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Debilitating heel pain - Advice please


I've often read this forum but never actually posted, it seems it contains a wealth of first-hand knowledge about chronic pain - whatever the exact cause.

Back in 2003 I had a discectomy to relieve the sciatica symptoms caused by DDD in my lumbar spine (I'd suffered for about 15 years before the surgery). All was really good until 2006 when the pain became unbearable again, this time I had a fusion at L5/S1, again, I was lucky that I recovered relatively well and the pain reduced by about 80% most of the time.

Then in 2009 I had what I thought was plantar fasciitis in both feet but it soon developed into something worse, to cut a long story short it is now very debilitating, I can not walk at all without pain and the pain is there 24/7, just slightly better if I don't walk anywhere. I'm obsessed with sitting down! After about 5 mins of walking the pain is about 8/10 and stays that way for hours afterwards. My feet and calf muscles also become very weak.

Like everyone here it affects every waking moment of my life and worse still, it affects my family. It's frustrating for them and also difficult to watch me hobbling around all the time!

My real question is that I don't know if this is a problem in my feet or my back! They cannot find anything wrong with my feet but there is some epidural fibrosis affecting S1 on the left but I would have expected pain all the way down my left leg into my heel, not both heels and calf muscles.

Has anyone experienced chronic heel and foot pain but without the associated leg pains? That said, over the last month or so I a lot of pain has started in my lower back!

I'm off to see my original surgeon next week, if it is the fibrosis causing this does anyone know if there is any treatment available? I'm not sure I can go on forever with this pain as it is getting worse all the time.

Sorry to whine about it but I'm sure you guys understand more than anyone how distressing it is to be in so much pain all the time. In my opinion it's something that is difficult to adjust to, everyday I treat it like I'm in pain for just that day, everyone can cope with one day but when it hits me that this might be permanent it's hard to not become depressed.

Thanks for reading.



  • Heel pain here. For a quick background, I fell and sprained my ankle badly March 2012. Have had ongoing foot/ankle issues. In January 2013 I had what I thought was plantar fasciitis - pain in my right heel was terrible, could barely walk. Podiatrist ordered an MRI and didn't see plantar fasciitis just some swelling and fluid remaining from ankle sprain. A couple of months later I had my first bout with back pain and was also diagnosed with foot drop. Had diskectomy and laminectomy. The foot drop and numbness/soreness in foot are only slightly better. Now yesterday, I woke with horrible plantar fasciitis-like symptoms again. When I get up from laying down or sitting, I can barely put any weight on my right foot. The pain in the heel is dibilitating. Will try to get back in with podiatrist this week. I truly think this is a foot thing not related to the back, but sugery was in May so it might be related nerve pain. Anyone else have this?
  • not quite the same, but yes you can definitely get heel pain without leg pain, all coming from the back. long story short, l5-s1 fusion a year ago. went in with sciatica in the back of my thigh and low back pain. woke up with those, but added in this horrible pain in my heel. no pain in my lower leg, and thigh really wasn't that bad. but if i moved the wrong way, it felt like someone was slicing a hot knife through my heel on my right foot. totally came from the nerve being poked during surgery. heel pain improved drastically over the next couple of months, still have some numbness, and occasional pain in the hell, but for the most part it doesn't bother me much anymore, and its been just over a year since the surgery.

