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Question: I have been diagonses with Plantar Fascititis. I work 9-12 hrs a day on my feet whole time,i have been in pain for the last 4 years but the last 8months to a year have been escrusiating pain. If I am not off my feet enough to let my feet rest and get better, wouldnt surgery be a better option to fix this, I think going on for 9 more months with this pain that i have felt for 4 yrs and always being on my feet with my occupation is crazy before surgery would be thought of, so pay this doctor lots of money for all the visits and cortizone shots until the time comes, WHY?????
Answer: Plantar fasciitis can be be extremely painful and can linger a long time.  Its caused by abnormal pulling or stress that causes a chronic inflammation or degeneration within the fibers of the fascia.     Understand that I am answering your question without the benefit of examining you, but in short, it sounds like surgery is an option for you.  You have had this pain a long time, and non surgical methods aren't working.  If you are on your feet so much, a custom orthotic may be needed.  I am not clear if you have one or not.   I treat fasciitis initially with stretching exercises, both active stretches and with something called a plantar fasciitis night splint, which your doctor may have or you might find one on the internet.      Shots are helpful but rarely curative.   A properly fitted total contact orthotic is the best treatment in my opinion, and I have seen greater than 93% pain relief in 3 months.   Surgery is not without risks and complications, and should rarely be a first choice.   The May/June 2013 issue of the The Journal of Foot and Ankle Surgery has an article that discusses a traditional from of surgery for fasciitis versus an instep fasciotomy through a small incision.  The study concluded that the instep procedure resulted in better pain relief and less complications.     I prefer the instep fasciotomy when I do this surgery.  Other methods include an endoscopic technique, which I have also done, but the instep procedure in my opinion is preferable.  It still would require almost a month of down time if you are on your feet all the time at work.   Patients and doctors need to be comfortable with each other and the treatment plan.  I always offer my patients a second opinion with another local doctor, and other doctors do so with me.  Its a nice way to have another opinion without any concerns on either party.  Sometimes the other opinion helps me rethink my approach.  
Question: Both of my big toes have pincer nails. The right one is worse than the left. Is this fixable or am I stick with deformed toenails?
Answer: A pincer nail can be caused by several things,  including damage or infection to the nail root or damage to the underlying bone in the toe.  Using high percentage urea nail gel may help , but often the shape of the nail is a result of the shape of the nail root.  In many cases your best option is to have the nail removed, which is a simple office procedure.

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