Robert Rosenstein, DPM
Jennifer Zienkowski, DPM
Michael Coppers, DPM
CONDITIONS AND TREATMENTS
SWELLING
Plantar fasciitis is the term commonly used to refer to heel and arch pain traced to an inflammation on the bottom of the foot. More specifically, plantar fasciitis is an inflammation of the connective tissue, called plantar fascia, that stretches from the base of the toes, across the arch of the foot, to the point at which it inserts into the heel bone. Overpronation is the most common cause of plantar fasciitis. As the foot rolls inward excessively when walking, it flattens the foot, lengthens the arch, and puts added tension on the plantar fascia. Over time, this causes inflammation.
Also known as heel spur syndrome, the condition is often successfully treated with conservative measures, such as the use of anti-inflammatory medications, ice packs, stretching exercises, orthotic devices, and physical therapy. Note: Please consult your physician before taking any medications. In persistent cases, Extracorporeal Shock Wave Treatment (ESWT) may be used to treat the heel pain.
Extracorporeal Shock Wave Therapy (ESWT) is used to treat chronic heel pain (plantar fasciitis). "Extracorporeal" means "outside of the body." During this noninvasive procedure, sonic waves are directed at the area of pain using a device similar to that currently used in nonsurgical treatment of kidney stones.
Extracorporeal Shock Wave Therapy is prescribed for patients who have experienced plantar fasciitis for an extended period of time -- six months or more -- and have not benefited from other conservative treatments. The brief procedure lasts about 30 minutes and is performed under local anesthesia and/or "twilight" anesthesia. Strong sound waves are directed at and penetrate the heel area to stimulate a healing response by the body. ESWT is performed on an outpatient basis. Although there are no bandages, someone will need to drive the patient home.
People who are not candidates for ESWT include pregnant women and individuals with neurological foot disease, vascular foot disease, pacemakers, or people taking medications that interfere with blood clotting (such as Coumadin).
This therapy is a safe and effective alternative treatment for heel pain and only requires a short recovery time. Clinical studies show a 70 percent success rate for treatment of plantar fasciitis using Extracorporeal Shock Wave Therapy.
Swelling of the feet, ankles and legs, also known as edema, is often caused by an abnormal build-up of fluids in ankle and leg tissues. Painless swelling of the feet and ankles is a common problem, particularly in older people. It may affect both legs, including the calves and/or thighs. Because of gravity, swelling is particularly noticeable in the lower legs. Swelling in the legs and feet may also be a symptom of other, more serious health issues, such as heart failure, renal failure, or liver failure.
Common causes of foot, ankle, and leg edema include:
- Blood pressure-lowering drugs.
- Body fluid overload.
- Burns.
- Certain antidepressants.
- Congestive heart failure.
- Diagnostic tests.
- Environment.
- Estrogens and progestin oral contraceptives.
- Extremity surgery.
- Generalized allergy.
- Glomerulonephritis or other kinds of kidney disorders.
- Infiltration of an intravenous site.
- Injury or trauma to the ankle or foot.
- Insect bite or sting.
- Long airplane flights or automobile rides.
- Long-term corticosteroid therapy.
- Medical treatments.
- Medications.
- Menstrual periods (for some women).
- Pregnancy (mild to severe swelling).
- Prolonged standing.
- Starvation or malnutrition.
- Sunburn.
- Testosterone.
- Venogram.
- Venous insufficiency (varicose veins).
You can mitigate swelling by elevating your legs above the heart while lying down. Avoid sitting or standing without moving for prolonged periods of time. Avoid putting anything directly under the knees when lying down, and don't wear constricting clothing or garters on the upper legs.
Exercising the legs causes the fluid to work back into the veins and lymphatic channels so that the swelling goes down. Mild pressure applied by elastic bandages or support stockings can help reduce ankle swelling. A low-salt diet may also help reduce fluid retention and decrease the ankle swelling.




