Welcome to the Website of

Dr. Michael Zapf, DPM, MPH, FACFAS

 Thank you for visiting my website. I have been placing information and articles on this site for many years and have received millions of  hits during that time (and not that many of them were mine). I have designed it for people who like to read about their foot and ankle problems. Since I started the web site, I have added two associates to my practice, Dr. Darren Payne and Dr. Stephen Benson.  Since my site is filled with just my thoughts and opinions they are not, necessarily, shared by my colleagues. To see our less controversial (and less windy) practice web site, I offer you: www.ConejoFeet.com, the practice site for The Agoura Los Robles Podiatry Centers (ALRPC). The ALRPC practice site has a lot of material about our office, many of our policies and the registration forms to be filled out before your visit. I suggest all prospective patients visit www.ConejoFeet.com.

 I made the web site to give my patients the extra depth information that I don’t always have time to cover in the office visit. Visitors who are not my patients are welcome to browse the information found here. My younger colleagues are both under 50 and they, like many their age, do not favor in depth reading. They prefer their information presented to them in a few short, crisp bullet points. I, being of the, ahem, older generation, like to read about my ailments in greater depth. Here, I present the greater depth. If you ask a question about heel pain or bunions that I have not answered in my two monographs, I will quickly add it so that it is as complete as I can make it. If you agree with this philosophy, welcome to my page. If you correspond with me please let me know if you like the in depth reporting.

 Remember, this site is in no way intended to tell you how your own ailment or problem should be treated, only the approach I use when confronted with certain situations. Your problem may well be different from what you think it is and should always be evaluated by the appropriate professional, whether podiatrist, orthopedist or other authority. Please understand that I, nor anyone else, can offer you a proper diagnosis or treatment plan without seeing and feeling the problem at hand (foot?).  Happy reading.

 Sincerely, Michael Zapf, DPM, MPH, FACFAS, FACFAOM

 P.S. All the information in this web site is © by me and it is mine alone. No picture or any of the articles cannot be used by anyone without permission from me, personally.

 


01/08/2012HomeNews+FAQShock Wave

 

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And from Tracey:

I have a few questions regarding my painful neuroma.  I began treating with
my Podiatrist approx. 9 months ago.  He began with medications (Bextra)
then oral steroids along with shots.  Four months into treatments he advised that
having my bunion removed with help with placement of my foot which may alleviate
pain. 

I am going to start this answer by making a big assumption: that you do in fact have a neuroma. If you do, I personally do not use anti-inflammatory medications or oral steroids for a neuroma pain. When you squeeze the nerve in a neuroma the pain is very sharp - almost like getting stabbed with the tip of an ice pick. I do not think that any pain medicine can solve this type of pain. I will inject them with cortisone in an attempt to shrink the neuroma and provide what is all too often only temporary pain relief. I would never suggest that having a bunion repaired would help a neuroma unless it was a highly unusual one involving the first interspace (between the first and second toes). I have never heard anyone suggest that a bunionectomy will help a neuroma. Very curious.

 
It has been over two months since my bunionectomy (Left foot)  which went very
well.  I went back to work sooner than expected and and doing quite well with it.
The problem is that the pain to the other area Neuroma has not subsided.  In fact
now that I am back on my foot regularly because I am recovered from bunionectomy the neuroma pain is getting worse everyday.
 

That would have been my guess.

 

My Doctor keeps injecting it and switched me to Celebrex and yet another round
of Steroids.  He is convinced that most neuromas can be cured without surgery.
I am wondering if I should see a different doc.  My current doctor came highly recommended buy I am tired of the pain, along with the shots I have been continuing to get.  Alcohol along with others.  He's tried them all. 
 

Well, you cannot say you did not get conservative treatment. Personally I would have done the neuroma surgery at the same time as the bunion so there would only need to be one recovery. I am not sure why your doctor is shying away from the neuroma surgery. If cortisone injections (3), alcohol injections and oral anti-inflammatory medications have failed then you have little to risk.

 

How long should I continue with treatment options?  I prefer to have surgery and
get it over with so I can get on with my life.  I am also wondering since the ball of my foot is killing me and it clicks when I wiggle my toes with my hand, but the most nagging pain I am experiencing is under my SECOND toe not so much the
third and fourth.  Could it be possible one neuroma is causing all this pain, tingling or could I have more than one neuroma??
 
 Well, now you bring up the concept of metatarsalgia under the 2nd metatarsal head or at the 2nd metatarsophalangeal joint. This is the ever famous so-called predislocation syndrome that I talk about elsewhere on the web site. If you have this condition, and not a neuroma, then I understand your doctor's reluctance to do surgery. [See how difficult it is ot answer questions without seeing the foot.] Neuroma surgery is quick, easy and successful. Surgery for metatarsalgia is not highly successful and sometimes not all that easy. Ask your doctor which you have: metatarsalgia of the 2nd MPJ or a neuroma. Neuromas hurt with compression of the forefoot (such as with shoes) and not walking barefooted on a hard floor surface. Metatarsalgia is worst barefoot on a hard surface and less painful in a shoe, especially a padded shoe.

Good luck!

 
Tracey
Chesterfield, Michigan

   

 

 

 

 

 

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Last modified: January 08, 2012