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You have probably heard of carpal tunnel syndrome, but did you know that tarsal tunnel syndrome is also a common condition? This is a condition in the feet that is similar to carpal tunnel syndrome except instead of taking place in the wrist it is in the ankle.
The tarsal tunnel is a small tunnel-like space that lies on the inside of the ankle, next to the bone. The “tunnel” is covered with the flexor retinaculum (a thick ligament). This ligament protects and maintains the structures within said tunnel, such as arteries, veins, tendons and nerves.
When one has tarsal tunnel syndrome it means that there is a squeezing on one of the nerves within that tunnel (posterior tibial nerve). This causes symptoms that shoot throughout the trail of the nerve runs from the inside of the ankle into the foot. The compression can cause tingling, numbness and aching in your foot that is sometimes very piercing.
Tarsal tunnel syndrome can be caused by anything that produces compression on the nerve. There are several different things that can increase your chances for this.
- Injuries, such as ankle sprains can produce inflammation and swelling can cause the nerve compression.
- People with flat feet are at a higher risk of developing this due to the way the fallen arches cause outward titling of the heel, leaving potential for muscle strain and nerve compression.
- Diabetes, arthritis and other systemic diseases cause swelling and therefore also increasing potential for nerve compression.
- Finally, one other thing that is likely to increase your chance of tarsal tunnel syndrome is an abnormal or enlarged structure, such as a varicose vein, bone spur, swollen tendon or ganglion cyst, that forms within the “tunnel” of space.
A foot and ankle surgeon or a podiatrist, such as Dr. Inderjit Panesar, is best suited to do the examination if you think you might have this problem. The specialist will work with you for a treatment plan after a thorough examination. Sometimes surgery is required, but other cases of tarsal tunnel syndrome can be treated with local steroid injections and weight loss.
Rest, ice and anti-inflammatory medication can also be very beneficial in reducing the swelling and potentially boosting healing. There are several different things that can be done to help reduce pain and the compression of the posterior tibial nerve, but the first step is getting the proper diagnosis to get the best treatment plan.
If the first few steps you take in the morning are painful, you might be experiencing plantar fasciitis. It’s one of the most common causes of foot pain, with over two-million people seeking medical treatment each year. Many people typically seek treatment after having months or years of heel pain.
The stabbing pain that is felt is caused by inflammation of a band of tissue known as the plantar fascia that connects the heel bone to the toes. The pain is normally localized near the heel but can be felt anywhere along the plantar fascia ligament. The pain tends to be worse first thing in the morning and after long periods of sitting or standing. When there is no weight put on the foot, the ligament shortens and tightens,
There are many reasons why one might develop plantar fasciitis. Some of these factors include being overweight, being on your feet for extended periods and wearing shoes with inadequate support and high impact sporting activities. In addition, flat feet or high arches, excessive pronation (when the foot rolls severely inward when walking) or wearing high heels on a regular basis can be aggravating factors.
To diagnose plantar fasciitis, a physician will examine the foot, including looking for areas of tenderness, the height of the arch and ankle mobility. Imaging tests such as X-rays or MRIs may also be used to rule out other potential causes of foot pain, such as fractures or arthritis.
There are three main ways to treat plantar fasciitis:
- Stretching the plantar fascia and the muscle group in the back of the leg,
- Wearing good quality and supportive shoes or orthotics,
- Reducing inflammation.
If plantar fasciitis remains untreated, chronic heel pain can develop with irreversible consequences including: scarring and thickening of the plantar fascia at its origin in the heel. The ligament could also become partially or completely ruptured if a person with plantar fasciitis continues their high-impact activities.
Stretching is the single most important thing to do to eliminate and prevent pain. Physicians also recommend taking a break from high-impact exercises like running and switching to low-impact exercises like swimming or yoga. Over-the-counter anti-inflammatory medications such as ibuprofen and the use of ice and massage can be used to reduce inflammation and pain. If pain continues it is important to see your physician for a more extensive treatment plan that could include steroid injections and sometimes surgery. More than 90 percent of people with plantar fasciitis experience a significant reduction in pain after less than a year of treatment
The feet are relatively small body parts that experience significant pressure and stress on a daily basis. For that reason, it’s important to make sure your feet stay healthy and be aware of the symptoms of foot conditions such as plantar fasciitis.
If you are experiencing pain in your feet please call Miller Orthopedic Specialists at 712-323-5333 (Council Bluffs Office) or 402-991-9958 (Omaha Office) to schedule an appointment to evaluate, diagnose and develop treatment plan that is both beneficial and appropriate for you.
