Dr. Joel W. Brook describes treatment options for common ailments like plantar fasciitis, bunions, and Achilles tendon pain.
What is involved with getting my bunion fixed?
We recommend fixing bunions only if they are painful, progressively getting worse, or make it difficult to comfortably wear shoes. The severity of your bunion determines the appropriate repair procedure. With each procedure, the goal is to realign the joint, relieve the pain and discomfort, and correct the deformity. This is accomplished by a day surgery procedure, and most patients are able to immediately walk without crutches. Greater than 80 percent of our patients stop taking pain medication three to four days after surgery. The long-acting anesthetic Exparel minimizes postoperative discomfort for most bunion repair procedures. Patients can typically begin to cross-train one to two weeks post-op and get back into some form of regular shoes in about a month. It can take several months for all the swelling to resolve.
Any new and improved treatments for my plantar fasciitis?
Many of the mainstay therapies are still quite effective. We recommend patients become involved in an aggressive stretching or therapy program. Most patients benefit from the arch support provided by either custom or prefabricated orthotics and the limited use of anti-inflammatory medication. In cases where these are not effective, there are other options. The first is EPAT–extracorporeal pulse activation technology. This uses shockwaves to stimulate the healing of chronically inflamed tissues. This is performed in-office and has been effective 80 to 90 percent of the cases used. The second is a nerve ablation procedure called Neurotherm. This is a pain management tool that uses radiofrequency waves to disrupt the pain signals from the nerve in the heel. Surgery is the last option and rarely utilized.
Is the dull pain I have in my Achilles tendon something I need to be concerned about?
Achilles tendonitis is one of several sports injuries that affect people of all activity levels. Pain is not normal. Whether dull or severe, pain associated with any tendon, especially the Achilles, should be evaluated. Early intervention can prevent long-term or severe sequela. Pain is an indication of inflammation, and long-standing inflammation can lead to damage or rupture of that tendon. Typically, treatment involves stretching, physical therapy, possible short-term immobilization, as well as oral and/or topical anti-inflammatory medications. Chronic tendon inflammation also responds well to EPAT therapy. Advance studies, such as MRI, may be necessary to fully evaluate the extent of the injury or determine the need for surgery.
I hate my fungal toenails. What can I do get rid of them?
Onychomycosis is the medical term for fungal nails. The first step is to appropriately diagnose the condition. This is done with clinical examination and a painless biopsy of the nail. Different treatment options and topical therapies are available. These are cost-effective, but in and of themselves are not the most effective way to eradicate this infection. We have found them to be a good adjunctive treatment to other therapies. Oral anti-fungal medications are an option available to some patients. Although safe, many patients choose not to use these as they can have a negative effect on the liver. State-of-the-art treatment involves the use of laser therapy. This is a painless treatment that is effective in greater than 80 percent of our patients and has no side effects.
Is it necessary to have my child’s feet examined?
In the vast majority of cases, no. Your pediatrician is aware of normal and developmental milestones. Parents can become concerned if they feel that their children’s feet are flat or pointing in or out, if they walk on their toes or they see other disturbances in gait. Your child’s feet are unique as they are growing, and their growth plates have not completely developed. If you suspect that your child’s feet or ankles are not developing correctly, or if your child has sustained a foot injury or ankle injury an examination of the feet can help differentiate between what is normal and when there is a problem. The parents can expect to come away from the visit feeling well educated about their children’s feet and whether any treatment is indicated. We use conservative treatments to make remedying your child’s condition as easy for you and your family as possible. We start with the least-invasive approaches, only moving to more involved treatments as needed.
Dr. Joel Brook, D.P.M., M.S., F.A.C.F.A.S, is a Dallas, Texas-based podiatrist. Dr. Brook has been named a D Best Doctor numerous times for his dedication to foot care and ankle care. Dr. Brook specializes in:
- Reconstructive Surgery
- Bunions and hammertoes
- Pediatric and adult flatfoot
- Tendon ruptures
- Wound care
- Keryflex nail reconstruction
- Laser therapy for fingernail and toenail fungus
- Injectable fillers for the relief of forefoot pain and/or to add padding in the forefoot to wear high heels comfortably
- Diabetic Foot and Wound Care
- Ingrown Nails, Warts, and
- Other Foot/Ankle related Skin Conditions
- Pediatric Foot and Gait Issues
- Tarsal tunnel
Contact Dallas Podiatry Works, foot and ankle care specialists, to find out how to alleviate heel pain, ankle problems, sports injuries, foot pain, plantar fasciitis and more. New patients can reach Dallas Podiatry Works at 972-947-9608.