An important distinction needs to be made between an over-the-counter foot insert and a custom molded prescription orthotic. Any shoe insert that you by over-the-counter is nothing more than a piece of plastic with some foam. A shoe store, even if it’s a running shoe store, does not provide custom orthotic. A Custom molded prescription orthotic is made by a foot and ankle physician and involves taking biomechanical measurements, performing a gait analysis and incorporating any pathological foot or ankle conditions. Custom molded prescription orthotic can be made for athletic shoes, flats, dress shoes and even some high heels. The best custom molded prescription orthotics are made at Issaquah Foot & Ankle Specialists.
Please contact us if you have any questions, concerns, or if you would like to make an appointment at (425) 391-8666.
How long will it take for my heel pain to go away? This is a great question. Plantar fasciitis is one of the most common problems that we see at our clinic. Some people come in fairly quickly after the problem starts. These people can have fairly fast improvement and/or full recovery. Other people tough it out and wait to come in until several months or sometimes even longer than a year. The longer that you wait before treating this problem, the longer it will take for the problem to resolve in general. Also sometimes there is much more inflammation associated with the plantar fasciitis.
When a patient comes in to our clinic with plantar fasciitis or heel pain, we like to do ultrasound diagnostic imaging and evaluate the status of the plantar fascia. Most commonly, the inflammation is at the attachment site at the calcaneus or heel bone. The normal thickness of the plantar fascia in this location is 3–4 millimeters. If the plantar fasciitis is 6 mm or greater typically it is going to take some time for this to get better. In more severe cases the plantar fasciitis may be 8–10 millimeters thick and this will take much more work to resolve. The more severe cases can take several months before there is 90% improvement or better. In these cases there may even be a partial tear of the fascia. Usually if it is this severe, patients are put in a cast boot and we do a cortisone injection. But this is just part of the solution. The nice thing about a cortisone injection is that it offers immediate and fairly dramatic improvement. But if this was the only treatment that we provided, the problem very likely would recur.
We have to combine this with other treatments to make certain that the problem continues to improve and resolve. This includes mechanical support such as prescription orthotics good shoes and good house shoes (no barefoot!). For severe cases we also often utilize extracorporal shockwave therapy. This is a great treatment alternative to a cortisone injection. I actually recommend a cortisone injection or the shockwave therapy, but we don't combine these two treatments. These two treatments do not complement each other. Remember that the recovery time for plantar fasciitis is quite variable as we discussed above. And again, the more severe cases can "turn the corner" quite a bit quicker if a more aggressive treatment such as a cortisone injection or shockwave therapy is done.
Please contact us if you have any questions, concerns, or if you would like to make an appointment at (425) 391-8666.
There are a lot of treatments available for fungal toenails. Being that there are a lot of treatments available, this tells us that fungal toenail treatment can be challenging. The most affective techniques we have found is a combination of therapeutic approaches. We have an FDA approved laser that we combine with some topicals and an oral vitamin that has given us a very high success rate. Often times we are able to avoid oral medications that require liver function testing. Our protocol is the most successful protocol we have seen and it has taken us years to develop. Patients have seen dramatic improvement in their nails.
