Case Study #1
HILT for chronic Plantar Fasciopathy with Plantar Fibroma
Patient: K.D.
CC:
Heel pain, left
HPI:
A 41-year-old female complaining of well localized pain to the plantar aspect of her left heel for
the past 6 months. Previous x-rays confirmed heel spur. She relates a history of plantar fasciitis
2 years ago treated with a series of 3 cortisone injections and a walking boot which provided
significant improvement. She describes aching and throbbing ranging from 5-9/10 to her left
heel. She notes pain especially with early morning ambulation.
Treatment has included cortisone injection, Amniotic Membrane/Umbilical Cord Particulate,
taping of foot, night splint, application of ice and elevation all of which have failed to provide
improvement. The pain limits the activities of daily living.
Baseline Diagnostic MSK US, 10/12/2018 performed at BUMC:
The central band of the left plantar fascia is markedly thickened at the calcaneal origin site and
diffusely hypoechoic, measuring 7 mm in thickness at the proximal aspect, consistent with
plantar fasciitis. There is adjacent fusiform hypoechoic thickening of the plantar fascia
approximately 2 cm from the proximal insertion which measures 1.0 x 1.1 x 0.5 cm, consistent
with a plantar fibroma. Elasticity evaluation demonstrates predominantly low velocities
throughout the imaged plantar fascia and plantar fibroma.
Findings consistent with chronic left plantar fasciitis with an associated 1.1 cm plantar fibroma
located approximately 2 cm from the proximal insertion.
Follow-up Diagnostic MSK US s/p HILT, 10/09/2019 performed at BUMC:
Decrease in size of the hypoechoic lesion in the central band of the left plantar fascia,
currently measuring up to 6.3 mm in the largest AP diameter compared with 11.1 mm on
ultrasound examination dated 10/12/2018
Follow-up Diagnostic MSK US s/p HILT, 5/05/2020 performed at SimonMed Imaging:
Interval increase in length and slight interval decrease in thickness of the small plantar
fibroma in the central limb of the left plantar fascia currently measuring 14 mm
anterior-posterior by 4 mm craniocaudal compared to 6.3 mm anterior posterior by 4.9 mm
craniocaudal on the ultrasound examination of 10/9/2019. The patient does not have pain in
this region with transducer pressure. Interval improvement of left plantar fasciitis with
decreased thickness of the proximal central plantar fascia.
Testimonial Case Study #1
High Intensity Laser Treatment for Plantar Fasciitis and Plantar Fibroma
Plantar fasciitis is by far one of the most painful conditions that a person can experience and I
had been suffering for well over 5 years when I came to see Dr. Bocian. My pain level was a
constant 10 out of 10. Getting out of bed in the morning was so painful, I could no longer leave
this untreated. I was desperate for help.
I had previously been given multiple injections, worn a walking boot, slept in a night brace, all
with no relief. After an extensive evaluation, Dr. Bocian suggested a trial injection (human
amniotic membrane and umbilical cord matrix). This treatment brought no relief, again.
I was beginning to consider surgery by now. I had heard and read many testimonials about
unsuccessful surgical procedures so I was not convinced that was the best decision.
At this point in my treatment, Dr. Bocian recommended that I undergo a series of High Intensity
Laser Treatments. I was wary but willing to try it in order to avoid surgery.
The simple treatment was provided in the doctor's office by his friendly, professional staff. I had
been informed that I might not feel relief until I received several treatments. I began to feel minor
relief after approximately 4-6 treatments. The progress was slow, but I continued to receive the
treatments.
When I received the final treatment, I would rate my pain at a 4 out of 10. This was a huge
improvement after having been in so much pain for so long. The pain continued to decrease
even after I had finished the treatments. It has now been several months since my final
treatment and I am thrilled to say I have no pain at all.
The laser treatment not only gave me my life back, but it also saved me from undergoing
surgery that likely would not have worked. I recommend this treatment to anyone who suffers
from plantar fasciitis.
K. D.
10/23/2019
Case Study #2
HILT for chronic Non-insertional Achilles Tendinopathy
Patient: Y.S.
CC:
Pain Achilles tendon, proximal to insertion os calcis, right
HPI:
A 60 year old female complaining of burning and aching pain 10/10 to her right Achilles tendon
proximal to its insertion into the heel bone for the past 1-1/2 years. She notes pain with early
morning ambulation. She denies any history of trauma. The pain limits the activities of daily living.
Treatment included a cortisone injection in December 2019, 6 to 8 weeks of physical therapy, night
splint and a below the knee walking boot.
Baseline Diagnostic MSK US, 10/23/2020 performed at SimonMed Imaging:
Mild diffuse thickening of the right Achilles tendon compared to the left with severe insertional
tendinosis and multiple calcifications. No definitive right Achilles tendon tear is seen.
