The treatment of chronic heel pain or plantar fasciitis can be very frustrating for patients. Typically the vast majority of people with plantar fasciitis and heel pain are able to resolve it through conservative care of physical therapy, stretching, icing, custom orthotics and anti-inflammatory management short-term.
Heel pain and plantar fasciitis originate from strain to the plantar fascial band that leads to microscopic injury and inflammation of the plantar fascia. Some patients with chronic heel pain not responding to typical conservative management may have developed what we term plantar fasciosis or fasciopathy. Fasciosis or fasciopathy is a conversion of the type of tissue of the plantar fascia from a rather healthy plantar fascial tissue to something that is more similar to scar tissue from longer term chronic inflammation that doesn't resolve.
In these patients, a procedure may be the answer to resolving the battle with this chronic heel pain. Radiofrequency Coblation and the use of platelet-rich plasma or PRP, is one procedure that can be considered by the patient.
This procedure uses what is called a Topaz wand which in day surgery is inserted through small puncture wounds in the skin overlying the chronic plantar fascia. The Topaz wand is an instrument that provides a radiofrequency to vaporize some of the chronic plantar fascial tissue. This provides a controlled "reinjury" to the chronic plantar fascial tissue. This stimulates regenerative repair of this chronic fascia.
To augment this process, the use of platelet rich plasma or PRP is also a part of this procedure. At the time of the procedure a small vile of the patient's blood is drawn and then spun down in a centrifuge to isolate the platelet portion of the blood. Platelets have what is called platelet derived growth factor. These are naturally occurring proteins that stimulate new vessel ingrowth and healing.
After the Coblation part of the procedure is performed this platelet rich plasma is injected into the area to augment the healing process and stimulate new vessel ingrowth and repair of the chronic tissue.
This procedure is performed on an outpatient basis in a surgery center setting. Patients are weight bearing following the procedure and in a Cam Walker boot immobilizer. The dressing applied at the time of surgery is removed in 2 days and there are no incisions or sutures.
The nice thing about this procedure over more traditional fascial releases is that it's less invasive and patients are weight bearing immediately.
If you are struggling with chronic heel pain that has not responded to conservative care please make an appointment with us so we can discuss whether or not you are a good candidate for this procedure.
If you were to examine your feet for a second you would be able to tell if you had a bunion or not? A surprising amount of people have bunions but they don't even notice the issue because it so minor and insignificant that it doesn't cause problems. Of course, this isn't the case for everyone. A bunion or what is medically called hallux valgus, is a malangulation of the great toe joint. It is largely genetic but can be affected by shoe gear. The lateral deviation of the great toe at the joint causes the discomfort in the joint. It is not so much a bump of bone but instead a poorly angulated joint. Basically people inherit a foot type that is biomechanically prone to develop this. They can be symptomatic in early teens and throughout life. For the most part, there is not much one can do to prevent the development of this deformity if you have the genetics for the biomechanics that produce this deformity. If you're dealing with bunion related pain and discomfort, our Aurora Colorado podiatrists, Dr. Robert Anderson and Dr. Erik Thelander, are here to help you tackle your symptoms.
Wear the right shoes
One of the worst things you can do is to put on shoes that are too tight and put too much pressure on your bunion. This is certain to lead to pain and swelling. When choosing shoes look for ones that allow your toes enough room to move around comfortably. There should be minimal pressure placed on the deformed joint. Also look for shoes that provide proper support particularly for your activity level. Avoid high heels or shoes with pointed toes if possible.
Consider orthotic inserts
Prescription orthotics can also be one way to improve the support and stability your shoes offer you. These orthotics are custom made to fit your foot and arch and are a prescription device made through our office.
Other options to consider include cortical steroid injections, and nonsteroidal anti-inflammatory drugs.
In some circumstances patients will need surgery to alleviate the deformity and the discomfort. The foot experts at Centennial Foot and Ankle Specialist in Aurora, Colorado are ready to help you manage your symptoms and determine the proper treatment for your situation.
Prompt treatment is the key to straightening your toe if you have a hammertoe. Dr. Robert Anderson and Dr. Erik Thelander of Centennial Foot and Ankle Specialists in Aurora, CO, discuss treatment options and explain what you can do to ease your discomfort.
Wearing roomy shoes
Tight shoes press on your toe, worsening pain and causing corns and calluses to form on the top of your toe. Look for shoes that offer taller, wider toe boxes to prevent the problem.
