Heel Pad Syndrome

Foot pain is a huge part of my life. I’m considered clinically disabled and sometimes have to use a cane or a wheelchair to get around. Here’s the story of my incredibly painful and expensive journey on my way to a diagnosis and, hopefully, a cure…

How Did It Start?

I started noticing my foot pain when I began working for CVS on June 1st of 2010. I didn’t see a doctor until the fall of 2011, because I didn’t realize how serious of a problem it was. I assumed that I was experiencing foot pain because of my weight problem, so I was embarrassed. I wish I would’ve gotten it checked out sooner, because I probably could’ve avoided these past two years of excruciating pain.

At the time of my first doctor’s appointment, the pain was so bad that I would cry after every shift at CVS (and sometimes during). Eventually, I realized that I had to quit my job because I just couldn’t do it anymore. Working was only making my feet worse and making my life miserable. Although I hope that eventually I find a complete cure for my disability, I don’t expect to ever again be able to work in a retail setting. Doctors worry that, even if I am someday pain-free, any type of over-exertion of my feet (such as a retail job) will slowly make the problem reoccur.

Diagnosis

After I had gone through a year and a half of extreme pain, I realized that I needed to see a doctor. I saw my mother’s podiatrist who originally diagnosed me with Plantar Fasciitis. After going through his treatment options with no success, I realized that I needed to see another doctor and get a second opinion.

I went to a few appointments with a neurologist at NeuroHealth and got an EMG test which confirmed that I had Tarsal Tunnel Syndrome. (Do not take this test if you don’t have to – it’s really painful.) He was able to help me get my handicapped parking permit, which is a complete necessity at the University of Rhode Island, where I go to school.

After my EMG test, I started seeing Dr. Greenburg, a podiatrist based in Pawtucket. I also saw two different physical therapists from Physical Therapy Services of RI (I highly recommend that company!)

Treatment

As of now, I’ve been through six months of twice-a-week physical therapy on my feet, but it didn’t help very much and eventually I stopped going after they realized they couldn’t help me. The physical therapy has loosened my muscles and provided me relief for a few hours on the days that I had appointments.

I’ve worn two different foot splints that work to correct your feet during your sleep, but neither made any difference. I’ve committed countless hours to stretching out my foot and calf muscles at home with frozen water bottles, tennis balls, phone books, my boyfriend’s hands, my own hands – but nothing has worked beyond temporary relief.

When I had exhausted all other options, I finally was given cortisone injections into the arches of my feet, a common tool to relieve this type of pain. I experienced a blissful pain-free two-week period before the pain came right back. Repeated cortisone injections would have helped give me temporary relief but wouldn’t have fixed the real problem, so I chose to forgo that option. Also, the injections hurt like hell.

Next, I tried orthotics. Orthotics are shoe inserts that are molded specifically for your foot. They wrap these weird plaster stuff over your feet and then you get your own orthotics a few weeks later! (Only downside is they aren’t fully covered by insurance. These babies cost me $450 out of pocket). Well, the other downside is that they made absolutely no difference. Apparently, they do help a lot of people and they are supposed to be good for your feet whether or not they decrease your pain.

Possibility of Surgery

In the Spring of 2012, I booked a Plantar Fascia surgery with Dr. Greenburg. After hearing my physical therapist express his concern, I went to a different doctor for a second opinion. My new doctor, Dr. DiGiovanni (a Brown University Orthopedic Surgeon who I highly recommend), strongly advised against getting the surgery at that point in time. In fact, he all but came right out and said that Dr. Greenburg had only booked me the surgery to get my money. He said that no self-respecting doctor would suggest having surgery without fully exhausting all other options first.

Currently, I’m furious with Dr. Greenburg. I urge everybody to be very careful about who you let advise you on medical issues! (Another issue I had with him was that he all but promised me that the orthotics were supposed to help with my pain, made me cough up $450, but then when I confronted him about spending all that money on something that didn’t help, he went back on his word and said that he’d never said any such thing. Even though he did.)

The surgery is still on the table, but we decided to try a few more treatments before locking myself into a dangerous procedure that could permanently incapacitate me for life (if something went wrong).

