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Non-steroidal treatment for painful foot & ankle conditions

By Dr. Nicole Freels, FACFAOM

Non-steroidal treatment for  painful foot & ankle conditionsHave you ever wondered how an athlete can recover so quickly from a foot or ankle injury? Sometimes, it seems almost miraculous. One minute, they’re being carted off the field and then, two weeks later, they are back in the game playing as hard as ever.

What’s the secret? Well, there are several!
First, of course, we’re talking about elite athletes in top physical condition. They train constantly, strengthening their muscles, tendons and ligaments so they can withstand the punishment. They use the right equipment – including shoes – to protect their feet and ankles.

They try, for the most part, to eat a nutritious diet that provides the vitamins and minerals their bodies need to stay healthy and regenerate after injury. They receive nearly immediate care when they do get hurt.

They have access to experts: nutritionists, athletic trainers, massage therapists and physicians who employ the latest research findings to help them return to the field safely and quickly.

For more than 20 years they’ve had another advantage in healing that is just now becoming available to the general public: Platelet Rich Plasma Therapy, or PRP for short.

What is PRP?
Platelets are a component of blood. Thinking back to high school, you probably remember learning about the red blood cells, which carry oxygen throughout the body and the white blood cells, which are integral in fighting off infection. But you have probably forgotten all about platelets.

Platelets are small, colorless cells that circulate throughout the blood stream and aid in healing. When you cut yourself, platelets rush to the injury site and bind together, stopping the bleeding. They contain healing growth factors that can decrease inflammation and pain, improve tissue healing (tendons, plantar fascia, ligaments), and increase angiogenesis (formation of new blood supply).

In PRP, we draw some of the patient’s own blood into a tube (just like when you get a lab test). The blood is placed in a centrifuge and spun around very quickly, causing the different cells to separate from one another. We remove the concentrated platelets and inject them into and around the affected area. This concentration of platelets can contain five times or more of the usual amount of growth factors found in whole blood. This is especially helpful to patients who have poor circulation or for injuries that occur where blood flow is typically limited.

The area will be painful at first, but the pain can be successfully managed with Tylenol and ice. Following the injection, the affected area is immobilized (typically with a boot and/or crutches) for about two weeks. This allows the concentrated platelets to begin healing the injured area while preventing further injury.

Patients return to the office in two weeks for re-evaluation. If necessary, PRP therapy may be provided a second, or even third time.

PRP is quite safe and has been used to treat musculoskeletal conditions for more than 20 years.

Patients love it because it promotes natural healing.
In fact, both Tiger Woods and LA Dodgers pitcher Takashi Sarto have used PRP to help them recover from injury. It’s useful in the treatment of both acute and chronic conditions, including peroneal tendonitis, posterior tibial tendonitis, plantar fasciitis, Achilles tendinitis, ankle ligament sprains, and osteoarthritis.
PRP if not recommended for patients who:
• have metastatic disease
• have a tumor
• have an active infection
• have a low platelet count
• are pregnant or breastfeeding

Superior to steroid injections?
Steroid injections have been a staple in the treatment of painful foot and ankle conditions for decades. The benefits of steroid injections are many, including almost immediate relief with limited side effects.

However, some patients are allergic to certain steroid injection components and cannot receive this type of direct anti-inflammatory. Because PRP uses components of the patient’s own blood, the risk of an allergic reaction is extremely low, if not non-existent.

Many patients prefer the PRP approach because it employs your body’s own natural healing properties. We at Lexington Podiatry are pleased to offer this option to our patients. Please give us a call at (859) 264-1141 to learn more.

Dr. Nicole Freels, FACFAOM, is a podiatrist with Lexington Podiatry. Her office is located at 2700 Old Rosebud Road in Lexington. Visit her on the web at or call the office at (859) 264-1141.

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