What the heck is plantar fasciitis?  Well if you ever had severe heel or arch pain from getting up in the morning and it goes away during the day and then comes back again after you’ve been sitting.  Then you have plantar fasciitis.

90% of foot problems are inherited.  You can be born with a high arch foot or a foot that flattens out too much.  It may never bother you until later in life or until you are very active.  And because you are not getting proper support in your shoes you can start pulling and stretching a ligament on the bottom of your foot called the plantar fascia.  This ligament is very elastic and because when you go to bed at night you sleep with your feet going down.  This can cause the ligament to contract up so that when you first get up in the morning it’s very tight and can cause you severe pain.  The problem is that it comes and goes so most people will ignore it thinking it will go away by itself

Plantar fasciitis can be very painful.  Many people try home remedies or suggestions that they pick up off the Internet.  Most of these only help a little. If you have severe pain then you need to see a podiatrist.

Your podiatrist will recommend x-rays to make sure that there is no other problems going on inside your foot or heel.  There are many different treatment options to help alleviate your pain.  95% of the time conservative care will get rid of your pain and stop it from coming back.  These treatments include cortisone injections, night splints to keep your foot up while you’re sleeping.  Special straps can be used during the daytime.  Over-the-counter arch supports and custom orthotics.  Most times oral anti-inflammatories are not that effective.  In  extremely rare cases when treatment is not working physical therapy can be recommended.

Most recent articles have discussed Podiatrists treatment options from across the country with patient’s with plantar fasciitis.  The one thing that they all agree upon is that surgery is rarely recommended.  And should only be considered when all other treatments have failed and should not be considered for at least 6 months up to 1 year from the start of treatment..

Contact your local experienced podiatrist who can treat you properly. Howard J. Tzorfas D.P.M.


Why be concerned about falling?

  1. Falls and fall-related injuries are the leading cause of accidental death in older people.
  2. Half of seniors who fall, will fall again within a year
  3. Nearly half of the seniors who fall reduce their activity after a fall
  4. Most fractures among older adults are caused by falls

What if you or your loved ones could wear a simple brace in their shoes to prevent falling or injury.  There is a new prescribed custom made ankle foot orthosis designed to easily fit into most shoes.   By wearing this brace it stabilizes the foot in the presence of weakness and fatigue.  It stimulates skin receptors providing feedback to the brain.  Also it provides ankle support, improving balance and helps avoid falls by reducing postural sway.  It also provides foot clearance reducing the risk of tripping.  It can be easily put on and removed.  Extremely light weight.

Contact your local podiatrist to see if he or she provides this brace for their patient's.  Itinvolves an office visit where the patient's gait is analyzed and fiberglass casts are made of both feet.  Takes about 20 minutes for casting andthe braces usuallyarrive in 3-4 weeks.  Medicare and most insurances approve 100%.

 Diabetic Foot Care

The key to successful management of diabetes is keeping your blood sugar stable and taking good care of your feet every day.

Routine visits to a podiatrist are extremely important.

You should be inspecting your feet every day.  If you cannot reach them, then get a mirror and make sure your look at the bottoms of your feet and between your toes carefully.

You should look for the following changes.

  1. Red swelling and hot sensation (possible infection)
  2. Drainage or blood
  3. Foul odor
  4. Ingrown toenails
  5. Red streaks
  6. Pale or blue skin
  7. Numbness, tingling or burning sensation

Any of these changes can be signs of severe problems associated with diabetes.  Please see your podiatrist so he or she may evaluate them. Infections occur very quickly with diabetics, so never assume that these changes in your feet are something to be ignored.

Infections can develop and lead to limb loss or even death.

If you have diabetes, it is important to purchase the proper shoes.  Poorly fitted or incorrect shoes often are responsible for infections and even amputations.

Diabetic shoes are covered by Medicare, so if you are a diabetic, contact your local podiatrist for evaluations and to be fitted for Diabetic shoes. 

Leg Pain - Getting Help Does Not Always Mean a Hospital Visit

Leg pain, cramping, swelling, numbness or skin discoloration is common complaints that physicians hear from their patients.

About 33 percent of the estimated 9 million adults with Peripheral Arterial Disease (PAD) experience physical signs or symptoms of such intensity of frequency that they should seek medical help if they have not already done so.

Understanding and managing PAD is a process that requires specially trained medical practitioners who often use specific testing equipment to help determine the cause of the symptoms.

