About 3 years back my heels started hurting a lot the morning after I had gone for a run. It felt a bit different from the usual pain one gets after exercising. I hoped it will get resolved over a few days. But to my dismay and frustration the pain never resolved. It started getting obtuse and spread from my heels to my achilles area.
I was told it is plantar fasciitis. And the general sense was that it would heal over time. Most people had the issue resolved within a year was what I told. Hence I decided to brazen it out and lead life. Obviously I went easy on the exercise and running. But I continued to carry on all office work and travel as it came along. 8 months on, my pain was not resolved and the top of my feet and the balls of my feet had started hurting and going numb by then.
Once the pain and the numbness became persistent, I started visiting doctors. I went to several orthopaedics and got an MRI done as well. I tried Ayurveda as too. I spent two weeks in an Ayurveda hospital in Kerala. Unfortunately, nothing helped much. I went to Sports and Fitness centres. They were keen to show me their magic. They treated me for trigger points for five days and convinced me that my pain had reduced. I went along with them and was moved from recovery to rehabilitation to fitness within a month. The pain persisted, but with no other options I continued with them.
It was then that a colleague of mine, suggested Recoup, an institute for NeuroMuscular Treatment run by Dr. Deepak Sharan. I decided to go over there and meet the Doctor. I was diagnosed with plantar fasciitis, plus MTrPS (Myofascial Trigger Points) and peripheral neuropathy as well. I was suspicious to start with. No doctor, had given me such a long list of issues. All the orthopaedics had diagnosed me in a few minutes and had looked at my situation as a trivial problem. This diagnosis seemed much more complicated. I was really confused on which way to proceed. Somewhere at the back of my mind, I wanted to consider this as a minor sports injury and not a debilitating ailment. My family was of the opinion that my problem was really not that serious since all other doctors said so. Add to it the fact that, I was not limping and there were no overt signs of swelling scarring or injury.
But the pain was real and there was not going away from it. I decided to proceed with treatment at Recoup and told to myself that I will continue in the same place no matter what. Dr. Deepak Sharan brought in a holistic view to my problem. He is an Orthopaedic, and is also renowned for his neuro-muscular speciality. Recoup did not trivialise my pain. They looked at my case more as a clinical issue as against just a fitness issue. I started undertaking therapies over there. Apart from physiotherapy, I also underwent a somatosensory perception test and was advised therapies that would address the peripheral nerve issue.
We tried several therapies, ranging from dry needling, ultra sound, PEMF, aquatic therapy and of course Myotherapy. Through this time, I was also tested and treated for Uric Acid and Calcium deficiencies. I would visit the doctor every two weeks and every time he would religiously take notes and suggest modifications. However, the improvements were not coming through. It was having a toll on me as well since everyday I had to drive to the hospital for the therapy. I had to re-adjust my work timings. My employer – Thoughtworks had been very co-operative throughout the time and that made things easy for me. But the lack of improvement started playing on my mind. After close to one and half years, I was still not much better. I wondered if I would ever get cured. I was pretty close to giving up. In fact some of my near ones told me to just accept it and move on. Some even mentioned that the pain is in my mind and does not really exist. At Recoup, I undertook sessions on Chronic Pain Management and how it impacts a patient’s life.
Iam damn proud that I did not give up. I looked upon it as a process. Something I need to do everyday. I stopped thinking about life’s turns and what the future may hold. I learnt to live in just the present. A lot of credit should go to the Insitute’s Therapists; especially the Head, Jerrish Jose and another therapist and researcher; Joshua Samuel. They not only did the physiotherapy but also spent time talking to me during the sessions.
Around that time the doctor suggested that there is a specialist coming from Europe to train practitioners on prolotherapy. He suggested that I try it. He said it will be useful for me. Actually he had offered Prolotherapy within the first two months to me. At that time, I did not feel upto it. When I googled it and saw the videos, it looked very painful. But after close to 18 months I was ready for anything. I was administered prolotherapy on my left foot by the specialist. Surprisingly, did not hurt as much as I had thought. I guess I had worked up the pain so much in my mind, that when it actually happened it became a bit of an anti-climax.
I was limping for the next three days. But the pain felt different. Earlier the pain used to feel dried out, lingering and hobbling. This pain while higher felt more fresh. And what made me positive was, day by day the pain decreased. Mentally it felt great to just sense a decrease in pain almost every few hours. After about a couple of weeks, the pain stopped decreasing. But I definitely felt better. There was a wave of palpable relief for me. I started to take prolotherapy every 4 to 6 weeks at Recoup. Folks at home were not convinced about it. Their question was if it is so good, why is it not popular. I do not have an answer for that. I was just happy that I started getting it. Since then I have undergone about 8 prolotherapy sessions on both my feet. I progressively got better. Some sessions were more painful than the others. But there was no denying that it was helping me. On searching the Internet, there were many articles that said one will get relief within 3 sessions. It did not happen with me. Many articles also said that within two or three days the soreness from prolotherapy will go away. For me it took longer. It took me a full week to feel good enough to go out and walk distances after every session of prolotherapy. Maybe because if was on my feet.
The good thing now is that the gap between each session is increasing. Earlier, I would take it every 4 to 6 weeks. The last one I took was after 4 months. If ever I need to take one more, the gap would be six months I guess. I also realised that the healing continues into the second and third month of prolotherapy. I had to continue other treatments during the process though.I bought an ultrasound machine and used it regularly. During this time, we also did two rounds of PRP (Platelet Rich Plasma) on either of my foot. It worked better than prolotherapy but is much more expensive.
It’s been a little more than eighteen months since I started the first round of prolotherapy. And the improvement has been amazing. I can take public transport without worrying about pain any more. I can stand for longer periods of time. And I don’t get stressed on how to handle the pain each time I step out of my home. I can attend stand-ups at work, cook a dish if required and give a talk without worrying about pain. There is still some ways to go; for example, I still cannot wear shoes for long periods. Neither can I go barefoot except on soft surfaces like grass and sand. But it feels amazing to know that you are on the path to mend.
I can say with confidence that Prolotherapy has worked for me. It was not a silver bullet. I had to take 8 sessions over close to 18 months with gradual improvement. The PRP also worked well for me. But I was told we can take only 30 ml blood at a time and concentrate it to about 4 ml. So at a time, it could be administered only on a relatively smaller footprint. Since my pain was widespread on both feet it became a constraint. My biggest learning from some of these are, each person’s journey is unique. Younger folks tend to heal much faster. But in all cases the timeframe for healing and full recovery runs into months and years. It’s important to stay patient and follow the process. I cannot emphasise enough how important it is to reconcile to this reality and be mentally prepared for the long haul. The costs are not trivial either. But at Recoup I was fortunate in that their rates are reasonable and they also take a very holistic approach to treatment.