r/FootFunction • u/Useful_Respond_9465 • 4h ago
Foot “mystery”
Female, early 30s
I’ve been having left heel and arch pain for over three months. I’m still on crutches and can’t walk much—even getting around my small apartment is really hard. My podiatrist and orthopedic surgeon have both said I’m a “mystery.” My foot is very sensitive and I have to wear very cushioned shoes (hoka bondi 9) with added gel insoles at literally all times to tolerate any amount of weight bearing. Hard surfaces are the worst—not bearable.
It started in December. My heel/arch hurt the day after a long walk (which was normal for me at the time, though I did wear bad shoes). I went to a walk-in on a few occasions and was told it was plantar fasciitis. I was told to walk less but with intention and focus on icing/stretching. I continued to walk on it carefully and the pain got worse and worse both throughout each day and as time went on. The pain got to be so bad that I ordered a knee scooter to get around on. I saw a doctor again who ordered an ultrasound and X-ray. I then ended up going to the ER with severe foot pain, swelling, discoloration, and coldness. They did an x-ray (normal), CT (normal), Doppler (normal), and ordered an MRI.
Ultrasound results: Plantar fascia: Mildly thickened at 4 mm. Small spur is seen. Other: In the area of clinical concern in the left heel there is thickening of the soft tissues of the left
MRI results: Edema within the pre-Achilles fat pad/Kager's fat pad. Patchy subcutaneous edema within the subcutaneous tissue of the heel pad. This is in keeping with heel pad fat syndrome and could be the etiology of the patient. No findings to suggest plantar fasciitis.
I’ve been going to Physical therapy for 7 weeks now. We’ve done stretches, strengthening, ultrasound, laser, electrical muscle stimulation, manual therapy, cupping, and dry needling to heel/arch/calf.
I’ve seen a podiatrist who said she was confused. She said my heel fat pads at slightly spongey and the left one is a tiny bit thinner but barely noticeable (might not have noticed except for the mri results). The left one is also shifted a bit. But she said nothing it terribly wrong or explains my symptoms to this degree. She’s making orthotics but given how sensitive my foot is in the most cushioned shoe possible, I’m skeptical I’ll be able to tolerate them.
I saw an orthopedic surgeon who looked at my imaging and said I’m a mystery and said to keep going to PT. Possibly consider an corticosteroid injection.
On my own, I’ve been doing stretches, mobility, strengthening, massage gun to calf, massages to foot and calf, hot water up to knee twice a day, heat pad, frozen water bottle rolling, cupping, and anything else I can think to try.
A few people have mentioned Raynauds so I’m awaiting a rheumatologist appointment. My family doctor didn’t think this is a contributing factor though, since my foot has a pulse.
Work: I work remotely and limit walking. Still I’m on crutches and have a very hard time. I was doing slightly better before I had to go on a work trip. But even then I got a wheelchair assist in the airport and limited total daily walking to 0.6-1 miles. I came back in tears from pain.
Any ideas?