Plantar Fasciitis (Plantar fasciosis) is caused by swelling of the connective tissue that stretches from the base of the toes, across the arch of the foot, to the point at which it inserts into the heel bone. Also called "heel spur syndrome. The spur is almost never the cause of the pain.
Plantar Fasciosis (or heel pain) is commonly traced to a swelling on the bottom of the foot. Our practice can evaluate arch pain using the best modality which is diagnostic Ultrasound. Usually treatment is strapping of the foot along with a splint worn at night. Stretching exercises, icing and inserts are also used in most cases. Sometimes cortisone injections can be given as well. Dr. Bregman is one of the few doctors in the country performing injections into the fascia with a platelet rich plasma which is taken from the patient in an in office procedure. This actually allows the body to heal itself. Rarely surgery is indicated and is done endoscopically. We also perform shockwave treatment when indicated.
This condition is often misdiagnosed because using an Ultrasound is the only way to truly diagnose it. This also helps diagnose a nerve condition which may be responsible for the pain. If the pain is on the inside of the ankle area not on the bottom it is probably nerve pain. Often times both can be present. Special non-invasive nerve testing can be performed to diagnose nerve problems.
We offer several kinds of orthotics for people in various price ranges and use state of the art gait analysis equipment by Footmaxx.
We are now using State of the Art Topaz treatment for this condition which is a simple outpatient procedure with very tiny stab incisions and minimal downtime. This is using Coblation RF treatment. Please use the link below for current studies. www.clinicaltrials.gov
Coblation technique is not new and has been used for cosmetic surgery, spine, cardiac, neurosurgical, gynecological and urological surgeries. The technique is similar to an endoscopic plantar fasciotomy as far as recovery and usual incsion. However, there is no need for complete fasciotomy, which can be a draw back in the EPF procedure. There have been a few reports of dorsal midtarsal joint pain from loss of the Windlass effect after plantar fasciotomy. Post OP course is 1 week Non-Weighbearing then 4 weeks in walking boot or Cam Walker. Inflammatory postoperative swelling will decrease in three weeks. Sometimes, fascial nodules have been reported that can disappear, usually in twenty weeks.
To see a video example of the procedure performed on Patellar tendinosis, click here.