Usually patients will go to their GP when they experience episodes of leg pain, cramping or other signs of leg discomfort.  The GP normally refers that patient to a hospital vascular lab that specializes in the evolution and management of arterial leg pain.  But with new technology, we can now provide a baseline test in our office and still get immediate feedback from a specialist who will interpret the test

Leg pain can be caused by many different health disorders.  The diagnostic process begins with the practitioner taking a thorough medical history of the patient.  Based on the history, the practitioner will decide upon a course of action that may include further diagnostic testing.

 Diagnosing Leg Pain

Specialized equipment is sometimes called for when diagnosing PAD.  A new development in diagnostic technology well suited to GP offices is PADnet, which measures functional status of the limbsby recording segmental blood volume and communicates results immediately via a web interface to specialist for interpretation; these measurements provide practitioners with a clear measurable sign of what is going on with the patient’s lower extremity arterial systems.  PADnet is actually a group of tests that contributes to the overall diagnostic process.

Anyone experiencing leg pain or discomfort should first seek medical advice from his/her physician.  To ensure an accurate diagnosis, however, patients should speak to their doctors to see if they may be a candidate for a PADnet test.  For more information, contact your podiatrist. 


By Howard J. Tzorfas, D.P.M

New Treatment for Heel and Tendon pain.

Plantar fascitis typically caused by inflammation of the plantar fascia can cause heel pain and may also cause severe arch pain.  Tendinitis can occur in many different places in your foot including your Achilles tendon on the back of your heel,  and also around the top and sides of your foot.  These conditions can become very painful and can take many months to treat.

Treatments for these problems may  include cortisone injections, oral anti-inflammatories, custom-made arch supports, and physical therapy.  If these conditions don’t improve with conservative treatment  then, sometimes surgery is an option.

 Many of these conditions are caused because the  ligaments and tendons start to weaken as the body gets older.  There is a new oral supplement that is available in our office to help strengthenthe  ligaments and tendons. Colig-10 is a completely safe oral supplement taken twice a day for at least a few weeks to a month which supports ligaments and tendons.

Vitamins, grape seed, green tea and alpha lipoic acid are all-natural and combined into one pill. All of these nutrients can help heal and strengthen your tendons and ligaments.  This supplement is used in conjunction with other treatments to help you heal quicker and to avoid surgery.  Please contact our office if you have any questions.

                                                                                         HowardJ. TzorfasD.P.M.

New Insights For Treatment For Fungal Toenails

Fungus toenails can affect millions of people every day.  This condition causes toenails to appear yellowish, thickened, crumbling and can sometimes can be very painful.  This fungal infection can be very difficult to treat and can spread to all the toenails and sometimes to the fingernails.  It is recommended to have it treated because it will not go away by itself. 

Fungus develops underneath the nail and is caused by trauma which could easily be from banging or bumping toenails on a daily basis.  It is also aggravated by wearing closed shoes and constant perspiration or sweat.  Some people who have poor immune systems such as diabetics, cancer patients on chemotherapy, peripheral vascular disease can also have severe fungus toenails.

 There are 100s of different treatments for fungus toenails and it can take months up to years for a complete cure.  The first step for treatment is identifying the type of fungus, molds or yeast which is causing the infection.  The newest fungal culture can actually identify the genus and species of the fungus and can give proper treatments which will work on that specific fungus.  This is called a genetic molecular fungal culture. 

The #1 oral treatment is Lamisil tablets and has been around for over 20 years.  It has been   proven to be very effective and safe.  In rare cases it can cause liver enzymes to be elevated and it is recommended to have a liver function test performed after being on the medication for about a month.  Topical medications that have been an  effective range from over-the-counter medications that are dispensed in the podiatrist office such as formula 3 has been shown to be extremely effective with the other treatments.  Prescription topical medications have been shown to be effective but because there is no generic for these medications many prescription plans are not covering these treatments.

Though it appears that treating fungus toenails is very difficult, it can work and complete cures are possible.  It is obvious that the worse that the toenails are then more difficult it is to get rid of it.  Therefore it is recommended not to wait otherwise it will cost you more time and money..  For more information contact your local podiatrist.

                                                                                        Howard J. Tzorfas D.P.M.

