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Giza aka Douglas Muth's LiveJournal
So I finally have a diagnosis, and my foot problems have a name 
28th-Sep-2010 03:21 pm
Leopard White Mage
For the first time in about 6 months of knee/foot problems, I finally got a diagnosis, at least on my feet.

I saw my pawdiatrist (Dr. T) today, 6 weeks after getting my orthotics. I told him that I was still in pain, with several flareups having happened since I started wearing the orthotics, which otherwise have felt just fine.

He did another examination and told that I have something called "Cuboid Band Syndrome" [2], or muscle spasms in the outer part of my feet. It can be caused by overuse, and in my case: by walking around without arch support for 33 years. This is the pain that started at Anthrocon and continues through today. The orthotics didn't make it any worse (and in fact are still medically necessary for me), but I had enough issues going on with those muscles that they did not heal even with the orthotics.

The treatment for this consists to two things. First, a muscle relaxer (Cyclobenzaprine) to relieve the symptoms. Second, physical therapy to strengthen the muscle. I was fortunate to get the same physical therapy place as before, and even get assigned to the same specialist. Since she gave me knee exercises to do earlier in the year (exercises that I still do every night), adding in some foot exercises shouldn't be much of a problem either.

The Cyclobenzaprine could be interesting, though. My pawdiatrist said that it will "knock you out", and not to even think of driving a car or drinking booze after taking my dose. So this means I will probably not be consuming any alcohol while at WPAFW this coming weekend, but hopefully in less pain too.
28th-Sep-2010 10:17 pm (UTC) - Your feet
You should see a chiropractor about your feet as well, similar to carpal tunnel syndrome, the bones are misaligned in your feet as well. I know I am a chiro!
28th-Sep-2010 11:47 pm (UTC) - Re: Your feet

Thanks, but I'm already under the care of a specialist.

Also, I thought chiaropractors were about the back and neck.
29th-Sep-2010 12:07 am (UTC) - Re: Your feet
Actually we deal with all the joints primarily the spine, many chiros are trained in extremity manipulation. I see a lot of people with the same condition as yours. Orthodics and PT will help, but you should have the bones in your feet checked to make sure they articulate properly. Pawdiatrists typically do not look at how the joints function when in motion, if they do not articulate correctly you will have issues like yours, consider adding Chiropractic to the mix. Bones in the the spine work the same way, when mis-aligned they cause wear and tear on the joint causing degenerative changes eventually leading to pain, this is what has happened in the bones of your feet. Manipulation of the bones will allow the joints to once again function properly and slow done the degenerative process.

Just something to consider.
29th-Sep-2010 12:12 am (UTC) - Re: Your feet

I was told that the issue was strictly with the muscle. I'm just not seeing how bones enter into the mix.

I should also mention that I had an X-ray before the initial visit, and my pawdiatrist did not mention any issues. But feel free to look at them yourself if you want: http://www.flickr.com/photos/dmuth/sets/72157624358007271/
29th-Sep-2010 01:04 am (UTC) - Re: Your feet
Ah, the million dollar question, muscle is attached to bone, when bones don't function properly, neither do the muscles attached to them, they stay in spasm and don't function either, when the bones function the way the should the muscles also relax and function properly, the combination of aligning the bones and retraining the muscles(PT) will give you the best results as well as the orthotics to keep your arch supported. Looking at your x-rays, your feet could benefit. Not all chiros are trained in extremities, so if you consider it you need to ask to make sure they will check your feet. I will tell you that every chiro will check your spine before they work on your feet, its all connected. I am in NJ, if it is something you want to look into I could probably make a recommendation in your area, most insurance company pay for chiro.
Chiro and md look at 2 totally different things on x-ray, we look for functional issues and MD only look for pathology, X-ray radiologist are training to look for pathology, so when they do not see any pathology in the bones then they go right to it must be a muscle problem when in fact it is a combination of both and multiple therapy's can be of great benefit.
29th-Sep-2010 01:12 am (UTC) - Re: Your feet
Hmm, I'll keep that in mind.

After getting my feet taken care of, the next step is to see a knee specialist about my knees (look further back in this LJ if you'd like the whole story).

Then, it'll be January, my company will have open enrollment again, I'll switch to the PPO, get to a proper specialist (as per my pawdiatrist's suggestion) and see where things go from there.

Also, I think your comment about not all chiropractors being trained in extremeties is also important. That would make any sort of a search on my part more complicated.

FWIW, my primary care physician is a DO, so I'm hoping he'll be able to help me with more "total person" issues like you touched on there.

29th-Sep-2010 01:33 am (UTC) - Re: Your feet
Glad you have an open mind, we can check you knees too! I will say this, most DO's side on the medical profession and are not to fond of Chiro's, so just don't be to surprised if some DO's shun chiro care. Most DO's I know get very minimal training in manipulation and really do not do much manipulation at all, I just ask that if you want to find out more about Chiropractic, ask a chiro. Good luck, feel free to contact me if you have any questions!
28th-Sep-2010 11:11 pm (UTC)
Cyclobenzaprine can make you very drowsy. It can also have no effect you whatsoever. For me, personally, it knocks me on my ass. I've seen patients, though, who take it three time a day every day and go about their daily lives.

It all depends on how it affects you. Could go either way. :P
28th-Sep-2010 11:47 pm (UTC)

Oh yes. I had some years ago for a bout of TMJ and remember it quite well.

My pawdiatrist actually used the phrase, "knocks me out for the weekend", actually!
29th-Sep-2010 02:45 am (UTC)
Do you realize now 3 of your family members are taking physical therapy for the lower extremities?
Guess it means we are on our feet a lot. If you find a chiro like Dr Smith up here, you probably would benefit from some visits. He certainly helped me when I finally gave up on the medical doctor helping my sciatica years ago. But... make certain your insurance covers this.
29th-Sep-2010 02:50 am (UTC)
Okay, "pawdiatrist" (and that picture) are way too cute.
29th-Sep-2010 03:01 am (UTC)

That's because leopards are naturally witty and cute!
11th-Oct-2010 02:48 pm (UTC)
Been on pain killers and muscle relaxants before. The combination of those two things really makes it hard to focus.
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