Medically reviewed by Dr. Tom Biernacki, DPM · Board-Certified Podiatric Surgeon · Last reviewed: April 2026 · Editorial Policy
Quick Answer
For Cardiologists & Vascular Surgeons: Managing PAD Fee relates to foot pain — typically caused by overuse, footwear, or biomechanics. Most patients improve in 6-12 weeks with conservative care. Same-week appointments in Howell + Bloomfield Twp: (810) 206-1402.
✅ Medically reviewed by Dr. Thomas Biernacki, DPM — Board-Certified Podiatrist · Last updated April 6, 2026
For Cardiologists & Vascular Surgeons: Managing PAD Feet at Balance Foot & Ankle
Peripheral arterial disease creates a cascade of lower extremity complications that require coordinated management between vascular and podiatric specialists. Here is how we support your patients’ foot health in the context of their vascular disease.
PAD Foot Complications We Manage
- Non-healing wounds: Ischemic ulcers and wounds complicated by PAD require specialized offloading and wound care in addition to revascularization
- Gangrene prevention: Early intervention for ischemic tissue at risk, monitoring for wet gangrene development
- Nail care for anticoagulated patients: Patients on anticoagulation cannot safely perform home nail care — we provide safe medical nail care
- Edema management: Dependent edema from venous insufficiency + arterial disease creates complex wound environments
- Post-revascularization foot care: After angioplasty or bypass, healing patterns change — wound care protocol must adapt accordingly
- Biomechanical offloading: Redistributing pressure away from ischemic tissue while maintaining function
Our Vascular Foot Assessment Protocol
For every patient with known or suspected PAD, our assessment includes:
- Pedal pulse documentation (dorsalis pedis, posterior tibial)
- Capillary refill time and skin temperature mapping
- ABI (ankle-brachial index) if not recently obtained
- Skin integrity and wound documentation with photography
- Tissue perfusion assessment — are conditions suitable for wound healing?
- Coordination with your vascular team when perfusion findings suggest intervention is needed before wound care can succeed
MLS Laser Therapy for Microcirculation
Our MLS dual-wavelength laser therapy has demonstrated measurable improvement in microcirculation and wound healing in patients with moderate PAD. While laser cannot replace revascularization in severe ischemia, it can meaningfully accelerate healing in patients with adequate perfusion by:
- Stimulating angiogenesis (new capillary formation) in the wound bed
- Reducing the inflammatory burden that impairs PAD wound healing
- Accelerating cellular ATP production for accelerated tissue repair
The Vassallo Coordination Model
Our Howell office coordinates with Vassallo Medical Group (same road — Grand River Ave) for patients with diabetes, vascular disease, and systemic conditions. Coordinated care for Livingston County patients.
📞 (810) 206-1402 | Howell, MI
Compression for Venous + Arterial Mixed Disease
Mixed arterial-venous disease requires careful compression management. We work closely with your vascular team to select appropriate compression levels for patients with mixed disease — avoiding high compression that could compromise arterial perfusion while still managing venous hypertension.
Compression products we recommend: Medical-grade graduated compression stockings in appropriate mmHg for the patient’s ABI and clinical picture.
Refer PAD Patients to Us For
- Ongoing wound care between your vascular interventions
- Pre-amputation limb salvage attempts
- Post-revascularization wound monitoring and healing support
- Preventive foot care for PAD patients without active wounds
- Nail care and callus management for anticoagulated patients
Call us at (810) 206-1402 for urgent referrals. We communicate back to your office with every visit note.
✅ MLS Dual-Wavelength Laser — FDA-cleared
✅ EPAT Shockwave Therapy — 80%+ success rate
✅ Magnetotransduction (EMTT) — Deep electromagnetic healing
✅ 3D-Scanned Custom Orthotics
✅ Toenail Fungus Laser
✅ In-Office X-Ray & Ultrasound
✅ Diabetic Shoe Program — Medicare-covered
📞 (810) 206-1402 | Howell & Bloomfield Hills
Clinical Foot Care Beyond Products: Michigan’s Balance Foot & Ankle
Michigan patients using foot care products — wound care supplies, topical treatments, foot supplements, compression garments, orthotics, or stretching devices — as part of their foot health routine benefit from occasional clinical evaluation to ensure the products they are using are appropriate for their specific condition and that no developing pathology requires professional intervention. At Balance Foot & Ankle, our clinical evaluation confirms the diagnosis, assesses whether current product-based management is adequate, and identifies cases where professional treatment would produce better outcomes than continued self-management.
