I will try to be brief, but my story is kind of long, I apologize.
I was born with high arches and hammer toes. I never had any foot pain until the Summer of my 21st year. I worked in a warehouse as an order filler. I had to literally lift tons of boxes (5lbs - 100lbs each) for 8-10 hour shifts. I was young, and I wore crappy shoes with little support or padding, and I walked along concrete floors.
Anyways, by the end of the Summer my feet started hurting, especially my arches. So, I went to my doctor (1992), and he recommended me an orthopedist. I visited the orthopedist, he took x-rays, said I had high arches and that the warehouse work had injured my feet, and he prescribed me orthotics. I got the orthotics, and shortly the pain went away. Magic! I replaced the orthotics every 2-3 years, and still lived pain free.
Then about 3 years ago (2007) I started having foot pain again, even though I was still dutifully wearing my orthotics. I went and got a new pair, and the pain still didn't go away. I then went to Foot Solutions (a footwear chain here in CA that sells footwear and custom orthotics). They claimed their orthotics were the best (should be for $500). I got them and they caused even more pain (they were like walking on rocks). I then went to my general practitioner and he recommended me a local podiatrist. I went to him (and brought all my new and old orthotics), explained my problem, he visually examined my feet and he recommended orthotics made by the special company that he searched far and wide for. I think the company is "ComfortFit". He swore by their orthotics. So I paid another $450 out of pocket (my insurance doesn't pay anything for orthotics), and 3 copays of $40 for visits for fittings etc.
Well, I still had foot pain, and I went back to him a month later, paid a $40 copay, and he said, "These things can take time, come back in another month". So I went back a month later ($40 additional copay), and he says he will adjust the orthotic, and make the arch bit higher, and use a more soft material for the cushioned part. So, I get them, I still have pain, I wait a few months, go back (I refuse to pay the copay from now on), and he raises the arch a bit more. I'm trying to make this short, but it's been a year and a half and I still have arch, metatarsal, and ankle pain. I hate it when he adjusts my orthotics because he has to send them away, and then I suffer 2-4 weeks of agony without any orthotics at all. Yes, they help a little, but not much.
I've been to another podiatrist locally. Funny thing: I listened to him talking to the patient ahead of me, and he basically told me almost the EXACT thing he was telling them "I'll prescribe you orthotics and here are some stretches". He laughed at me when I told him that an orthopedist had told me that I had a congenital foot defect (he was very patronizing). Anyways, I didn't buy his orthotics.
So I called around to various podiatrists and asked them, "Do you do anything for high arches other than prescribe orthotics?" There replies were variations on "not really". But, of course, their orthotics were the best. No one was willing to offer me a refund if their orthotics didn't do the job, however.
Okay, so now I'm doing my best to become a foot expert. I'm studying the foot, researching on the internet, and I came upon this site. I am at my wit's end. How do I find a competent podiatrist to help me out? I need one that will spend more than 5 minutes with me. I need one that actually has great orthotics for high arches, or one that has alternative treatments (I'll pay for surgery). I'm getting to the point where I don't care what the cost is, or if I have to pay it all out of pocket. I am 39 years old and my foot pain is seriously limiting the activities that I can participate in. It hurts to talk a one mile walk. How am I to stay fit? I feel like an old man.
I would prefer a podiatrist in the San Diego or Southern CA area, but I'm willing to travel, as long as I have some guarantee that the podiatrist I am referred to is competent, and not just a run of the mill orthotics pusher.
