In the News

Plantar Fasciitis-My Heel is Killing Me!

By: Dr. Lauren Perica, D.P.M.

                Heel pain can be debilitating.  The physicians at Valley Podiatry Associates know firsthand just how difficult living with heel pain can be and the best ways to treat it.  But, what exactly is heel pain?

                Heel pain can be caused by several different disorders, but the most common cause of heel pain is known as plantar fasciitis.  Plantar fasciitis is an inflammation of tissue called the plantar fascia that starts in the heel bone, runs along the bottom of the foot and attaches to the toes, creating the arch of the foot.   When this tissue becomes irritated and inflamed it causes pain in the heel known as plantar fasciitis.  The most common symptoms of plantar fasciitis are pain in the bottom of the heel or arch, difficulty walking or standing, pain first thing in the morning or after rest and pain at the end of the day.  Each patient may experience heel pain in slightly different ways, but for the most part is all caused by the inflammation of the plantar fascia. 

                There are many type of treatment for plantar fasciitis.  To start, patients should seek treatment by a Podiatrist for evaluation and diagnosis.  Once diagnosis is confirmed treatment can include a regimen for inflammation reduction such as icing, stretching, supportive shoes, orthotics and possible anti-inflammatory medication such as steroid injections as tolerated, but when the standard treatments for plantar fasciitis fail to relieve symptoms, more advanced therapy may be warranted.

 At Valley Podiatry Associates, one of the more advanced and effective treatment options for plantar fasciitis includes extra corporal activation therapy or EPAT.  EPAT which is similar to shock wave therapy is performed at a physician’s office, is non-invasive, safe, requires no medications or lengthy procedures, is effective and will help get you back on your feet and back to your life.  The EPAT machine produces a pulse wave therapy to increase blood flow to the injured tendon or fascia also bringing the nutrients needed to heal the injury.  Patients receive anywhere from three to six treatments per foot, the sessions last approximately fifteen minutes and patients are able to walk out of the office the same day.  The EPAT treatment will also continue to have benefits and continue to decreased pain and improve function for about twelve weeks after treatment has ended. 

In a survey of Valley Podiatry Associates patients who underwent EPAT treatment for chronic heel pain, 80% of patients state that the treatment significantly improved their quality of life by having less pain and improved walking.  Patients were able to return to their previous activities, for instance one patient states, “(I am in) much less pain, actually walked 18 holes at a golf tournament.”  And 90% of patients would recommend EPAT therapy to a friend or family member.  On average the pain level before starting EPAT was a 9/10 on the pain scale and after completion of EPAT the pain was a 2/10 with many patients at a 0-1/10 pain scale. 

                Overall, EPAT therapy is safe, effective and has a high success rate.  For patients suffering with plantar fasciitis there are many treatment options out there, it is important not to ignore the symptoms of heel pain, seek medical treatment and know that no matter how painful, there is hope of walking one day without pain.             


Summer Sun and Good Foot Care

By: Dr. Lauren Perica, D.P.M.

Summertime in New England is one of my favorite times of year; it is sunshine, sandy beaches, BBQs and of course, summer footwear. For a lot of people summer is flip-flops, sandals and going barefoot, but this time of year can be particularly difficult for those suffering from foot pain.  As a Podiatrist, the summer months are a time of increased foot pain, calluses, splinters and heel pain.  Heel pain or plantar fasciitis is also a common complaint at the end of summer. Plantar fasciitis causes pain in the bottom of the heel or along the arch of one or both feet. This disorder is caused by inflammation of the plantar fascia that can be triggered by improper or unsupportive shoe gear, such as flip flops and excessive barefoot walking. For treatment, I advise a stretching routine, anti-inflammatories, proper shoe gear, orthotics, and icing. Other treatment options include use of a night splint, custom orthotics, EPAT, physical therapy and for more severe cases surgery.  
But what constitutes good shoes? I advise all of my patients to avoid cheap, flimsy, unsupportive sandals and flip flops, which can lead to a lot of foot pain and problems by the end of summer. When choosing summer footwear, be sure you are choosing shoes that support your arches, do not excessively rub or irritate and still protect your feet.  Swim shoes are also a great idea when going to the beach to avoid stepping on those sharp rocks and shells. I never advise walking barefoot and don’t forget to pack your sneakers on your summer vacation for those long days of sightseeing, trust me your feet will thank you. And remember, the use of proper footwear is key to a happy and healthy summer.  

MassLive Article on FootCare by Dr. Lauren Perica

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