An ankle sprain can happen to anyone at any age. Walking on an uneven surface or even wearing inappropriate foot wear can cause this type of injury. Many times a sprain occurs when the foot suddenly twists or rolls, forcing the ankle joint out of its normal position. This movement can stretch or tear the ligaments that hold the ankle bones and joints together.
If you have recently injured your ankle and are noticing the following symptoms you may have a sprained ankle:
- inability to put weight on the affected ankle
- skin discoloration
The ankle can sustain many different types of injuries. It’s important to see your doctor when you’re experiencing problems with your ankle as they can determine whether the injury is a sprain or something more severe. Your physician will perform a physical exam to determine if ligaments have been torn. During the exam, your doctor may move your ankle joint in various ways to check your range of motion.
Imaging tests, such as X-rays, may also be ordered to rule out a bone fracture. An MRI may be done if your doctor suspects a fracture, a serious injury to the ligaments, or damage to the surface of the ankle joint allowing your physician to make the proper diagnosis.
Your doctor may tell you to stay off of your injured ankle until the pain subsides. For mild sprains, this may take a week to 10 days, while more severe sprains may take up to several weeks to heal
Treating a sprained ankle promotes recovery and prevents further discomfort. You may be able to treat mild sprains at home.
Recommended home care treatments include:
- using elastic bandages (such as an ACE bandage) to wrap your ankle, but not too tightly
- wearing a brace to support your ankle
- using crutches, if needed
- elevating your foot with pillows as necessary to reduce swelling
- taking ibuprofen (such as Advil) or acetaminophen (such as Tylenol) to manage pain
- getting plenty of rest and not putting weight on your ankle
It’s also helpful to apply ice to the injured area as soon as you can to reduce swelling. On the first day, you should apply ice every 20 to 30 minutes, three to four times per day. Afterward, apply ice every three to four hours for the next two days.
Surgery for a sprained ankle is rare. It may be performed when the damage to the ligaments is severe and there is evidence of instability, or when the injury doesn’t improve with nonsurgical treatment.
In most cases, an ankle sprain isn’t very serious and will completely heal with proper treatment. The amount of time required for a full recovery will depend on the severity of the sprain. Most ankle sprains take a few weeks to fully heal. A more severe sprain may take months.
Although pain and swelling will eventually go away, your injured ankle may not be as stable as your unaffected ankle. Your doctor may suggest certain exercises to help strengthen the muscle about the ankle. However, you shouldn’t proceed with exercises until your doctor has told you to do so.
If you have recently sustained an injury to your ankle, contact Miller Orthopedic Specialists for more information or to set up an appointment.
Diabetes is a growing epidemic in the United States. According to the American Diabetes Association there are 26 million adults and children living with disease and an additional 7 million who have prediabetes. Diabetes complications in the feet can be dangerous and is the leading cause of non-traumatic lower limb amputation. These complications and amputations can be prevented with proper foot care from a podiatrist.
The connection between a podiatrist and diabetes is an important one as proper foot care can help avoid serious limb injury or loss. Podiatrists specialize in caring for feet so they can offer the best possible treatment and recommendations to their patients. This care improves patients’ outcomes by catching problems at an early stage and providing access to appropriate treatment. A podiatrist will complete a full examination looking for signs and symptoms representative of potential diabetic foot problems. Some examples to look for on your feet and ankles include:
- ulcers or non-healing wounds
If you have diabetes you are more vulnerable to foot problems because of possible nerve damage and poor circulation to your leg and foot. This can lead to loss of sensation in the feet, meaning that the damage is more likely to go unnoticed. In addition, high blood glucose leads to dry skin, making your feet more prone to cuts and tears. You are also more susceptible to foot infections, toenail fungus and athlete’s foot.
It’s important to educate yourself and your family on your condition. They can play a vital role in helping you control your diabetes. If your family has a history of diabetes, the chance of you developing diabetes also increases.
Your podiatrist will instruct you on proper self-exam and care for your feet. This could include how to properly wash and dry your feet, why it is important to keep your feet moisturized, what to look for when examining your feet, taking care of your toenails and exercising tips. They may also recommend special footwear, such as socks that pull moisture away from your feet or shoes specifically designed for people with diabetes. Educated patients with the right tools can prevent foot and lower extremity problems by controlling their diabetes effectively and taking some simple steps to care for their feet.
A podiatrist can perform vascular, neurological and functional tests which will tell you your foot health status. It is important to have your feet checked regularly, and you should be checking your own feet daily if you are diabetic. A podiatrist’s education, training, and experience qualify them to diagnose and treat conditions of the foot, ankle and related structures of the leg as well as perform surgery if needed.
If you have diabetes and would like to start a relationship with a podiatrist to ensure the health of your feet, make an appointment to see one of our physicians today.
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