The biggest outcome of that first appointment with my new doctor is that he completely changed my diagnosis. He said that I don’t have Plantar Fasciitis or Tarsal Tunnel Syndrome (previously, I’d been told by more than five doctors that I had PF and three told me I had TTS). I trust him because he is a lot more knowledgable than my previous doctors and he went into great detail about why he came to that conclusion. I also commend him for telling me the truth – that he has no idea what my problem is. Right now I’m still on the road to discovering the cause behind my excruciating pain and how to fix it without a diagnosis.

Click here for a detailed post about this incredibly emotional appointment.

EPAT

Dr. DiGiovanni suggested I try EPAT (Extra-Corporeal Pulse Activation Treatment) – basically, it’s a fancy name for shock therapy. EPAT is approved by the F.D.A, but it’s still very experimental, which means that it’s not covered by insurance (the procedure costs $500 per treatment site on average). It’s so experimental in fact that almost nobody’s heard of it and there’s not even a Wikipedia page that I can link to about this for you! (Click here for a detailed post about my first appointment).

In May/June 2012, I had five treatments in which a specialist rubbed a gel on the underside of my foot and rubbed a tool on the afflicted areas that made a lot of noise and produced “pulses” that are supposed to activate tissue and increase blood flow in the area. It did hurt, but it hurt in such a weird way that I can’t really explain it. The closest thing I can use to describe it is that it’s a little bit like getting a tattoo. The worst part was the night after the treatment, though. The increased blood flow made my feet swell and they were very painful to walk on.

Even though you only get a certain number of treatments, the procedure lasts 3 months. One month of treatments and then two months of recovery before an assessment of its success can be made. I have my assessment appointment at the end of July 2012 when I’ll meet with Dr. DiGiovanni and talk about my options. As of right now, I’ve noticed no change in the amount of pain I have, so I’m very disappointed.

Finally Getting a Diagnosis

On August 2nd, 2012 I had my EPAT follow-up appointment and met with Dr. DiGiovanni to discuss my current situation. After talking about the pain and my symptoms in detail, he was able to give me his professional opinion of what my diagnosis is. I have something called Heel Pad Syndrome. Technically, there’s no test to confirm this condition, so that’s why I said it’s his “professional opinion.”

Here’s a little bit about what it’s all about. Heel Pad Syndrome is a condition that somebody is either born with, or they’re predisposed to and it develops over time. The heel is the part of the body that supports almost all of a person’s bodyweight when they walk, run, or do anything involving their feet. The heel pad (also known as a “heel fat pad”) is a bunch of fatty tissue that protect the heel bone and cushion it during impact. Patients with Heel Pad Syndrome have a decreased amount of tissue making up their heel fat pad. The lack of proper cushioning results in pain when the heel comes in contact with the ground.

Dr. DiGiovanni gave me the bad news that Heel Pad Syndrome currently has no surgical or treatment options – in other words, there’s no cure. Right now, I’m exploring the options of acupuncture, pain clinics, and a silicone heel pad shoe insert in attempt to relieve some of the pain. None of these things are guaranteed to help, and it’s possible that I could simply have to live with this condition for the rest of my life.

After this appointment, I was glad to finally have a name for what has been hurting me for so long, but I also felt discouraged, disappointed, and helpless. In this post, I wrote about the extreme emotions I was having and all of the thoughts that were running through my head.

 

 

My Posts About Foot Pain

• About Tarsal Tunnel Syndrome
• Life in the Slow Lane
• What Scares Me
• What I’ve Learned
• Getting Cortisone Shots & Being Able to Walk Again
• Breaking Down After Working Out
  
• I Can’t Run a 5k
• Getting Orthotics
• Going to Physical Therapy
• Life-Changing Appointment with New Doctor
• First EPAT Appointment
• My Official Diagnosis & How I Feel About It
• Explanation of What Heel Pad Syndrome Is

 

I would highly advise anybody experiencing heel pain to see a doctor or a physical therapist right away. You do not want to end up like me, going through years of pain. I believe that if I had gone to see a doctor immediately, I could’ve avoided this completely.

 

Disclaimer: I am not a medical professional. Everything stated in this post is merely my opinion about my own personal medical problems.