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Plantar Fascia Case

Plantar Fascia Case

DISCLAIMER:

The case histories and outcomes presented here are for general information only and do not replace the advice of a health professional. You should always consult a health professional who can take your own particular circumstances into account and advise you on that basis.

History:

A 40-year-old female presented with pain in her left heel. It had been sore for a long time, but in the last 6 months had really flared up. The pain was worse in the morning and when walking or standing for long periods of time. She enjoys walking for exercise but hadn’t been able to because of the pain. This was interfering with her weight loss goals.

Objective:

On examination, pain was located to the medial-plantar heel (inside of the heel, towards the arch). The area was swollen and tender to palpate. The plantar fascia was tight to palpate.

Diagnosis:

Plantar fasciitis. An ultrasound investigation was ordered which confirmed thickening of the plantar fascia with intrasubstance tearing.

Treatment:

Repeated ultrasound therapy was performed and rigid strapping applied for a number of weeks. She was advised to wear supportive shoes as often as possible, and apply a heat/ice pack. Gentle calf stretches and massage for the plantar fascia was recommended on a daily basis. Custom orthotics was ordered to support the arch, whilst offloading the painful area. With each visit, she reported gradual improvement. A ultrasound guided cortisone injection was performed, and this provided further relief.

Outcome:

Fortunately within a few months of treatment, she was symptom free and able to walk comfortably. Now (three years later) she remains pain free and active.
Mortons Neuroma Case

Mortons Neuroma Case

 

DISCLAIMER:

  The case histories and outcomes presented here are for general information only and do not replace the advice of a health professional. You should always consult a health professional who can take your own particular circumstances into account and advise you on that basis.

History:

A 67-year-old gentleman presented with 40-year history of pain in the ball of his left foot. He was experiencing burning pain, tingling sensation and swelling. His foot was painful with every step and he couldn’t bear the weight of bed sheets on his foot. The pain was impacting his quality of life through  restricting his mobility and he was concerned about his ability to keep working. He had previously sought treatment, including two cortisone injections, which provided only temporary relief.
Morton’s Neuroma Removed

Objective:

On assessment, the area of pain was the left forefoot between the 3rd and 4th metatarsals. This area is known as the 3rd interspace, and is a common site of nerve entrapment. We referred him for an ultrasound investigation, which confirmed the presence of a moderately large neuroma/bursal complex.

Diagnosis:

Left 3rd interspace neurofibrosis (commonly known as a Mortons Neuroma)

Treatment:

The conservative and surgical treatment options were outlined. Given the long history of pain and failed conservative treatment, he decided to proceed with surgery. This operation was a day procedure, of approximately one-hour duration. During the surgery, the neuroma is removed from the interspace. Post-operatively a post-op shoe was worn for about 4 weeks, with regular visits to the office for redress and care instructions.

Outcome:

He is now 8 months post-op and reports that the surgery has “changed my life immensely”. He is now pain free and can carry out normal daily activities without any discomfort.