Pain in the Foot
Three years ago, Robert Martin, at the age of 59, was on the brink of losing his job. As a group leader for process mechanics at a biopharmaceutical company in North Carolina鈥檚 research triangle, Robert鈥檚 job was physically demanding, keeping him on his feet 8 to 10 hours a day. For 19 years he has been working with mechanics, walking from place to place across the expanse of his company鈥檚 manufacturing facility to make sure systems stayed running efficiently. That kind of day to day physical demand on his body, combined with his love for running and the outdoors, began to cause severe foot pain. The pain became so excruciating that Robert started to find it difficult to get out of bed in the morning, let walk and stand at his job all day.
His foot pain began in 2008. Robert was an avid runner, clocking x miles per week and whose hobbies included white water kayaking, camping, wilderness trekking, and climbing. His weekends were trips into nature, enjoying life to its fullest. However, once the foot pain set in, he gave up his favorite activities but neglected to visit a doctor right away. Instead, he suffered from the pain for five years before making his first of many doctor appointments. 鈥淓verything hurt,鈥� says Robert. 鈥淓ven mowing the lawn hurt. I would come home from work, and I couldn鈥檛 do anything but sit, put my feet up, and feel them throbbing.鈥�
The first podiatrist Robert saw was an individual in private practice; he refers to as Doctor X. Dr. X diagnosed Robert with plantar fasciitis, a common cause of heel pain. It involves inflammation of a thick band of tissue that runs across the bottom of the foot and connects the heel bone to the toes. It鈥檚 accompanied by stabbing pain that usually begins with a person鈥檚 first steps in the morning and can be exacerbated by body weight and periods of long-standing or heavy physical activity.
Doctor X initially suggested surgery. Robert declined, saying, 鈥淚 prefer to have treatment without surgery because I don鈥檛 think there鈥檚 anything a knife can do to help.鈥� Dr. X gave him injections, provided shoe recommendations and inserts, but everything seemed ineffective in the end. 鈥淚 just didn鈥檛 feel like he was listening to me or answering my questions,鈥� Robert explains, which is why he booked an appointment with Dr. Kashefsky, DPM, Associate Professor and Podiatrist in the Division of Vascular Surgery at 大象传媒 Chapel Hill.
It鈥檚 been a long road since Robert walked into the office of Dr. Kashefsky in late 2016. Dr. Kashefsky not only diagnosed him with plantar fasciitis but also found Robert suffered from neuropathy and metatarsalgia, a condition in which the ball of the foot becomes painful and inflamed. His symptoms included sharp or shooting pain, numbness, or tingling in his toes and pain that would worsen when he stood and walked 鈥� especially barefoot on hard surfaces. Although generally not serious, metatarsalgia can sideline patients, as it had done with Robert.
鈥淲e obtained a thorough history and physical,鈥� Dr. Kashefsky explains. 鈥淒uring my examination, I talked with Robert and physically examined his foot to find out where his pain was coming from so I could see for myself where it was hurting him.鈥� Dr. K as his patients refer to him as, made some specific recommendations to Robert. They began with new footwear. Robert purchased a pair of OOFOS recovery sandals which he used around the house, no longer able to walk around barefoot.
The next step for his life outdoors was a pair of Hoka鈥檚, a specialty athletic sneaker. At the same time, he started to get physical therapy, and Dr. K wrote him a prescription for orthotic shoe inserts from Limbionics in Durham. 鈥淭hese four things eliminated 90% of the pain,鈥� says Robert.
The next thing they did together was work on Robert鈥檚 body mechanics. Dr. K gave him some recommendations and worked with him to change his walk to put less pressure and pull on certain joints. 鈥淲hen I walk,鈥� says Robert, 鈥淚 stomp. Dr. K recommended I elongate my stride to distribute the weight. We discussed the mechanics of the feet and the body. Dr. K was really great at explaining and helping me understand my body and habits so that I could help myself reduce the strain I was putting on my own body.鈥�
The final step in Robert鈥檚 treatment was receiving Extracorporeal Shock Wave Therapy (ESWT). ESWT is an 18-minute non-surgical procedure used to聽cure chronic plantar fasciitis, Achilles tendonitis, tennis elbow, shoulder tendonitis, and other聽chronic tendinopathies. 鈥淭he ESWT equipment we have is not something that most practices have access to,鈥� says Dr. K. 鈥淯nfortunately it鈥檚 not currently covered by insurance, but I have yet to have a patient sorry they spent the funds to get the treatment, in fact, the feedback I鈥檝e gotten is that they wished they had done it sooner.鈥�
Dr. K talked with Robert about the ESWT treatment, pros, and cons and let him decide if he wanted to move forward with it. 鈥淚 decided I was willing to pay for it myself to get rid of the pain,鈥� says Robert. 鈥淲ithin a month, the pain was gone, my feet don鈥檛 hurt, and I鈥檓 on them all day. It really is a lifestyle change, a complete 180 from my life before. The whole series of treatments from the ESWT to the shoes and body mechanics got me back to where I want to be. I鈥檓 no longer kayaking on class 3 or 4 rivers. Instead, I鈥檓 doing white water canoeing, paddling class 1 and 2 and doing some overnighters, once again able to have fun in the outdoors.鈥�
Patients with foot and ankle problems don鈥檛 have to suffer with pain but can seek treatment from the 大象传媒 Podiatry Center. The caring medical professionals at 大象传媒 Health Care collaborate to improve the comfort and increase the independence of their patients. 鈥淒r. Kashefsky cares about his patients,鈥� says Robert. 鈥淗e never mentioned surgery, at any of our appointments because he understood from the beginning it wasn鈥檛 what I wanted. The whole practice was first-rate, top tier service. Everyone I interacted with including the guy behind the reception desk at check to Dr. K, were great. It was a good experience, and I highly recommend others not wait and suffer with the pain when there are solutions out there.鈥