    so in short, you can definitely have heel pain without any pain going all the way down your leg, and it can come from your back.
    Microdisectomy / hemi-laminectomy 6/2010 and revision 10/2010
    Cervical fusion C4-5 and C5-6 9/2011
    Lumbar Fusion L5-S1 6/2012
  • Tran - Thanks so much for responding. It is great to hear from someone who is a year post-operation. It's been a little more than 2 months for me and it is really discouraging how slow the progress is. BTW - I am still skeptical and seeing the podiatrist in a couple days to see if maybe I have a bone spur in my heel or something. I will update after the appt.
  • you are having problems with, pain in the heel can most definately be caused by lower back pain and problems. There is a map called a dermatome map on Spine Health. In fact, it is my avatar. Certain parts of the body are innervated by each spinal level, and compression or damage to those spinal nerves will create pain, numbness , pins and needles , burning, etc in that area innervated by that spinal nerve.
    If you look at the map, and know the level of your spinal problems, you can see what areas of the body are innervated by the nerves at that level and compare them.
  • Had the podiatrist appointment. My heel pain was at the back of my heel and could be pinpointed to one particular spot. The doc gave me a cortisone shot in the heel (oh so painful!). He said that if the back was causing this pain, then the shot would not give me relief. Today, my pain is a little better. It seems like the cortisone shot is doing the trick. It looks like I have more than one thing going on here. My pain issues stem from a bad fall over a year ago where I sprained my ankle and hurt my back, so I believe this particular foot pain was related to the ankle/foot issue and not from the sciatic nerve.
  • In addition to the possible spine issues or a podiatrist, certain types of arthritis can also cause debilitating heel pain when flaring, so if other things haven't worked, that is one more option to explore.
    4 level ACDF C4-C7 5-2-11, laminectomy & discectomy L4-L5 1/26/12, ALIF L4-5, L5-S1 12/10/12.
  • Thanks. The cortisone shot has helped some with the pain. I will ask the podiatrist about arthritis. Wondering how they test for that. I've had xrays and an MRI.
  • Pepperpot1808PPepperpot1808 Posts: 20
    edited 11/07/2013 - 8:30 PM
    I'm exhausted but happy to find people who are going through what I am - it's lonely when you don't know what's happening to your body! Disc fusion Feb. 22/10 L1-L3, then March 18/13 L1-5, S1, T11 (I don't know how to write it properly) because I was degenerating. Someone punctured my spinal cord, surgery May ? 2013 to insert a drain which broke and surgery June 27/13 to get the broken piece of drain without success, then two more months in hospital in Infectious Diseases with E. Coli and 4 other bacteria, discharged Aug. 25/13.

    I thought I would walk out of the hospital without pain. Boy, was I wrong! My right leg was paralyzed, my foot curled up into a fist, pain, pain, pain. Today is November 8, 2013 and I believe that what I have is plantar fasciitis - can't put my foot flat or walk without a walker. My surgeon wants me to see a podiatrist and I stubbornly want him to put a cast on the foot or do something so I can walk again! Wouldn't a podiatrist just tell me to ice my foot? Cortisone injections - forget it! If someone even touches my foot I jump up to the ceiling.

    So you guys say it's a foot problem, not a spine problem? Should I go see a podiatrist?

    And this abdominal swelling - I look pregnant and I barely eat. Water and apples. My belly keeps swelling along with the edema in my feet and ankles.

    I'm ready to slit my wrists. Any advice for me?
  • RickilalasRRickilalas Posts: 559
    edited 11/07/2013 - 8:48 PM
    I have been going to several doctors trying to find a ankle pain issue. Many test many injections then we found out it's a issue caused by scar tissue around the T8 area. Anything is possible. This has taken almost a year to find because it did not fit any textbook answer.
    I would guess and only guess that it has to do with the surgery you had not a foot issue.
    One foot doc wanted to just cut my foot and take a look. My answer was no way. They would numb my whole foot and I still had the pain meaning it was coming from above and not the foot. One last thought for the night. My dad went through a time he had foot drop. We got him some high top laced up wrestlers shows that help pull the foot up in place. Maybe worth a try.

    Good Luck
  • Hey Rick,

    I can't believe a doctor wanted to cut open your foot to look inside it! Or, no, let me amend that. I have seen some very strange things this past year, but that is one of the strangest.

    So your Dad wears high-tops! lol! I have several pairs which I love but right now I can't get my foot into shoes. I've ordered a pair of men's high-tops in a size larger than I would wear, and hopefully that would help.

    Thanks for the info, and best of luck to you.

