by Kim
(Kentucky)
I had plantar fascitis for 5 years and tried all of the conservative treatments and finally underwent surgery for it. The plantar fasciits pain is now gone but on pod#1 I developed pain along the outside of my foot below the area which you would normally present with bunion. I am a nurse and usually am in either tennis shoes but only wear nursing shoes at work and rarely wear dress shoes. This pain I felt like was caused by the fact I was in a cast after surgery and my foot was in the cast awkwardly and I was placing a lot of my weight along the outer aspect of my foot. I also started having a lot of nerve pain kind of all over the place in my foot. I was having nerve pain, stabbing, throbbing, muscle spasms so it was really hard to determine where all of this was coming from. I went into a cam walker for several weeks with no real change. I ended up having a tarsal tunnel exploration and release eight months after the first surgery. The nerve pain is now gone but I am left with all of this other pain. The pain is mostly a throbbing pain 24/7 but does have episodes of very intense pain. If I squeeze my foot together or even touch my foot in that area with my other foot it causes a very sharp pain. I am now taking Alleve several times a day with no relief at all and it seems to be getting worse. This pain did ease up quite a lot while I was off for the tarsal tunnel surgery but is now back now that I am back to my regular ADL's. It also is always swollen. I did undergo a MRI-Impression: evidence of recent plantar fasciotomy with mild subacute edema/inflammation. Marrow edema in the distal lateral aspect of the intermediate cuneiform is nonspecific and may reflect bone contusion, stress reaction or marrow ischemia.
My doc now says that it is my shoes and I need to with a wide toe box shoe, however, some of these shoes I wore before my original surgery with no pain whatsoever in these areas. I am at a complete loss at what to do, this is affecting me while I am at work, I limp a lot and have been unable to workout. Please help!!
Thanks, Kim from Kentucky
Hi Kim,
The first thing that strikes me is a very common problem with plantarfascial releases and that is what is known as lateral column destabilization. what happens if too much of plantarfascial ligament is cut it causes an imbalance on the lateral side of the foot. If that ends up being the actual diagnosis then it may take a while to remedy itself; physical therapy can be very helpful.
Rather than go on and on with this, I would suggest you seek a second opinion from someone familiar with the post op consequences of a plantarfascial release and go from there.
Marc Mitnick DPM
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