There continue to be new advances in all facets of medical care and that certainly includes treatment of the foot and ankle. I would like to discuss a few of the revolutionary ideas that have become important and effective treatments in the care of the foot and ankle.
1. Alcohol Sclerosing injections for Morton’s neuroma. Historically a pinched nerve at the ball of the foot has been treated with cortisone injections, custom orthotics and special pads under the foot. If this failed to relieve the symptoms, surgery was usually recommended. We now have a very viable alternative to surgery that works effectively in most people; in fact, studies show a success rate as high as 89 percent. The treatment is a series of alcohol sclerosing injections. The dehydrated alcohol injections have a high affinity for nerve tissue and are used to “deaden” the nerve impulses in the diseased nerve. Especially for people who would like to avoid the potential risks associated with surgery, this series of injections has proved to be an effective alternative.
2. Topaz coblation radiofrequency treatment of tendons and plantar fascia. Tendonitis and plantar fasciitis is often treated with oral anti-inflammatory medication, stretching, icing, activity modifications, bracing and taping, cortisone injections, and physical therapy. Most people get better with these treatments; about 10 percent do not. The Topaz procedure has been developed as a minimally invasive alternative to open surgery, with a sports medicine background. It includes a probe that is inserted into the damaged area of tendon or fascia, under light anesthesia. The low temperature radiofrequency treatment initiates a healing process of the chronic tendonitis or fasciitis.
3. Bleomycin treatment for plantars warts. Warts on the bottom of the foot, termed plantar verruca, are a viral infection in the outer layers of the skin. Traditional treatments include acid patches and anti-viral creams. Freezing or burning the warts are often the first line treatments in doctors’ offices. This will often work; in some cases, it does not penetrate deep enough to eliminate the plantars wart. People often talk about a wart “coming back,” however in most cases, the wart was not fully eliminated. Bleomycin is a highly effective injection used to eliminate warts. We deliver the injection using a Dermo-Jet “needle-less system.”
There are several other recent advances in the treatment of the foot and ankle that are exciting and proving to be highly successful, including wound care alternatives and surgical techniques. I will discuss some of these in a future column.
We are located in the Santa Clarita Valley Medical Plaza, at 26357 McBean Parkway, Suite 250, in Valencia. For more information, please call 661-260-1180.