Something New in Podiatry

In the past few years there have been many new technological advances coming out.  Finally there is something new for Podiatrists.  Podiatrists treat foot and ankle conditions on a daily basis.  One of the treatments for many of these conditions are custom made arch supports called orthotics.

Custom orthotics are able to be worn in many different shoes and sneakers and can relieve painful foot conditions such as flat feet, plantar fasciitis, tendinitis, and other foot problems.  These devices also can prevent future problems such as bunions, hammertoes, arthritic joints.  Custom orthotics have been made from a cast or mold of the patient’s foot.  These molds or casts then have to be sent to a laboratory where they are fabricated.  Special corrections can be placed into the orthotic for individual problems.  Many times these molds or casts are not that accurate and time prohibitive.

Just this month there is a new casting method.  It utilizes a digital scanner and an IPAD.  This revolutionary device can capture a 3-D image of the patient’s foot in a matter of seconds.  Corrections can easily be added and then images sent electronically to the laboratory.  The end result is a more accurate image or impression with decrease time in both scanning and making of orthotics.  Most insurance companies will cover or pay for the orthotics. For more information contact your local Podiatrist.

Young Women and fungus toenails

Fungus toenails are a very common toenail infection.  It can cause the toenails to become thick, yellow, discolored and many times become painful.  It can occur in almost any age group but effects mostly older adults because of their poor circulation and poor immune system.

It also is caused by trauma to the nail which could easily be from constant bumping and banging. Another possible cause might be from constantly being in closed shoes with excess of moisture and perspiration.  For many years fungus toenails in young women including teenage girls was a very rare occurrence.

There has now been a 10 fold increase in the amount of young women getting fungus in their toenails.  One of the possible causes is from overuse of nail polish during the winter months.  In the winter women tend to wear closed shoes, socks and/or stockings.  This can cause excessive perspiration and moisture which is a breeding ground for fungus toenails.  In addition continuous use of nail polish does not allow the nail to breath.

Once the fungus gets into one toenail it can spread to all the toenails and can even go to fingernails.  Treatment for this infection can take months and even up to years to get a complete clearing.

It is recommended to check your toenails every couple weeks.  Take the polish off your toenails and check to see if you have any yellowish or discoloration.  If you do, contact your local podiatrist so he can make a full evaluation and do a fungal culture.  Then, he can get you on the proper treatment for this problem.

                                                                                         Howard J. Tzorfas D.P.M.

Why do I need Diabetic shoes?

Diabetic shoes are specially constructed to protect your feet.  They are also  ”extra–depth” to accommodate special inserts which are custom made.  Special features and materials combine to provide your feet with extra protection they need.  Diabetics are prone to getting infections and ulcerations.  These shoes help prevent these problems and many more.  Medicare has shown that providing proper foot wear they have helped decrease the amount of amputations in the United States by 85%.

Medicare plus secondary insurance will pay 100% for one pair of diabetic shoes and 3 pairs of custom inserts per calendar year.  The inserts are made of a soft spongy material which only lasts for a few months.

Our office carries the #1 diabetic shoes in the country.  Please go on to their and you will see 100s of shoes from which to choose.

 In order to qualify for this program you must first make an appointment and come into our office for an examination.  We then perform a digital scan of your feet and measure your feet.  Your order is then sent through electronically and the shoes arrive in about 3 weeks.

Please call Dr. Howard J. DPM 908-236-6999.

New Treatment For Plantar Warts

Plantar warts are a virus that causes a growth on the bottom of your feet or toes.  It is caused by a tiny cut or nIck in the skin.  Once it enters the skin the pounding on the feet causes them to get deeper or spread.  There are many different treatments available for plantar warts.  Many of them can be very painful and have along  recovery.

Utilizing NASA technology a new cryosurgical device called CRYOPEN has been developed. Long thin Copper aluminum alloy tubes are kept frozen to -140° in a liquid helium chamber.  It is completely safe and no gases are exposed to the environment.

Treatments involve first having the top layer of the dead skin trimmed away. This is done painlessly.   Then the properly sized tube is applied directly to each of the warts for approximately 60-90 seconds.  There is minimal discomfort during and after the treatment.  These treatments slowly remove the warts and are performed on a monthly basis.  Many warts require only 2 to 3 treatments.  Bandages and medications are usually not required.

This technique is very child friendly because it requires no needles or injections, minimal discomfort, and performed quick as 60-90 seconds.  Please call our office if you have any questions at 908 236 6999.