  • Since I wrote my original post, the ortho finally ordered another MRI - herniation at surgery site (L4-5). Having surgery again 12/6. This time I am going to a neurosurgeon. He believes that the first surgery may have been unnecessary. My foot drop may have been caused by the bad ankle sprain I had. All the docs wanted to believe it was coming from my back, but the old MRI only showed a moderate bulge. Anyway, the surgery messed me up and NOW I have a much larger herniation. I am hoping some of the foot/heel pain subsides after this surgery, but the n/s thinks I may have nerve impingement or damage in my foot. The fun just doesn't quit!
  • So, bobdensley - what finally happened? You too, Tran. Sandi, I love your dermatome map and would like to get a really big one to put on a wall some place. Any idea where I could look?
  • pepperpot... its now been about a year and a half since my lumbar fusion. i still get sciatic pain in my thigh, and then random shots of pain in my foot. same places i've had issues with before the surgery, but its not too often, and pain levels aren't too bad. i know i've got nerve damage in there. months of calf pain in that same leg, MRI showed muscle issues that are typically caused my nerve damage. Lovely....
    Microdisectomy / hemi-laminectomy 6/2010 and revision 10/2010
    Cervical fusion C4-5 and C5-6 9/2011
    Lumbar Fusion L5-S1 6/2012
  • Pepperpot1808PPepperpot1808 Posts: 20
    edited 11/22/2013 - 9:00 PM
    As Kathleen said, thanks Tran for telling us how it is for you a year and a half later. Kathleen, I too, am discouraged at how long it is taking to "heal". In fact, plain depressed. I had no idea!

    Tran, what did the doctors do for you? I don't see the point in taking an MRI if nothing will happen. Was it just to say "Oh! That's why!"

    I'm sorry I sound cranky. It's not at you. I'm tired and sore and worried. Besides, I asked.

    So nerves can damage muscles? I know I sound stupid but I never thought about it or needed to before this. So I guess I will be going for an MRI.

    When does it end??? I know I've only just started and where do you get the strength to go through such an ordeal?

    Thanks, Tran.

  • I suffer from this debilitating heel pain you describe, for about 8 months now. I recently saw a podiatrist that diagnosed me with plantar fasciitis. I was fitted for a pair of custom made orthotics that I had to pay $300 out of pocket for as insurance does not cover these. I was desperate for relief so opted to pay the asking amount just to get rid of this pain. They did absolutely nothing for me.......Anyway, it turns out that, as someone stated above, that certain kinds of arthritis can mimic plantar fasciitis. One of those being rheumatoid arthritis which I am going to be checked for as soon as I get my appt. with a rheumatologist. My dr thinks I have either this or lupus.I don't know if you have any of the symptoms that I'm about to mention but its something that "can" cause this horrible heel pain--my symptoms are: I keep a low-grade fever all the time which spikes out of nowhere, this morning my temp is 101.4 (highest temp with this has been 102.?) I ache all over my body exactly like I have the flu, I will freeze even with pj's on, heat turned up to 72 while I'm wrapped in a blanket. I find it hard to walk from the body aches along with this bad bad BAD heel pain. Also, loss of appetite. I don't know if you have had anything like this going on but it is one of the things besides plantar fasciitis or a spine problem that can cause such debilitating heel pain.
  • Symptoms? Almost exactly I don't want to wear clothes cause even my skin hurts but I'm freezing! Heat cranked up to 30 degrees (Celsius), no appetite, can't walk and it's not just the heel pain, it's under the toes too. The metatarsal? All this from spinal fusion? Such misery!


  • what did the docs do for me? well, at this point, its not much. i can't take steroids, so that limits things alot. i've been on NSAIDs since the doc gave me clearance for them post surgery. Basically, i live with what is left of the pain. some days are ok, some it bothers me alot.... i just keep going. there isn't much to do about the nerve pain.

    as for the muscle problem. my MRI basically said that there was edema and enlargement of the muscle. basically instead of the muscle shrinking because of the nerve damage, it enlarged. not exactly a common occurrence. but i have some sort of connective tissue disorder, so that might also be affecting things. have to see my rheumatologist and see what he says next. again, not much i can do about it. i just live with the pain it causes.

    i do make sure i keep myself active though. 5 days a week in the pool, typically 2 hours a day. keeps me moving, and the company keeps me sane. i figure my alternative is spending most days in bed by myself... doesn't sound fun.

    unfortunately for me, i don't think its ever going to end. its been over 4 years since this entire ordeal started. you just learn to keep going. cause really, the alternative sucks too.
    Microdisectomy / hemi-laminectomy 6/2010 and revision 10/2010
    Cervical fusion C4-5 and C5-6 9/2011
    Lumbar Fusion L5-S1 6/2012
  • Pepperpot1808PPepperpot1808 Posts: 20
    edited 11/23/2013 - 9:01 PM
    You sound very accepting. Have you done your fighting, or are you just choosing not to? I'm envious of you having access to a pool! All the doctors say to swim, but for me it's a difficult trip.

