"After my athletic injury, I had met with several doctors in the Northern Virginia area… many were quick to diagnose, quick to jump into surgery, and quick to misdiagnose. Dr. Pontell not only examined my foot via MRI, Xray, Ultrasound and in person – he explained EVERYTHING to me... After completely healing, at 38 years old I can run longer, and run faster than I ever had been able to run before – even before my injury. I’m in the best shape of my life. I tell everyone all the time that I am able to do what I do because of him - my foot he reconstructed is a million times stronger than my uninjured foot." -A.D.
"I went to Dr. Hallivis based on his reputation and his extensive experience. He definitely stood up to his reputation. He was professional, friendly, approachable and knew everything there was to know about my problem. He treated me and my pain resolved in 2 days. His office ran on time and his staff was warm and helpful. I would recommend him to anyone with a foot problem.” - M.H.
Athlete’s Foot Treatment
If untreated, skin blisters and cracks caused by Athlete’s Foot can cause serious bacterial infections. The treatment of Athlete’s Foot depends on the type and extent of the fungal infection, so it is important to consult our practice before choosing a therapy.
Athlete’s Foot can usually be treated with antifungal creams. Reinfection is common, so it is important to continue the therapy as prescribed, even if the fungus appears to have gone away. Lasting cases of Athlete’s Foot may require foot soaks before applying antifungal creams. Severe infections that appear suddenly (acute) usually respond well to treatment. Toenail infections that develop with Athlete’s Foot tend to be more difficult to cure than fungal skin infections.
Cryotherapy is a standard treatment for warts that uses a very cold substance (usually liquid nitrogen) to freeze and deaden the tissue. Cryotherapy can be done in a doctor’s office and takes less than a minute.
During the procedure, the doctor applies the liquid nitrogen to the wart using a probe or a cotton swab. Liquid nitrogen can also be sprayed directly on the wart. The freezing liquid can cause discomfort or pain, which is why a numbing drug (local anesthetic) is sometimes used.
Most cryotherapy treatment requires return visits to ensure that the wart is completely removed. Studies show that cryotherapy is successful about two-thirds of the time, and when combined with salicylic acid treatment, up to 78% of the time.
Extracorporeal Shock Wave Therapy (ESWT)
Extracorporeal Shock Wave Therapy (ESWT) is used to treat chronic heel pain (plantar fasciitis). “Extracorporeal” means “outside of the body.” During this noninvasive procedure, sonic waves are directed at the area of pain using a device similar to that currently used in nonsurgical treatment of kidney stones.
Extracorporeal Shock Wave Therapy is prescribed for patients who have experienced plantar fasciitis for an extended period of time — six months or more — and have not benefited from other conservative treatments. The brief procedure lasts about 30 minutes and is performed under local anesthesia and/or “twilight” anesthesia. Strong sound waves are directed at and penetrate the heel area to stimulate a healing response by the body. ESWT is performed on an outpatient basis. Although there are no bandages, someone will need to drive the patient home.
People who are not candidates for ESWT include pregnant women and individuals with neurological foot disease, vascular foot disease, pacemakers, or people taking medications that interfere with blood clotting (such as Coumadin).
This therapy is a safe and effective alternative treatment for heel pain and only requires a short recovery time. Clinical studies show a 70 percent success rate for treatment of plantar fasciitis using Extracorporeal Shock Wave Therapy.
Iontophoresis is a procedure used to treat excessive sweating in the hands or feet. The procedure involves one or a series of short, 10- to 20-minute sessions in the doctor’s office during which a light electrical current is passed through water into the feet. The current is gradually increased until the patient experiences a slight tingling sensation. It is believed, although not clinically proven, that this process plugs up the sweat glands.
Neurolysis is a therapeutic procedure used to treat neuromas. During this nonsurgical procedure, the affected nerve is chemically destroyed via seven weekly injections of ethanol mixed with a local anesthetic. Because nerve tissue has an affinity for ethanol, it absorbs the substance, which, after repeated exposure, becomes toxic and destroys the pain-causing nerve. Neurolysis has a success rate of more than 60 percent. However, this treatment modality is not widely accepted by insurance companies.
Physical therapy can often help decrease the pain and swelling in a painful area of the foot or ankle. Heel spurs, bursitis, plantar fasciitis, bunions, corns, and calluses, as well as many post-operative surgical conditions, respond well to physical therapy.
Common kinds of physical therapy may include hot packs, massage, paraffin baths, electrical stimulation, ultrasound, and diathermy (deep heating of tissues through use of electric current) to relieve pain and swelling, increase range of motion, prevent joint stiffening, rebuild muscle strength, and support the proper alignment of foot structures.