For Michigan patients managing chronic conditions — diabetic foot care, neuropathy management, post-surgical recovery, or persistent tendinopathy — regular podiatric check-ins at appropriate intervals ensure that small changes are caught before they become significant complications. The right interval varies by condition and risk level: high-risk diabetic patients benefit from quarterly visits; stable patients using products for minor chronic conditions may need only annual check-ins. At Balance Foot & Ankle, we help patients identify the appropriate visit frequency for their specific situation. Livingston and Oakland County patients can call (810) 206-1402 to schedule at our Howell or Bloomfield Hills office.
Related Treatment Guides
- Peripheral Arterial Disease Foot Care
- Plantar Fasciitis & Heel Pain Treatment
- Custom 3D Orthotics
- Sports Foot & Ankle Injury Treatment
Michigan patients experiencing foot or ankle problems can schedule an appointment at Balance Foot & Ankle — with locations in Howell (4330 E Grand River) and Bloomfield Hills (43494 Woodward Ave #208). Call (810) 206-1402 for same-week availability.
Medical References & Sources
- American Podiatric Medical Association — Patient Education
- American Orthopaedic Foot & Ankle Society — Foot Conditions
Join 950,000+ Learning About Foot Health
Dr. Tom shares honest medical advice, supplement reviews, and treatment guides you won’t find anywhere else.
Subscribe on YouTube →📍 Located in Michigan?
Our board-certified podiatrists treat this condition at two convenient locations. Same-day appointments often available.
Managing PAD and Foot Circulation Issues?
Our podiatrists work closely with cardiologists and vascular surgeons to provide coordinated care for patients with peripheral arterial disease and circulation-related foot problems.
Clinical References
- Criqui MH, Aboyans V. Epidemiology of peripheral artery disease. Circ Res. 2015;116(9):1509-1526.
- Gerhard-Herman MD, et al. 2016 AHA/ACC guideline on the management of patients with lower extremity peripheral artery disease. Circulation. 2017;135(12):e686-e725.
- Armstrong DG, et al. Diabetic foot ulcers and their recurrence. N Engl J Med. 2017;376(24):2367-2375.
Insurance Accepted
BCBS · Medicare · Aetna · Cigna · United Healthcare · HAP · Priority Health · Humana · View All →
Howell Office
3980 E Grand River Ave, Suite 140
Howell, MI 48843
Get Directions →
Bloomfield Hills Office
43700 Woodward Ave, Suite 207
Bloomfield Hills, MI 48302
Get Directions →
Your Board-Certified Podiatrists
Ready to Get Back on Your Feet?
Same-week appointments available at both locations.
Book Your AppointmentMore Podiatrist-Recommended Foot Health Essentials
Hoka Clifton 10
Max-cushion everyday shoe — podiatrist favorite for walking and running.
PowerStep Pinnacle Insole
- The Pinnacle Full length insoles for men & women provide maximum cushioning, from high activity to moderate support. The PowerStep arch support shape provides stability to the foot and ankle, helping to relieve foot pain.
- When you spend all day on your feet, every step counts. PowerStep insoles are a podiatrist-recommended orthotic to help relieve & prevent foot pain related to athletes, runners, Plantar Fasciitis, heel spurs & other common foot, ankle & knee injuries
- The Pinnacle plantar fasciitis insoles offer superior heel cushioning and arch support. The dual-layer cushioning is designed to reduce stress and fatigue, while PowerStep premium arch support is designed for plantar fasciitis relief.
- The PowerStep Pinnacle arch support inserts for men & women can be worn in a variety of shoe types such as; athletic, walking, running, work & some casual shoes. Orthotic Inserts are ordered by shoe size, no trimming required.
- Made in the USA & backed by a 30-day money-back guarantee. PowerStep orthotic inserts for men & women are designed for shoes where the factory insole can be removed. HSA & FSA Eligible
The podiatrist-recommended over-the-counter orthotic.
OOFOS Recovery Slide
- The Original Recovery Footwear.
- Finding Your Size - For your perfect fit, consult the “size chart” link above. Wear a half size? In general, we recommend that women who wear a ½ size size UP, and men who wear a ½ size size DOWN
- OOahh - An evolution of the OOriginal, the OOahh slide features our proven foundation of OOfoam technology + patented footbed design with a slide-style strap that has become a best-seller in the OOFOS line
- OOfoam Technology - Our revolutionary OOfoam technology absorbs 37% more impact than traditional footwear foams to reduce the stress on your feet, joints & back. Plus, the closed-cell foam is machine washable and designed to minimize odor
- Patented Footbed - Our patented footbed cradles and supports arches to reduce energy exertion in the ankles by up to 47% compared to competitors’ footwear. So walking is easier. Recovery is faster. And yOO feel better
Impact-absorbing recovery sandal — wear after long days on your feet.
