Question
Dr. Katz,

Am a 43yr. hold male in otherwise decent health.  Was diagnosed with plantar fasciitis 2 years ago in both feet which developed when I started exercising by walking uphill.  Was given custom orthotics and then pain subsided.

But, over the past year burning and tingling in the feet has gone from minor annoyance to more major issue, especially as I went from 135lbs. to 105lbs. from Jan. to June due to stomach problems making it very difficult to eat.  Since mid-september have gained most of the weight back, am now 130lbs. (5' 9" tall).

Went to a couple of foot dr.s - 1 put neuropads on both big toes, and they only turned about 1/2 pink.  The other tapped my ankles and said I have tarsal tunnel in both feet.  He also ordered EMG / NCS which was normal. Temperature / vibration sensation in both feet was normal, and I am not diabetic.  Xrays also normal.  Neither dr. said to do any exercises or recommended PT. The 2nd dr. gave me a set of new custom orthotics about a month ago, but the don't seem to make things either worse or better.

Also, I did have a spinal fusion at L4-L5 10 years ago, but my back has actually been feeling better over last 6 months.  Also, due to my back over the years instead of bending down I often squatted like a baseball catcher, and sat on my heels at times - do you think this could have caused this problem?  Also, I have a desk job where I sit all day; the last 10 years I've been sitting in a "kneeling chair" that helps my back.

Over the past 6 months the pain has flared up and down, but the last 3 weeks it seems constant.  It hurts bad enough that I find it difficult to stand or walk for more than 5 minutes.  Any thoughts you have on the cause / treatment would be great.

thanks,

Stu

Answer
Hi Stu,

Tarsal tunnel is a possibility and I would consider some physical therapy.  

The pain could still be from your back even without back pain.  I would consider being worked up for arthritis or autoimmune disease.  If you are a heavy alcohol drinker that could also be a factor.

If you hit a dead end, I would see an alternative medicine physician and see if you have a gluten sensitivity or leaky gut syndrome.

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
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