If you experience nagging heel pain when you wake up in the morning or after spending a significant time on your feet, you're not alone. The American Academy of Podiatric Sports Medicine (AAPSM) confirms that heel pain is the most common complaint among podiatric patients, affecting more than one million Americans each year.

The cause of the pain, most often, is Plantar Fasciitis - an inflammation of the tendon that runs along the arch of the foot from the heel to the toes. Fortunately, about 90% of all Plantar Fasciitis cases resolve with conservative treatment.

However, up to 10% of cases, or 100,000 annually, may become chronic, excruciating and debilitating. While invasive surgery has been the primary option to treat chronic Plantar Fasciitis, a new, minimally invasive technique promises pain relief and resumption of normal activities with fewer side effects.

"Coblation therapy is a relatively new procedure that uses low-temperature radiofrequency to destroy the nerve fibers in the inflamed tendon," explains Dr. Joseph Fox, a podiatric surgeon with Gramercy Surgery Center and more than 20 years of experience in treatment of musculoskeletal conditions of the foot. "The destruction of those fibers in the Plantar Fascia allow for immediate pain relief following coblation therapy, and we believe that new nerve fibers regenerate within about three months post-operative," Dr. Fox continues.

Indeed, recent back-to-back studies published in the American Journal of Sports Medicine confirm this theory. In the first study published in May, researchers at the University of California San Diego found that nerve fibers were significantly decreased, scarring was nonexistent, and pain relief was evident within two weeks of coblation treatment. The same researchers published a follow-up study in July, noting evidence of full nerve regeneration at 90 days post-treatment, and pain relief remained evident. The studies used a new coblation therapy device called Topaz, which allows surgeons to remove small amounts of dead nerves and/or tissue in the tendon (debridement) without affecting healthy cells.

"The coblation technology and the Topaz device are a source of hope for tens of thousands of patients each year who suffer a great deal of pain and debilitation from chronic Plantar Fasciitis, but who are unable or unwilling to undergo invasive surgery," Dr. Fox notes.

The Plantar Fasciitis Epidemic
Cases of Plantar Fasciitis are on the rise; in fact, the AAPSM calls heel pain associated with the condition a new epidemic. The reason for the increase, Dr. Fox says, is that Plantar Fasciitis is a repetitive stress, or overuse, injury. "The condition usually affects fairly athletic people between the ages of 40 and 60, and since Americans are living longer and staying active later in life, we are continuing to see more and more cases of these overuse injuries," he explains. Other factors that contribute to the development of Plantar Fasciitis include high arches, flat feet, and tight calf muscles or Achilles tendons.

Symptoms of Plantar Fasciitis include heel pain that intensifies after long periods of rest or sleep, when the tendon has a chance to tighten up, as well as after long periods of standing or motion using the feet, such as walking or running. Most cases respond well to conservative treatment, such as icing the foot (rolling a frozen water bottle with the bottom of the foot for 15 minutes several times a day), gentle stretching exercises for the calves, Achilles and Fascia, massage, anti-inflammatory medications and cortisone injections. When these fail, invasive surgery to release part of the tendon is an option. However, the risks associated with any invasive surgery - hemorrhaging, infection, lengthy recovery time and possible nerve damage - serve to make this surgery a last resort for most patients dealing with chronic Plantar Fasciitis.

"As new medical technologies are developed and refined, they can provide excellent alternatives to standard treatment protocols - particularly when those protocols carry certain risks that exclude certain patients," Dr. Fox points out. "Coblation therapy is proving to be one of these new technologies that can extend the benefits of healing and pain relief to more patients who need them," he concludes.

BIO: Dr. Joseph Fox
Dr. Fox is an adjunct professor emeritus at New York Downtown Hospital. He is a graduate of the New York College of Podiatric Medicine and did his surgical residency in the Maryland State Hospitals system. Dr. Fox also holds a Masters in Public Health (MPH) from Johns Hopkins School of Public Health. He has attending privileges at New York Downtown Hospital and St. Vincent's Medical Center. Dr. Fox has been practicing podiatry in New York for over twenty-five years. Through his extensive training, Dr. Fox can treat the entire spectrum of podiatry, from routine foot care to advanced podiatric surgery.

About Gramercy Surgery Center:
Gramercy Surgery Center was founded in 2006, to provide patients with friendly, high-quality, and professional care. Gramercy Surgery Center has received approval from NY State Department of Health under Article 28 CON. Gramercy Surgery Center is also Medicare-certified. The facilities offer patients and their families a comfortable, private, and friendly environment, quite opposite to the disturbing emergency and trauma situations that patients might encounter in a hospital environment, while providing the highest quality of care in all aspects of the surgical experience.