Welcome to the personal website of

Dr. Michael A. Zapf, DPM, MPH, FACFAS, FACFAOM

Thank you for visiting the web site of Dr. Michael Zapf. He is a member of the Agoura-Los Robles Podiatry Centers

The "real" practice web site, the one that contains registration forms, doctor information for all the office and directions to the office is located at:

www.conejofeet.com   ç Click here

I am Dr. Michael Zapf. I have been offering a full range of podiatric medical services, from ingrown nails to heel pain and foot surgery, to my friends and neighbors in the Las Virgenes, Conejo and Simi Valleys since 1985. This is my personal web site. It has been up since 1990 and has received more than 2 million visits. The entire site is my responsibility only and nearly everything on the site was written by me. You are welcome to peruse this site and learn what you can about me, your feet and the problems your feet can develop. Things happen fast in medicine so whatever you read could well be outdated, especially if it was written many years ago. On this site you will read historic articles that I wrote for a lay audience as long as 25 years ago, so please do not take anything on this site as definitive or as applying directly to your condition. You may wonder why I have my own site even though there is also an official practice site. Well, my partners are of a younger generation raised on tweets, e-mails and iPhones. They want a professional site that they believe better represents the professional nature of our practice. They also believe that people no longer take the time to read anything of length. I, on the other foot, think there is still a world out there full of people who still read lengthy descriptions of problems and solutions. if you are one of those old fashioned readers, then this site if for you. Let me know what you think. Let me know you are out there.

Please note that all information and photographs on this site are copyrighted by me, Michael Zapf, DPM, and cannot be used for any private or commercial purposes. I work with two other podiatrists in my practice who may or may not share any of my ideas and philosophy. Do not expect them to practice the way I do or even believe in any of the speculation I present here. If you appreciate what I have written and want me to be your treating doctor, you will have to ask for me specifically. Even if my office says at first, " He is booked until next month",  I still want to see you as long as you are a little flexible with your schedule. If your visit is an emergency, I know that  you will be happy with either of my associates, Dr. Darren Payne or Dr. Steve Benson. They are exceedingly well trained and capable in any foot emergency.

 

Michael Zapf, DPM, MPH, FACFAS, FACFAOM     (If you want to know what all those initials mean, click here   è  

Our office phone number is (818) 707-3668 and my e-mail address is zfootdoc [at] doctor [dot] com

Agoura Hills Office: 28240 Agoura Road, Suite 101, Agoura Hills, CA 91301

Thousand Oaks Office: 555 Marin Street, Suite 290, Thousand Oaks, CA 91360

For the address, hours and registration forms please see the practice web site: www.conejofeet.com


07/24/2010HomeNews+FAQShock Wave

 

To Order Foot Supplies è ç click

For Information about Laser Treatment for Fungal Nails Click hereè
 

For information about Shockwave Therapy for heel pain          click here è

Exciting news!!! New Thousand Oaks Location  è

 

 

Radiofrequency Ablation
A New Tool in Our Practice for Heel Pain and Neuromas
Michael Zapf, DPM, MPH, FACFAS
Darren Payne, DPM, AACFAS

 

Great news for people with HEEL PAIN and NEUROMAS - May 1, 2007
 

Radiofrequency ablation (RFA) is a non-surgical procedure used to treat neuroma and heel pain. After local anesthesia, a physician guides a catheter with an electrode at its tip to the area of a nerve lesion like a neuroma or to a painful tissue like the plantar fascial where it inserts on the heel bone. Then a mild, painless radiofrequency energy (similar to microwave heat) is transmitted to the tissues causing an injury to the nerves in the area that will result in less or no pain from the neuroma or plantar fasciitis. RFA is used by cardiologists for correcting heart beat irregularities and oncologists for treating some tumors. We are the first doctors in the northern Los Angeles—Ventura area to use RFA in the foot.

RFA is done either in the office with local anesthesia or at the surgery center or surgery hospital with sedation. For the neuroma three or four areas of the nerve are treated and for heel pain treatment involves three to six areas of the nerves. Post-operative care involves a strapping of the foot and tennis shoes for a few days.

 

Here is where RFA is used in the foot  (fOR hEEL pAIN sEE bELOW)

1. NEUROMAS

- A swollen and painful trapped nerve usually located between the 3rd and 4th toes but could also be between the 2nd and 3rd toes. Neuromas and trapped nerves can occur elsewhere in the foot and in areas of a scar.

    Self—home treatment
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bulletWider, softer and more cushioned shoes
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Over-the-counter insoles

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Ice therapy

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Diagnostic work-up in the office
               
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bulletPhysical examination
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X-rays to rule out boney causes

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Ultrasound to measure the size (more than 5mm is significant)

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        Office treatment

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Up to three cortisone injections

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Custom orthotics with neuroma pads

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Series of 4% alcohol injections (mild “mini” neuroablation) one week apart for 8 weeks. For more into ->

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RFA IS DONE HERE "BEFORE SURGERY" IN THE TREATMENT PATHWAY

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Theory of RFA for NEUROMAS: The RFA will “kill” enough of the nerve that pain relief will be great enough that surgery can be eliminated or postponed. The  regenerated nerve is not as painful as it was before the RFA.

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              Surgery

RFA should be tried before surgery in which the neuroma is removed under local anesthesia with sedation at any of our local surgery locations. Rarely is this done in the office.

 

 2. HEEL PAIN - PLANTAR FASCIITIS Inflammation of the plantar fascia where it attaches at the heel bone often accompanied with bursitis and first-step pain.

 Self- home treatment:

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 Heel lifts

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Over-the-counter insoles

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Stretching exercises

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Ice therapy

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Diagnostic work-up in the office

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Physical examination

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X-rays to look for spurs or stress fractures

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Ultrasound to measure the thickness of the plantar fascia (More than 5mm thick is significant)

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          Office treatment

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Up to three cortisone injections

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Anti-inflammatory pills

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Custom orthotics

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Night splint

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Physical therapy

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RFA IS DONE HERE "BEFORE SURGERY" IN THE PATHWAY OF HEEL PAIN TREATMENT

Theory of RFA FOR PLANTAR FASCIITIS: The pain of plantar fasciitis is transmitted by several nerves that can be inactivated by RFA to give time for the body to “heal” the area. The tissue is injured and healing ends the pain,

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            Surgery

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 Shockwave treatment—ESWT—done usually in the office under local anesthesia For more info -->

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 Plantar fasciotomy done in the office or at the surgery facility under local anesthesia -->

 

 

 

   

 

 

 

 

 

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Copyright © 2000 Michael A. Zapf, D.P.M., F.A.C.F.A.S., F.A.C.F.AOA.M.
Last modified: July 24, 2010