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The excessively high-arched (equinus) foot is often the most problematic and difficult to treat, but I don't hear a word of actual diagnosis in your comments, and I think that's the place to start. Many persons with such a foot structure have pain in the ball and heel of the foot due to the fact that these are the only areas of the foot which come into contact with the weight bearing surface and they must bear the entire weight of the body. Also common is an exceptionally tight heel chord and its extension, which is the plantar fascia. Non-reducible severe hammertoes are also part of this scenario. Conservative treatment of an equinus foot is often a non-fancy filler-in sort of basic "arch support" the effect of which is to bring the entire weight-bearing surface up to the foot. However, because the high-arch foot is problematic for shoe fitting, as both its structure and the general inability for it to depress on weight-bearing results in irritation and pressure from the vamp of the shoe and this is made worse by placing anything in the shoe under the foot. So there is a revolving door aspect to treatment attempts. There is also surgery available to reconfigure the profile of the foot, but this is not often done except with very severe deformities.
You have made it a point to point out each time you have been charged after buying the orthotics and I personally think that it is improper to sell anyone anything, whether it be an appliance for the body or something mechanical for non-medical usage and then charge additionally to make it do what the seller said it would do. I also know that there are many podiatrist who sell orthotics to just about every patient they see. I think that the basic problem here is that you are being led to believe that successful treatment of your condition is more certain than statistics will back up. I don't know of anyone who has the magic answer no matter how much you pay.
__________________ Foot Doc
Last edited by FootDoc; 16th July 2010 at 12:49 PM.
I visited my current Podiatrist for the LAST time on Wednesday, and I asked him for my formal diagnosis. He said he believes that I have tenosynovitis, and mild pes cavus. He said I had equinus when I first came in, but now i have much more mobility in my foot. He said that because I can now bend my foot back sufficiently past 90 degrees that I no longer suffer from equinus (this made the least sense to me). I told him about the new pain in my ankles (mostly on the right one, just below the bone) and the new pain in my right knee (on the inner side). He said that the orthotics fit properly and that they were doing their job. He said that the continued pain in the foot, and the new pain in the knee and the ankle were because I hadn't properly stopped "the cycle of inflammation". So he prescribed to me a 6 day series of anti-inflammatories. I forget the name of them, but the are the ones that you take 6 the first day, 5 the second, 4 the 3rd, etc, for 6 days. He said that once I have broken the "cycle of inflammation" that I should be back to normal. Well, I think that he is full of BS, but I have yet found a podiatrist (excluding you) that I didn't feel was full of BS, but I am going to go through with the anti-inflammatories for 6 days, and then, if the pain still persists, I will go to a new podiatrist. Again, if anyone in the SoCal area is reading this, and you know of a real podiatrist, or a real orthopedist that specializes in feet, please let me know their name. Any additional info/advice you can give me, FootDoc, would be greatly appreciated. Thank you!
I have developed hammertoes which rub and become inflamed when I wear tight fitting shoes so I finally went to a podiatrist. He took X-rays to see if there was anything causing the hammertoes and found that I have fallen arches. He showed me the X-rays so that I could see that they were indeed fallen. He recommended orthotics, and I am lucky that my insurance will pay for most of the cost so I ordered some.
The orthotics have just arrived. The instructions recommend adjusting to them by wearing them for one hour the first day and then adding an hour every day until I am wearing them full-time. The instructions say that it has taken years to develop the problem and we are trying to teach our body to work in a new way. This makes sense to me so I am trying to break them in gradually.
The podiatrist recommended that I look for shoes with a wide toe-box such as Merrells, Danskos, Eccos, Keens, and Asics tennis shoes. These are all brands that I have already been wearing to try to keep my toes from rubbing.
He also recommended a product called Silipads which are gel-covered tubes that can be cut to fit over my toes when I am walking so they won't rub. So far these have made a big difference for me.
The podiatrist said wearing the orthotics won't actually cure my fallen arches or my hammertoes, but will help to stabilize them. I plan to follow his directions, because years ago I visited a podiatrist (a different one) and had good luck getting rid of a neuroma by wearing an orthotic. Because it quit bothering me and the orthotic was getting worn out, I quit wearing it. But I think I made a mistake in not replacing my running shoes last year and trying to get an extra year out of them. Now I am paying the price so I plan to wear the orthotics faithfully to see if that makes a difference.