Cushion your hammertoe
Corns and calluses can add to the pain of a hammertoe. Cushion your toe by applying corn and callus pads to reduce friction and pressure when you wear shoes. You may also want to reduce the size of the corn by gently filing it with a pumice stone. Don't attempt to treat the corn yourself if you have diabetes, as this can lead to an infection. Instead, call our Aurora office to make an appointment.
Try toe exercises
Straightening your bent toe may be possible when it's still flexible. If you don't take steps to address your problem during this phase, the toe may eventually become so rigid that it will be impossible to bend it. Exercises don't require any special equipment and can be completed in just about 10 minutes.
Prescription orthotics may also be helpful if you have a hammertoe. The custom-made shoe inserts redistribute the weight of your foot, which may increase your comfort.
Surgery may be recommended if other treatments aren't helpful. Although the type of surgery will depend on your condition, your podiatrist may suggest one of these procedures:
- Tendon Transfer: A tendon transfer can be helpful if your hammertoe is still flexible. During the surgery, the tendon that runs underneath your toe is moved to the top of your toe, which allows the toe to straighten.
- Joint Resection: Joint resection may be used if your hammertoe is fixed. The surgery involves cutting the ligaments and tendons in your toe and removing the end of the bone. Pins may be used to hold your toe in the correct position while you recover.
- Joint Fusion: During the joint fusion procedure, the bent part of your bone is removed and ligaments and tendons are cut to allow your toe to straighten. Eventually, the two pieces of bone fuse together.
Are you concerned about a hammertoe? Call your Aurora, CO, podiatrists, Dr. Anderson and Dr. Thelander, at (303) 632-3668 to schedule an appointment.
People with diabetes are prone to foot problems, often developing from a combination of poor circulation and nerve damage. Damage to the nerves in the legs and feet diminishes skin sensation, making it difficult to detect or notice pain or temperature changes. A minor sore or scrape on your foot may get infected simply because you don't know it is there. A decrease in blood flow makes it difficult for these injuries to heal. And when a wound isn't healing, it's at risk for infection. Left untreated, minor foot injuries can result in ulceration and even amputation.
Foot Care for Diabetics
Simple daily foot care can help prevent serious health problems associated with diabetes.
We recommend the following tips for keeping your feet healthy and preventing foot complications:
- Wash feet daily. Keep feet clean with mild soap and lukewarm water, and dry thoroughly.
- Moisturize. Moisturize daily to keep dry skin from cracking, and avoid putting lotion between your toes as this may cause infection.
- Trim your toenails carefully. Cut straight across, avoiding the corners; visit our office for assistance
- Never treat corns or calluses on your own. Visit your podiatrist for treatment.
- Protect your feet from hot and cold.
- Keep the blood flowing in your feet and legs. Elevate your feet when sitting, don't sit cross-legged, and stay active.
- Inspect your feet every day. Check your feet for cuts, redness, swelling and nail problems. Contact our practice if you notice anything unusual, even the slightest change.
- Avoid smoking. Smoking restricts blood flow in the feet
- Wear comfortable, supportive shoes and never walk barefoot
- Visit our practice for regular exams. Seeing a podiatrist at our office regularly can help prevent diabetic foot problems.
At our practice, we understand that living with diabetes can be challenging. Let's discuss simple ways you can reduce your risk of foot injuries. We'll work with you to create a treatment plan that fits your lifestyle and gets you back on your feet so you can enjoy the things you love. Remember to inspect your feet every day. If you detect an injury, no matter how small, come in for an exam right away.
Welcome to the Blog of Centennial Foot and Ankle Specialists
Whether you are an existing patient or searching for a podiatrist in the Centennial, CO area, we're excited you are here. With the podiatry industry advancing, we recognize the importance of keeping our patients and visitors up to date with all of the new and exciting things taking place in our practice.
As we move forward with our blog, we hope to promote podiatric awareness as a vital part of your healthy, active lifestyle.Here you will find a variety of articles and topics including the latest developments in podiatry, podiatric treatments and helpful foot care advice from Dr. Robert Anderson, DPM, FACFAS and his staff.
We hope you find our blog to be helpful, engaging and informational to ensure the long-term health of your feet.
As always, feel free to contact us with any questions or concerns.
-- The Centennial Foot and Ankle Specialists Team
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