Monday I visited my new primary care physician with hopes of getting prescriptions for custom orthotics and an insurance-covered inhaler.
Y’know, walking and breathing… important things for health.
I told him about bilateral arch pain since I started marathon training. He poked at my socked feet and asked if it hurt (not really). He did NOT ask me to stand or walk to see my biomechanics or ask what home-care I’ve tried.
The doctor just started talking prescription anti-inflammatory drugs.
He explained, “‘-itis’ in ‘plantar fasciitis’ means inflammation. You need anti-inflammatories.”
As gently as possible I shared, “Well… a lot of podiatry is now calling it ‘fasciosis’ because of its degenerative nature and lack of inflammation for most of the injury…” and I also asked, “what is your criteria to determine if it is plantar fasciitis?”
He did not like that. He dumbed it down for me. “If there is pain, there is inflammation. If it wasn’t inflamed, you wouldn’t have pain, and you wouldn’t be here.”
(At that point, I could think of several reasons why I shouldn’t be there…)
Somehow we got away from discussing his diagnosis criteria, as well.
But I still needed this guy on my side. I suggested that I take over-the-counter NSAID (non-steroidal anti-inflammatory drug) to start. He said Tylenol was too weak and starting naming all the prescriptions stronger than Tylenol (First off, Tylenol isn’t an NSAID, and yes, all those drugs are stronger hence they are prescription). Ok. Fine. Whatever. Write the prescription. I’ll figure it out later.
He then told me a doctor-residency anecdote about how he treated his dad’s feet by suggesting more supportive shoes and gave me a referral to a podiatrist without writing the orthotics prescription. I pointed out that I’d have to wait for his referral to go through, make an appointment for a podiatrist, get a prescription for custom orthotics, wait for that appointment, then wait to get the orthotics made. He laughed at my “impatience” and wrote me a prescription for custom orthotics.
I felt like a pushy patient, but the healthcare system is tiresome.
Good news is he wrote me a prescription for a different inhaler that was in my hands 3 hours later. So, I’ll give him that. And I got a referral for a podiatrist who I hope can confirm my diagnosis and go over ALL my treatment options.
The pharmacy automatically filled my anti-inflammatory prescription, too. I received a prescription for the NSAID Diclofenac sodium (Voltaren) totaling 180 pills (including refills). 180 pills? How is this a viable health solution for a 26 year old?!
My (3 personal and not-a-doctor) concerns with running and anti-inflammatory drugs
- I use PAIN to determine how my body feels. If I am painful, I do not go run. It is my body telling me ‘HOLD UP GIRL! SOMETHING IS WRONG!’. If I mask this pain, how will I know what is going on with my body? A lot of pain is unnecessary and unhelpful, but I don’t have a lot of pain.
- Inflammation is part of the body’s healing process. It signals that something is wrong, so your body sends stuff to attack, protect, and heal. A lot of inflammation is unhelpful and even damaging, but I don’t have a lot of inflammation.
- Anti-inflammatory drugs do not fix my problem. My problem isn’t inflammation and pain. Inflammation and pain are responses to something that is wrong. I need to fix the thing that is wrong, not mask its symptoms.
I’ve taken two doses in the last week, on days with sharp pain and I know that I am not going to run. I’m not sure how much it helped those days as my pain comes and goes anyway. I was unimpressed.
Don’t get me wrong, I think drugs are good. I take a prescription synthetic hormone every day to balance my hypothyroidism. I use my prescription inhaler so I can breathe while I run. I’m just not sure if taking a prescription-strength NSAID twice a day is the answer to my foot problems.
Disclaimer: This is just me talking about whether I should take my medication. It is not about you and your medical treatment journey.
- British Journal of Sports Medicine on NSAID recommendations
- NSAID prevents endurance-training adaptations of muscles in mice
- Runner’s Connect’s Ibuprofen and running