF. I have had more shots than I care to remember over the years. Multiple shots, especially in the beginning, are not uncommon to help calm the tendon down. The sleep splint is the worst, I hated it so much and it did not help me at all! Physical therapy was great and I have to wear custom orthotics 95% of the time. I find taking a towel or an exercise band and putting it under my foot and pulling it gives me a good stretch. My go-to exercise is putting my feet out in front of me and spelling the alphabet with my toes. Rolling your foot on a frozen water bottle or tennis ball may also be helpful.
The whole rate your pain on a scale of 1-10 is ridiculous and should be banned. I sympathize with you on the foot pain. I don’t have PF but I have been having an ache in the arch of one foot. I blame this on COVID since I have spent much time barefoot or in slippers with no real arch support. I do find that stretches help, as does rolling a golf ball under the foot. I hope you find the treatment that works for you soon.
I read your first line and I was so excited because for the last six months or so I have had a pebble in my shoe except that it is not a pebble and it is in my foot not my shoe and what the heck is going on? It’s not enough for me to have actually DONE anything about it yet but it’s on my list to go to a podiatrist. So I am glad to hear your experience.
You may have a plantar fibroma which is a benign nodule in the fascia of the foot. I have one and it feels like I am standing on a marble in the arch of my foot. I have been wearing a boot for the last month to see if it decrease the swelling. Surgery is an option but there is a high probability of recurrence. Good luck!
Here to second or third or whatever rolling the frozen water bottle on your foot. At least 10 minutes. It works so incredibly well that I can only conclude Big Podiatry has shadow banned its mention. 🤣
Ugh that all sounds really frustrating. I had a not great experience with a podiatrist years ago. I had a lot of foot pain and he thought I had a stress fracture, and then that resolved kind of after being in a boot for 2 months or so. Then I had pain in the other foot and he thought it was again a stress fracture. But then I got diagnosed with RA and I think that was probably the culprit all along. I did a have a lot of pain in my feet, but it was probably joint pain, not a stress fracture. So I would try out a physical therapist next? That is interesting about his comments about cortisone shots. I have had so many because of my RA. During my first pregnancy with Paul, I had 9 shots into various joints in my hands plus my shoulders at one point. The PA who gave me the injections ended up tracing my hands and noting where we did the injections so I could keep track and know when I would be able to get another injection in that joint. They aren’t pleasant but they also aren’t that bad. The worst part is the pain that comes about 4 hours after the injection. But my injections are going into very small joints and then it swells and it’s unpleasant. But then the issue resolves!
Oh and my coworker had PF years ago and he would rolls a can of soup back and forth on the bottom of his foot. We called the can “foot soup” and when it resolved he joked about giving me the foot soup which grossed me out so much for some reason!
I’m so, so sorry.
I am currently going through an issue with a tendon in my foot and it is THE WORST. So painful and I’m in near-constant pain.
I’ve never had an injection for plantar fasciitis, but I did have something called bleomycin (that is so expensive) injected to deal with plantar warts. It was literally the most painful thing I have ever had done to me. I cried and swore loudly (and I don’t swear out loud). It was done by a dermatologist and he said it was the most painful procedure he did; the injection hurts itself and then the ingredient is caustic. I needed about 15 injections one week, and then they redid them two weeks later. The second time hurt even more. And here’s the rub: IT DIDN”T get rid of the warts.
Thankfully we found another treatment that worked and that didn’t hurt at all.
All this to say…I really hope you get relief soon and yes, injection in the foot hurt like the dickens.
The x-ray decision would have done me in! Just tell me what to do, please. I remember having to make the decision which cochlear implant brand to get (there were three at the time) and feeling like I was absolutely not qualified to do that. But a medical test? That is the doctor’s job, thank you very much.
Your foot pain sounds so impactful to daily life, and I truly hope the second injection does the trick so you don’t need a third. Maybe a planned treat after the second injection will help make it less onerous?
First of all, I am very sorry about your foot pain and I do hope that the second (NOT the third) will resolve your issues. I think I missed it – what did the doctor say was the problem with your foot?
Secondly, I hear you about the strangeness that doctors will ask you about procedures. I feel like that is a distinctly American thing (I was never asked, but told which procedures/tests I needed when going to the doctor in Germany… the first time I came here and someone said “it’s up to you”, I was completely flustered and thought “what do you mean, it’s up to ME? How could I possibly make a decision about the tests I needed?”…. I feel like the doctor should know, based on symptoms and pain descriptions what to test for…. but I’ve been learning that a lot of doctors employ a “process of elimination” when they treat you and also “poke in the dark” a lot. Not very reassuring.
Dang, Suzanne. This sounds so painful and also, really frustrating to continue to have pain even after going through all of these steps with the podiatrist. Hopefully, you just need to have multiple injections and then your pain will decrease for GOOD. But what a miserable experience. (Also: Have you ever tested to find out your Enneagram? I feel you are a classic 9, like me, haha. The podiatrist could have cut off my foot and I would have been like “All good, thanks for your help!!!!!!!!”
Rating my pain level is so tough because it is SO SUBJECTIVE. What feels excruciating to me may feel like nothing to other people. My grandfather had a super-high pain tolerance; he’d rate his pain a 3 or 4 after SURGERY. Meanwhile, I’m a 6 when I have a headache so…
I really love your blog and just found you through Elisabeth Frost. I got PF during the pandemic from being barefoot all the time, and I bought a truly ugly pair of Vionics slippers to wear every single second of the day, and they solved my problem. I cannot explain, though, how ugly they are.