As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. Product recommendations are based on clinical experience; prices and availability shown above update live from Amazon.
When to See a Podiatrist
If foot or ankle pain has been bothering you for more than a few weeks, home care alone may not be enough. Balance Foot & Ankle offers same-week appointments at our Howell and Bloomfield Hills clinics — no referral needed in most cases. Bring your current shoes and a short list of symptoms and we’ll build you a treatment plan in one visit.
Call Balance Foot & Ankle: (810) 206-1402 · Book online · Offices in Howell & Bloomfield Hills
Pros & Cons of Conservative Care for foot care
Advantages
- ✓ Conservative care first
- ✓ Same-week appointments
- ✓ Multiple insurance accepted
Considerations
- ✗ Self-treatment can mask issues
- ✗ See a podiatrist if pain >2 weeks
Dr. Tom’s Recommended Products for foot care
Affiliate disclosure: As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. We only recommend products we use with patients.
Footnanny Heel Cream Dr. Tom’s Pick
Best for: Daily moisturizer for cracked heels
Ready to Get Back on Your Feet?
Same-day appointments in Howell + Bloomfield Twp. Most insurance accepted. Dr. Tom Biernacki, DPM & team.
Book Today — Same-Day Appointments Available
Call Now: (810) 206-1402
About Your Care Team at Balance Foot & Ankle
Dr. Tom Biernacki, DPM · Board-Certified Foot & Ankle Surgeon. Specializes in conservative-first care, minimally invasive bunion surgery, and complex reconstruction.
Dr. Carl Jay, DPM · Accepting new patients. Specializes in sports medicine, athletic injuries, and routine podiatric care.
Dr. Daria Gutkin, DPM, AACFAS · Accepting new patients. Specializes in surgical reconstruction and pediatric podiatry.
Locations: 4330 E Grand River Ave, Howell, MI 48843 · 43494 Woodward Ave Suite 208, Bloomfield Twp, MI 48302
Hours: Mon–Fri 8:00 AM – 5:00 PM · (810) 206-1402
Dr. Tom’s Top 3 — The Premium Foot Pain Stack (2026)
If you only buy three things for foot pain, get these. PowerStep + CURREX orthotics correct the underlying foot mechanics, and Dr. Hoy’s pain gel delivers fast topical relief. This is the exact stack Dr. Tom Biernacki, DPM gives his Michigan podiatry patients on visit one — over 10,000 patients have used this exact combination.
Dr. Tom Biernacki, DPM is a board-certified podiatrist + Amazon Associate. Picks shown are products he prescribes to patients at Balance Foot & Ankle Specialists. We earn a commission on qualifying purchases at no extra cost to you. All products independently tested + reviewed for 30+ days minimum. Last verified: April 28, 2026.
PowerStep Pinnacle MaxxDr. Tom’s #1 Brand
Dr. Tom’s most-prescribed OTC orthotic. Lateral wedge corrects overpronation that causes 90% of foot pain. Deep heel cradle stabilizes the ankle. Built by podiatrists, used by patients worldwide.
- Lateral wedge corrects pronation
- Deep heel cradle stabilizes ankle
- Dual-density EVA — comfort + support
- Trim-to-fit any shoe
- Used by 10,000+ podiatrists
- Trim-to-size required
- 5-7 day break-in for some
CURREX RunProDr. Tom’s #1 Brand
3 arch heights for custom fit (Low/Med/High). Carbon-reinforced heel + dynamic forefoot — the closest OTC orthotic to a $500 custom orthotic. Engineered in Germany.
- 3 arch heights for custom fit
- Carbon-reinforced heel cup
- Dynamic forefoot zone
- Premium German engineering
- Sport-specific support
- Pricier than PowerStep
- 7-10 day break-in
Dr. Hoy’s Natural Pain Relief GelDr. Tom’s #1 Brand
Menthol-based natural pain relief — Dr. Tom’s #1 brand for fast relief without greasy residue. Safe for diabetics + daily use. Cleaner formula than Voltaren or Biofreeze.
- Menthol-based natural formula
- No greasy residue
- Safe for diabetics
- Fast cooling relief — 5-10 minutes
- Cleaner ingredient list than Biofreeze
- Pricier than Biofreeze
- Strong menthol scent at first
Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.