Plantar fasciitis is a common ailment often heard in the news for its effect on athletes but has the potential to affect non-athletes just as well.   Anatomically, the plantar fascia refers to tissue on the bottom surface (plantar surface) of the foot that spans from the heel all the way to the toes.   The area where the tissue attaches at the heel can become inflamed producing heel pain.  With plantar fasciitis the pain often manifests itself when first standing or walking in the morning.  This is because overnight or even after long periods of sitting, the plantar fascia tenses up so when standing and placing pressure on the fascia the pain is exacerbated.

There are risk factors in the development of plantar fasciitis including certain sports like running where there is continuous stress placed on the plantar fascia.  Obesity is also a risk factor since the increased weight places more pressure on the plantar fascia.  Shoe gear can also influence the development of plantar fasciitis.  Shoes with decreased arch support or a poor fit can increase the stress placed on the fascia.  Another risk factor is the biomechanics of one’s foot.  Pronation is a movement that occurs when the foot is rolled inward towards middle of the body so that the outside of the foot begins to lift off the ground.  When a person overly pronates as he or she walks the arch flattens and lengthens, putting tension on the plantar fascia.

Conservative treatment for plantar fasciitis includes applying ice and taking non-steroidal anti-inflammatory drugs to relieve the pain.  Physical therapy and night splints may help stretch the plantar fascia and relieve the tension.  Orthotic devices and padding can also be made to provide support and accommodation.  Steroid injections are also an option to alleviate pain. 

You don’t have to suffer from heel pain.   The physicians at Atlantic Foot and Ankle Associates take a conservative approach for the treatment of plantar fasciitis.  Make an appointment at one of our four offices conveniently located in Palm Coast, Orange City, Daytona Beach, and Port Orange and we’ll have you back on your feet… pain free!

By Dr. Andrew Green, DPM

Plantar warts are a common condition we treat at Atlantic Foot and Ankle Associates. They are noncancerous skin growths that commonly occur on the soles of your feet. They are caused by the human papillomavirus which enters the body through tiny openings or cuts in the feet. They most commonly occur in children or patients with autoimmune deficiencies.  Most plantar warts are not serious in nature, but if left untreated can spread to other parts of the body and even become painful.

They often occur as a small flesh-colored callus on the bottom of the foot. They typically have black pinpoint discoloration in the middle of the lesion which is a characteristic feature of plantar warts. They can present as a single lesion, as multiple lesions or one large lesion called a mosaic wart.

Left untreated they can potentially disappear on their own, but commonly take up to 7 years to do so. Because of its potential to spread and cause pain it is better to have it treated as soon as possible. Even though they are a virus they are not highly contagious.

There are many different treatment options for treating plantar warts such as topical treatments, injection therapy and laser destruction. We perform all these treatments at all four of our offices located in Daytona Beach, Palm Coast, Port Orange, and Orange City. Each treatment is chosen depending on the size, location and effectiveness of other treatments in the past.

The topical treatment is the most commonly used method of treatment in our office for single lesions. This consists of debriding (trimming) the wart and then applying a strong salicylic acid compound to the area. This is effective roughly 85-90% of the time. If unfortunately this method fails after two or three attempts then an injection therapy is usually performed. This is where we inject a live yeast under the wart and in response the body fights and rids both the yeast and wart simultaneously. If this too fails, then our laser method is our last line of defense for this condition. This is more aggressive in which we numb the area with a local anesthetic and then burn the wart with a high power laser. Though this is a highly effective treatment method it does have a downside in which there is an increase of healing time (3 to 4 weeks).

Preventive medicine is the best medicine for plantar warts. This consists of avoiding direct contact to warts, keeping your feet clean and dry, avoid going barefoot in public areas, don't pick at warts (this may cause them to spread), and washing your hands. If you feel you may have a plantars wart do not hesitate to treat it. The sooner it is treated, the better the outcome.

By Dr. Andrew Green, DPM