Me and my operation: How a teaspoon of my own blood banished years of foot pain
21:28 GMT, 16 April 2012
Patients with conditions such as tennis elbow and plantar fasciitis, which triggers pain under the heel, are being injected with their own blood to boost healing. Fleur Allen, 37, a restaurant manager from Blaby in Leicestershire, had the treatment and tells CAROL DAVIS her story.
Around four years ago I started to feel a sharp stabbing pain in my left heel, as though I’d stood on a pin.
It happened whenever I got out of bed in the morning or if I’d been on my feet for a few hours. Given I run a restaurant and have three children, aged eight, 11 and 13, I’m on my feet a lot and so it really started to bother me.
Pain free: Fleur with her children had a blood injection to treat plantar fasciitis
After about a month I saw my GP, who said I had something called plantar fasciitis — I’d damaged the plantar fascia, a broad band of tissue which runs under the sole of the foot to the heel.
He said it can become inflamed through over-use or injury, and being on my feet all the time meant it was being continually damaged and couldn’t heal properly
I saw a podiatrist, who made me insoles to wear inside my shoes, which support the arch of the foot — they helped a bit, but after a few weeks, the pain came back and got worse.
It started the minute I put my feet on the floor in the morning. So next we tried ultrasound treatment, blasting my foot with soundwaves to stimulate healing. Again it helped a little but I was taking up to six powerful painkillers a day.
Two years ago I started getting pain in my right heel too, so driving was painful. Now I was in agony and feeling desperate — I even paid to have shock-wave therapy to stimulate the damaged tissue through the skin and try to prompt it to heal, but that didn’t make any difference.
'Athough the injection itself would be painful, there was a 90 per cent chance it would end the problem for good'
I was offered surgery too, to cut through some of the inflamed tissue in my foot to release it a bit, but it would mean eight weeks off work to recover; I couldn’t face it.
So last October my GP referred me to Dr Patrick Wheeler at Leicester General Hospital. He said they were trying a new treatment, where they would inject some of my own blood into the foot around the plantar fascia.
It sounded very odd, but Dr Wheeler explained that part of the problem was that the plantar fascia has a very poor blood supply. Blood contains lots of chemicals which help repair the body and without enough of it, the damaged tissue doesn’t heal very easily. Injecting blood there would stimulate the tendon to heal.
Pain under foot: Plantar fasciitis is more common in women (posed by models)
He said that though the injection itself would be painful, there was a 90 per cent chance it would end the problem for good, and I could walk immediately afterwards too.
I had the treatment in January. First, a nurse took blood from my arm, just like an ordinary blood sample, while Dr Wheeler injected local anaesthetic around my left heel. Then he injected the blood into my heel — it made me flinch and hurt for a couple of minutes.
My heels hurt badly that week and my husband Robert had to help out at home.
But a week later, I’d been at work for hours when I suddenly realised there was no pain, even though I hadn’t taken any painkillers. I just couldn’t believe it: when I got home, I jumped up and down to show Robert that I could do it without any pain.
Dr Wheeler had explained once one heel was treated, the other would probably get better by itself since I wouldn’t be walking awkwardly on it to compensate, and sure enough the pain in my right heel died away, too.
Now I might get the odd niggle of pain, but nothing like the agony I’d been in for years. I can run around after the children all day, and go on bike rides and three-hour walks, and feel absolutely great.
Dr Patrick Wheeler is consultant in sport and exercise medicine at University Hospitals of Leicester. He says:
Blood injections have the potential to help many thousands of patients suffering with conditions such as plantar fasciitis as well as tennis elbow, golfer’s elbow and patellar tendinopathy which causes pain just below the knee.
In all these conditions, the location of the damaged tendon or tissue means it has a poor blood supply, which delays healing.
Plantar fasciitis is very common, affecting one in ten of us at some time in our lives. It’s caused by damage to the plantar fascia, which runs from the heel and under the foot, and acts as a shock absorber and support within the foot.
When the plantar fascia is damaged repeatedly, it can develop lots of tiny tears — scar tissue builds up which is more brittle and so more prone to further damage. The problem is more common in women than men, and we think it may be partly genetic.
We also know that the plantar fascia can be damaged by repeated activity, including sport, and occupations that involve a lot of standing and walking. The condition can be very life-limiting and disabling. In the majority of patients the pain will settle on its own over a period of several months.
'Blood contains platelets and growth
factors which are involved in healing. Increasing the supply of blood to
this damaged tissue prompts it to repair itself naturally'
Doctors can also offer painkillers, or patients can try exercises to stretch the sole of the foot and the calf which can reduce the pain.
We can also try steroid injections to relieve the pain, or special orthotic inserts inside the shoes to correct gait and relieve pressure on the heel.
Another option is to wear a night splint, which stretches the plantar fascia during the night, reducing the pain first thing in the morning which tends to be when it is at its worst.
When nothing else works, we can also offer surgery to cut and release the plantar fascia.
However, this takes patients several months to recover from and carries standard surgical risks including infection, and a small risk of nerve injury, which can cause pain or even permanent loss of sensation.
Back on her feet: Fleur can now go for three-hour walks
Autologous blood injections involve an injection of a small quantity of the patient’s own blood to the site of injury, and have been used in some countries for more than ten years to treat conditions such as this.
The treatment is being done at just a few centres privately around the country and with limited availability on the NHS — it would only be offered to patients for whom other techniques have not worked.
Blood contains platelets and growth factors which are involved in healing. Increasing the supply of blood to this damaged tissue prompts it to repair itself naturally.
Over the past few years doctors have used something similar called platelet-rich plasma therapy, where we take a blood sample from the patient and then separate out the platelets and plasma which is rich in growth factors.
But this treatment means taking a larger volume of blood, 30 millilitres or more, whereas with autologous blood injections we need just a tiny amount — around three millilitres, or less than a teaspoonful — and there’s no need to separate it.
The procedure only lasts about five minutes. The nurse takes blood from the patient’s arm, while I use ultrasound scanning to find the damaged area of the plantar fascia.
I then inject the patient’s blood, around 2cm deep under the foot, withdraw the needle, and we put a plaster on the site.
The patient does some foot exercises on the bed for a minute or two, and then starts walking immediately afterwards — the aim is to promote healing and the growth of new tissue where it is needed during normal walking.
Patients spend the next few days walking gently, and I see them two weeks later.
A patient may still feel pain for a week after the injection, partly because of some bruising and partly because it takes time for the healing process to start.
Around 90 per cent of my patients say their pain has diminished considerably, and more than half say it has gone completely.
We have been doing this for around three years now, and hope that it will provide a permanent cure for patients who have had years of disabling pain.
The procedure costs around 175 privately and a similar cost to the NHS