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Tue, 11 Jun 2019

Tarsal Tunnel Syndrome

tarsal tunnel syndrome, podiatry

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.

Be sure to call our Council Bluffs office at 712-323-5333 or our Omaha office at 402-991-9958 to schedule an appointment with Dr. Panesar to see how he can help relieve your foot pain!

Tue, 28 May 2019

Larose marks 30 years, Thor brings fresh insight to Miller Orthopedic Specialists

Dr. Daniel J. Larose, sport medicine doctor was the first partner under Dr. Ronald Miller, who started with Miller Orthopedic in 1972. Photo and article by Susan Payne.
Dr. Thor, total joint specialist, review scans in the Miller Orthopedic location on 1 Edmundson Place. Photo and article by Susan Payne











This year, Miller Orthopedic celebrates its newest physician, Dr. Clayton Thor, and the 30-year anniversary of Dr. Daniel Larose, one of the first recruited associates under Dr. Ronald Miller in 1988, founder of the practice.

Thor is a total joint specialist, a graduate of University of Nebraska at Lincoln and the University of Nebraska Medical Center. He completed his residency at William Beaumont School of Medicine, Department of Orthopedic Surgery in Michigan and was fellowship trained in adult reconstructive surgery at Hedley Orthopedic Institute in Phoenix.

Thor brings his passion to the Midwest, a place he calls home.

“It’s been a whirlwind, but in a good way. I’m working on building a practice and doing what I love, taking care of as many people as I can,” Thor said. “I love being back here.”

Thor said he does a few things differently than most physicians in the area in total hip and total knee surgeries.

“I use a minimally invasive muscle sparing procedure. I’m able to split muscle and take down less tendons, so people get up and move quicker,” he said. “With total knees, I use a robotic assisted surgery to do scans before surgery, and use computer software to perfectly place the implant.”

While Miller Orthopedic welcomes the newest physician to the team, Larose is one of the longest standing physicians with 30 years in the field and no plans for retirement.

“We came here in 1988 and it was a nice, easy going place. My wife liked it a lot too, to raise our kids. She felt like she could be here and not worry about heavy traffic or feeling unsafe,” Larose said.

Larose is one of 12 orthopedic specialists on the Miller Orthopedic team, partnering with the University of Nebraska at Omaha Mavericks, Iowa Western Reivers and more recently, College of Saint Mary Flames in sports medicine.

“We don’t formally teach medical students, but we are starting a program with the College of Saint Mary that they will do clinic rotations,” he said. “We cover southwest Iowa clinics and I’ve been going to smaller communities, we have about 10 satellite clinics.”

In the last 30 years, Larose said he’s proud of the growth he has seen first hand.

“I’ve seen a lot of patients and now I’m starting to see the children of the patients I’ve seen. We have grown and Council Bluffs has grown quite a bit, as well,” Larose said.

To read the original story from the Daily Non-pareil, click here!


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