THE FOLLOWING IS OFFERED AS GENERAL INFORMATION ONLY, AND MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER'S PROBLEM. IT IS NOT BASED ON ACTUAL KNOWLEDGE OR EXAMINATION OF THE QUESTIONER AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION. ONLY THROUGH HANDS ON PHYSICAL CONTACT WITH PATIENTS CAN ACCURATE MEDICAL ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER SHOULD CONTACT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS FORTHCOMING HEREIN.
It has only been recently, if at all that not only general orthopedists, but internists and GP's tended to consider foot complaints as menial nuisances which will simply go away with rest. So I am not surprised that the doctor you saw wanted to focus on the knee, even though it is entirely possible that your knee problem is due to an antalgic gait (an abnormal gait intended to avoid or lessen pain) resulting from your foot problem.
That being said . . Gee . . You certainly do have a lot of areas of pain. There are well-know scenarios which doctors see frequently, if not every day, in their practice and just a couple of symptoms when put together can make for an easy diagnoses. But, in your case, you're all over the lot, and that makes thing far more difficult. What goes through your doctor's mind, or what SHOULD go through his/her mind is getting an accurate picture of your complaints (subjective symptoms) and by examination, findings of pathology or abnormality (objective symptoms). . . and in your case, possibly separating them into groups, as you may, indeed, have concurrent problems. The diagnostic process generally generates a whole bunch of possibilities, termed the "differential diagnoses", which the doctor then narrows down by a process of elimination and exclusion.
What I am getting at, very slowly, is that with any patient's condition, a good diagnosis is a primary prerequisite for effective treatment. You've given a pretty fair review of your complaints, but only through a through hands-on diagnosis will you get any real opinion of value, and not just "shoot-from-the-hip" guesses . . . particularly since you have had previous surgery, and that always complicates and changes the anatomy from original factory specs.
It is good to hear that your doctor gave you a lengthy attempt at conservative management of the heel spur/plantar fasciitis problem, as conservative management works well in the vast majority of cases. I can't say with any degree of certainty that your present state has anything to do with the surgery which you had undergone. But I can tell you that, in my experience, "open" heel spur/plantar fasciitis surgery often seemed to have an inordinately stormy and lenghthy post-operative period. Due to this, I pretty much stopped doing them, except in very severe cases following adequate conservative treatment, and with the clear understand of the patient regarding increased potential for post-operative problems. The much newer endoscopic plantar fasciotomy, in my view, is far superior to the "open" procedure in that the post-operative complains are far fewer and far less severe. This procedure does not remove the spur, but in actuality, the spur is not the source of pain anyhow.
As far as treatment for recalcitrant plantar fasciitis is concerned, you may hear about Extracorporeal Shock Wave Therapy (ESWT), many times from either those doctors who have invested VERY serious bucks in the equipment or have an interest in a facility which has done so. As far as I am aware, this mode of treatment is still generally considerer investigational or experimental and likely will not be under-written by health insurance companies. That is not to say that it may not prove effective, but, in my view, unless it's a matter of life or death, it's wise never to be either the first or the last patient to be given a treatment with a specific modality.
I'm afraid that only by happenstance are you going to find any valuable answers to your problem in a forum such as this . . or ANY forum, for that matter. It is going take hands-on examination by a sharp clinician.
Best of luck.
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