    I've never heard of muscle enlargement as an illness, along with your edema. I'm learning a lot here, thank you.

    And who knows what will happen within another 4 years? Chin up!

  • I went to see a podiatrist yesterday who pushed and massaged my foot (yeow!) and he is sending me for an ultrasound. I really hate the idea of having someone push a want into my foot but it's to see if I have a mass they can remove.

    Now what he told me is that the nerves that are felt in the foot are the L1 to L5 and S1! He told me that I managed to hit all the crucial vertebrae (he meant "had fused") for the foot and this kind of pain is inevitable.

    For me, it was in the heel really badly, but now it's behind my toes - metatarsal? On my requisition form it says "R foot plantar 2nd and 3rd metatarsal heads ---> palp mass"

    I can't get an ultrasound appointment until December 10th which really annoys me. It seems SO far away! Then what? Surgery? Grrrrr.

    Happy Thanksgiving to my new American friends!
  • RickilalasRRickilalas Posts: 559
    edited 11/28/2013 - 1:39 AM
    I just wanted to toss in that I had a second.SCS added this week and my ankle pain is gone.
    My first SCS has a lot of scar tissue that may or may not of caused the pain. No way to prove it anyway but scar tissue was around the T9 area. I need the surgery report to know where for sure. Anyway with the second SCS my foot feels normal again. I know this may not be close to your issue but I just wanted to let you know it can be anywhere and many different issues that can cause these problems. Just do not give up and never take no for a answer. I am sure glad I did not do the exploratory foot surgery because it was not in the foot at all.
    My pain management doctor was the one that found this for me and it took almost a year to do so. We can never give up.

    Hang in there and good Luck
  • Haven't been on the forum for a while. Thought I would update. Regarding the heel pain....I finally begged enough and was able to get an MRI of my foot. I too have plantar fasciitis. I also have several inflamed tendons and a bone spur on my heel. I also had a new MRI of my back and the herniation is back and worse than before in the surgery spot. I am having my second discetomy next week. I am also scheduled for physical therapy and a podiatrist appointment next week for my foot. I went to see a naturopath last week who prescribed a topical for my foot that is helping a lot. Hoping the surgery doesn't aggravate my foot. I'm pretty sure that the plantar fasciitis and tendonitis issues are separate from my back (had a bad ankle sprain a while back) but I'm wondering if there could be any correlation between the disc issue and the problems with my foot. Hope you all are finding some relief.
  • Kathleen
    I had a very strange issue with my left foot feeling like it was in a meat grinder .
    We did everything to find out what was wrong with my foot.
    This may in no way relate to your foot issues but mine turned out to be scar tissue in the thoracic part of my spine. Never would have thought that. Never give up and never take no for a answer. There is more if my information under SCS treatments under a thread called medtronics scs vs a Boston scientific scs.

    Hope you get help
  • Thanks, Rick. I am really glad this surgery will be performed by a neurosurgeon. Last time my surgeon was a orthopedic. With all the nerve issues I have going on, I think it is the right move. I am so hoping to come out of surgery and feel relief in the foot.
  • kathleenkkathleen Posts: 28
    edited 12/23/2013 - 5:25 PM
    Hi all -
    Had my second back surgery on 12/16. Foot feels about the same. It's hard to tell - the foot drop might be slightly better. The foot pain has been better since I had the injection into the plantar fascia area. I am doing physical therapy twice a week where they are performing graston therapy on the posterior tibial tendon (where I have tendinopathy) and plantar fascia. Hoping that with the physical therapy and the back surgery, I hope I will being doing a lot better in a couple of months. I would encourage any of you with heel/foot pain to get a foot MRI. It's possible that spine issues have caused you to change your gait which can mess up tendons.
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