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My own experience

I will start the ball rolling with my own experience.  My heel pain started shortly after I got new shoes – waterproof shoes with “good support” for walking the kid to school – nothing else had changed.

The pain was in the typical place, the medial side of calcaneal attachment of the plantar fascia.  Weight-bearing was tender, as was pressure on the medial side.  At first I had it just on the left; that cleared up by itself within a week or two, only to be replaced by a more persistent dose on the right.  It was a fairly classic presentation, except it was worse in the evening and in bed, rather than on rising in the morning.  After about two months of it, I also developed pain the buttock.

I saw five professionals about it, over the course of a few months.

  1. podiatrist

Professional, good history and biomechanical examination.  Diagnosed ‘Plantar Fasciitis’.  Had not elicited tenderness, so I showed him where it was, so he diagnosed ‘heel spur’.  Having demonstrated a small degree of pronation of the right foot, he recommended a custom orthosis, for a mere £250.  He did not mention stretching.  I pointed out I had come because his business card said he did acupuncture, so he suggested a follow-up appointment for that.  Uninspired, I delayed making that appointment.

  1. remedial massage

Someone I had attended in the past.  Professional and thorough, as always.  She did deep, connective tissue massage with focus on the feet, posterior legs, back and neck.  Commented that I had less tension than expected.  Recommended stretches for feet and calves, with clear instructions and demonstration.  I was sore afterwards but it soon walked off.

  1. GP

Pleasant and unhurried but only examined one foot, pressing so lightly he got nowhere near the tender spot.  Also examined buttock, through my jeans, and tested my passive hip movements, which he noted to be ‘pain-free’ in spite of having made me wince.  He agreed with the diagnosis of PF and poo-pooed the idea of heel spur.  He diagnosed the hip pain as due to ‘walking funny’.  He agreed that an orthosis was a good idea but not spending a fortune on a custom one.  He recommended taking NSAIDs regularly.

  1. TCM practitioner

Disappointingly unprofessional.  I felt manipulated by the receptionist to see a particular practitioner (not the one I had asked to see), then pressured by him to buy supplements from them.  After listening to my presenting complaint, almost the only question he asked me was if I took vitamins.  He never even asked my address.

The examination homed in on a single muscle in the calf.  There was no examination of tongue or pulse.  He suggested cupping and did lots of it, on the feet, legs, back and neck - static and sliding.  I had to ask for acupuncture to be included; he needled several trigger points.  His needle technique was good, with minimal insertion pain and several good twitches.

Sadly, in spite of returning for a couple more sessions, I got no discernible benefit, just some spectacular bruises as trophies.

  1. consultant radiologist

Ultrasound scan showed “classical plantar fasciitis, with thickening of the fascia”.

  1. again – podiatric acupuncture

Attending, belatedly, for follow-up, I got the podiatrist to try out acupuncture although he did not seem very confident about it.

He examined me again and found the ashi point and a number of tender points in the calf.  He explained clearly the medical acupuncture approach he would take and proceeded to needle the points he had found.  He got good deqi responses.  I got significant benefit within a couple of days.  The same was repeated another week on, with increasing benefits.  I also asked him about off-the-shelf orthoses and he told me the type to get.  I bought a pair online, for a tenner, and have used them since.  I did not go back for more sessions, as I was almost pain-free, and had other priorities for my disposable income.  His acupuncture had started a process of healing, and the orthoses kept it going.

So, how do I summarise this experience?

What worked?

  • I had no doubt that the podiatric acupuncture had helped and was confident it was not ‘just placebo’ in view of the lack of response to the other acupuncture. It was simple, quick, comfortable and effective.
  • Cheap insoles, bought online.

What did not?

  • Obvious commercial vested interests undermined my trust in two of the practitioners.
  • The combined cupping and needling, in this instance, was not good.
  • I did not attend for a full course of acupuncture, so I can only judge the short-term effect of a couple of sessions.
  • Because of my inside knowledge, I am aware that the approach of the ‘TCM’ practitioner left a lot to be desired. It was not representative of good TCM practice but naïve clientele would not know that.
  • Because I was interested to see how people practised (and because they did not ask) I did not reveal my expertise in this area. If I had, we could have had a constructive dialogue leading to a better experience.

Suggestions for change?

  • It would be great if we could find a system of funding that facilitates both ease of access and integrity of practice.
  • I am curious about what is going on when a problem starts on one side then moves and settles on the other. Maybe someone could research this.