Follow-up Diagnostic MSK US s/p HILT, 02/23/2021 performed at SimonMed Imaging:
There is interval improvement in appearance/heterogeneity of the insertional distal right
Achilles tendon compared to the prior study.
Moderate insertional tendinosis of the right distal Achilles tendon with interval improvement
compared to the prior study. Mild thickening of the right mid Achilles tendon consistent with
mild tendinosis compared to the contralateral left side.
Testimonial Case Study #2
High Intensity Laser Treatment for Chronic Non-insertional Achilles Tendinopathy
In April of 2019, I injured my Achilles tendon. I was diagnosed with Achilles tendonitis. For 18
months prior to laser treatment, I experienced constant burning, sharp, and aching pain 10/10. I
had difficulty walking, climbing ladders, or standing for long periods of time. I could not rest my
heel on the couch. I had to keep a pillow under my calf so the heel was not touching anything. In
the morning there was extreme pain putting my foot on the floor and walking.
Prior treatment included use of a night splint, stretching exercises, walking boot, soaking in
Epsom salt, heat, ice, elevation, physical therapy, orthotic devices, and cortisone injection. I was
informed there was nothing more that could be done, and I had to “deal with the pain”.
The pain interfered with activities of daily living including riding my ATV, walking the dog,
standing to make meals, practicing T’ai Chi and riding a bike. I could not remain on my feet for
long periods of time.
I received 10 High Intensity Laser Treatments (HILT) beginning on October 28, 2020. I noticed
an improvement in the pain and mobility levels. Immediately following the final HILT, on
February 23, 2021, the pain was gone. Mobility was increasing exponentially. I currently have a
100 percent recovery.
Three years since completing Dr. Bocian's High Intensity Laser Treatment (HILT), I have no pain
and no mobility issues. 100 percent improvement continues. Quality of life has returned. No
limitations to physical exertion.
I highly recommend Dr. Bocian's High Intensity Laser Treatment (HILT). I am not only extremely
satisfied with the outcome but overjoyed to get my life back. The noninvasive treatments are
perfect for recovery. The insightful discovery of utilizing the HILT for Achilles tendonitis was
brilliant!
Y.S.
9/24/2023
Case Study #3
HILT for Morton’s Neuroma
Patient G.L.
CC:
Painful Morton’s neuroma, left
HPI:
This 57-year-old male complaining of intermittent sharp, stabbing, knife-like pain 9/10 and
constant dull aching pain to the plantar aspect of his left forefoot for the past 12 months. The
pain occurs after walking > 1/2 mile. He notes occasional tingling to his toes. The pain
interferes with his ability to golf.
Treatment has included 2 cortisone injections and a series of 6 alcohol sclerosing injections all
of which have failed to provide any significant improvement.
Baseline MRI 10/27/2015 performed at SimonMed Imaging:
15 x 5 x 11 mm Morton's neuroma at the second interspace. Associated second intermetatarsal
bursitis.
Follow-up baseline MRI 9/30/2016 performed at SimonMed Imaging:
No significant change in size or appearance of the second interspace Morton's neuroma since
10/27/2015. Decreased second intermetatarsal bursitis.
Follow-up MRI s/p HILT 8/18/2023 performed at SimonMed Imaging:
Concern for an 8 x 3 mm Morton's neuroma involving the second webspace, at the level of the proximal phalangeal bases, which appears decreased in size from prior exam dated
9/30/2016 (previously measuring 12 x 5 mm)
Testimonial Case Study #3
High Intensity Laser Treatment for Morton's neuroma
I began experiencing Intermittent sharp stabbing, knife-like pain 9/10 to the plantar aspect of my
left forefoot in 2014. The pain occurred after walking > 1/2 mile and interfered with my ability to
golf.
Prior treatment Included 2 cortisone injections and a series of 6 alcohol sclerosing injections
which failed to provide any significant improvement.
I completed a series of laser treatments for Morton's neuroma left foot in 2015 which eliminated
the pain for the past 8 years. I experienced near 100% relief of pain for 8 years following
treatment.
I am currently experiencing some slight recurrence of pain at a lower level to the plantar aspect
of my left forefoot. The pain occurs if I step directly on the area while golfing at the end of a
round. I am still free of pain during daily activities.
I have recently developed pain in the plantar aspect of my right forefoot. MRI confirmed
Morton's neuroma of the second webspace, right foot.
I have recently started laser treatment for Morton's neuroma, right foot. I have also requested
additional laser treatments for my Morton's neuroma, left foot.
Overall I am extremely satisfied with the result of laser treatment for Morton's neuroma. I would
definitely recommend this treatment. It has helped me immensely and has improved my quality
of life.
G.L.
9/29/2023
