Plantar fasciitis and neuromas can be debilitating conditions, causing persistent heel pain and discomfort for those affected. Board-certified podiatrist Dr. Alan Shih at Head to Toe Healthcare, PLC in Southern Arizona advocates for alternative approaches when conservative treatments and surgery may not be the optimal solutions.
Plantar fasciitis, marked by inflammation in the plantar fascia, is a prevalent cause of heel pain. Factors such as poor foot structure, unsupportive footwear, and prolonged weight-bearing activities contribute to its development. Surgical interventions, including the cutting of the plantar fascia, are often considered for severe cases. Close to a third of patients have a heel spur visible on an X-ray. However, Dr. Shih emphasizes that such procedures compromise the foot's stability, potentially leading to increased stress on the remaining plantar fascia.
In the case of neuromas, a painful nerve condition commonly found between the 3rd and 4th toes, conservative treatments like cortisone injections and orthotics may not always provide lasting relief. While surgery is a common recommendation, Dr. Shih prefers a more nuanced approach. He advocates for surgical decompression of the nerve, preserving nerve anatomy to allow the nerve to function properly. This approach aims to alleviate discomfort without the risk of complications like stump neuromas, a concern when cutting out a nerve.
Dr. Shih clarifies, "I am not inherently against surgery but I believe it should be carefully considered." For neuromas, he emphasizes the importance of preserving nerve anatomy through decompression surgery, as opposed to the more common practice of cutting out a section of the nerve. This approach aligns with his commitment to maintaining nerve function while minimizing potential complications.
While surgical interventions are often the go-to option for recalcitrant neuromas and plantar fasciitis, Dr. Shih introduces Radiofrequency Ablation (RFA) as a viable alternative. Widely used in interventional pain medicine, RFA involves using radiofrequency energy to disrupt the painful signals in the nerves, providing relief without resorting to surgery.
Unlike cryotherapy, which can lead to the destruction of both sensory and motor nerves, RFA acts like a precision tool, isolating sensory nerves responsible for pain sensation. This targeted approach minimizes the risk of muscle function loss and foot deformities associated with broader nerve destruction. Dr. Shih highlights the safety and minimal invasiveness of RFA, often resulting in high patient satisfaction and a swift return to normal activities.
Dr. Alan Shih's approach to addressing chronic plantar fasciitis and neuromas emphasizes preserving nerve anatomy and exploring alternatives to traditional surgery. By advocating for surgical decompression and introducing Radiofrequency Ablation as a minimally invasive option, Dr. Shih offers hope to individuals seeking relief from persistent foot pain. As the medical field continues to evolve, non-surgical interventions like RFA may play a significant role in providing effective and efficient solutions for these common foot conditions.
