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Tarsal tunnel syndrome is a condition in which there is a compression of the posterior tibial nerve. The posterior tibial nerve runs along the inside of the ankle into the foot. Tarsal tunnel syndrome is named for the tarsal tunnel, which is a thin space along the inside of the ankle beside the ankle bones. This space contains various nerves, arteries, and tendons, and includes the posterior tibial nerve. The tibial nerve is the peripheral nerve in the leg responsible for sensation and movement of the foot and calf muscles. In tarsal tunnel syndrome the tibial nerve is compressed, causing tingling or burning, numbness, and pain.
Common causes of tarsal tunnel syndrome involve pressure or an injury. Injuries that produce inflammation and swelling in or around the tunnel may place pressure on the posterior tibial nerve. Direct pressure on the tibial nerve for an extended period of time, sometimes caused by other body structures close by or trauma to the tibial nerve, can result in tarsal tunnel syndrome. Diseases that damage nerves, such as diabetes or arthritis, may cause tarsal tunnel syndrome. Those with flat feet are at risk for developing the condition, as the extra pressure and strain placed on the foot may compress the posterior tibial nerve.
Feeling different sensations in the foot at different times is a common symptom of tarsal tunnel syndrome. An afflicted person may experience pain, tingling, burning or other unusual sensations in the foot of the affected leg. Symptoms are primarily felt on bottom of the foot and/or the inside of the ankle. Symptoms can appear suddenly and may occur due to overuse of the foot.
To diagnose tarsal tunnel syndrome, your podiatrist may examine the foot and tap the posterior tibial nerve to see if symptoms surface. He or she may also order an MRI to determine if a mass is present.
Treating tarsal tunnel syndrome will depend on the decision of your podiatrist. Multiple options are available, however, and can include rest, ice, immobilization, oral medications such as anti-inflammatory drugs (NSAIDS), physical therapy, injection therapy, orthotics, supportive shoes, braces, and surgery.
In most cases, foot surgery is often chosen as the last available option for conditions that have otherwise been unsuccessfully treated. Surgery may be necessary for several reasons, including the removal of foot deformities (e.g. bone spurs or bunions), arthritis problems, reconstruction due to injury, and congenital malformations (e.g. club foot or flat feet). Regardless of one’s age, foot surgery may be the only successful option for treatment for certain conditions.
The type of surgery one undergoes depends on the type of foot condition the patient has. For the removal of a bunion growth, a bunionectomy is necessary. If the bones in the feet need to be realigned or fused together, a surgical fusion of the foot is needed. For pain or nerve issues, a patient may require surgery in which the tissues surrounding the painful nerve are removed. Initially, less invasive treatments are generally attempted; surgery is often the last measure taken if other treatments are unsuccessful.
While in many cases surgery is often deemed as the final resort, choosing surgery comes with certain benefits. The associated pain experienced in relation to the particular condition is often relieved with surgery, allowing patients to quickly resume daily activities. The greatest benefit, however, is that surgery generally eliminates the problem immediately.
Podiatry history has shown that foot treatments continue to evolve over time. In the field of foot surgery, endoscopic surgery is just one of the many advanced forms of surgery. As technology vastly improves so too will the various techniques in foot surgery, which already require smaller and smaller incisions with the use of better and more efficient tools. Thanks to such innovations, surgery is no longer as invasive as it was in the past, allowing for faster and easier recoveries.
An ingrown toenail is a nail that has curved downward and grown into the skin. This typically occurs at either the nail borders or the sides of the nail. As a result, pain, redness, swelling, and warmth may occur in the toe. If a break in the skin forms due to the ingrown nail, bacteria may enter and cause an infection in the area; this is typically characterized by a foul odor and drainage.
Ingrown toenails have multiple reasons for developing. In many instances, the condition is a result of genetics and is inherited. The most common cause, however, is improper trimming; cutting the toenails too short forces the skin beside the nail to fold over. An ingrown toenail can also develop due to trauma, such as stubbing the toe, having an object fall on the toe, or participating in activities that involve repeated kicking or running. Wearing shoes that are too tight or too short can also cause ingrown toenails.
Treatment for an ingrown toenail varies between patients and the severity of the condition. In most cases, it is best to see your podiatrist for thorough and proper treatment. After examining your toe, your podiatrist may prescribe oral antibiotics to clear the infection if one is present. Surgical removal of either a portion of the nail or the entire nail may also be considered. In some cases, complete removal or destruction of the nail root may be required. Most patients who undergo nail surgery experience minimal pain afterward and can return to normal activity the following day.
Ingrown toenails can be prevented with proper nail trimming and by avoiding improper-fitting shoes. When cutting the toenails, be sure that you are cutting in a straight line and avoid cutting them too short. Shoes should not be too short or tight in the toe box.
Flatfoot is a foot condition in which the arch of the foot has either partially or totally dropped or has never developed. While it is common in babies and small children, it can become a problem for them in adulthood if the arch never forms. For adults, the development of flat feet can be brought upon by injury, as a result of pregnancy due to increased elasticity, or obesity. Those who have health concerns such as rheumatoid arthritis or diabetes may also be at greater risk for developing the condition.
If you suspect that you have flat feet, it is best to consult your podiatrist. Your foot doctor will examine the suspected foot and observe how it looks while you sit and stand. He or she may take an X-ray to determine how serious the condition is. Some common signs of flatfoot include toe drift, in which the toes and front part of the foot point outward, a short Achilles tendon, and a heel that tilts outwardly while the ankle tilts inward.
Once flatfoot has been diagnosed, your podiatrist may suggest one of several treatment options. Flat feet can be rigid, in which the feet appear to have no arch even when the person is not standing; or flexible, in which the person appears to have an arch while not standing, but once standing the arch disappears. Those with flexible flatfoot may be told to reduce any activities that cause pain and to avoid extended periods of walking or standing. Another suggestion may be weight loss, as excessive weight may be placing pressure on the arches
In few cases, if the condition is severe and all other methods have been exhausted surgery may be required. This is normally avoided, however, due to a lengthy recovery time and high cost.
Sever's disease, also known as calcaneal apophysitis, is a medical condition that causes heel pain in children’s feet while they’re growing. Sever's disease occurs most commonly in boys and girls between the ages of 8 and 14.
Sever's disease occurs when the child’s growth plate, or the calcaneal epiphysis, an area attached to the Achilles tendon, is injured or when the muscles and tendons of the growing foot do not keep pace with bone growth. The result is constant pain experienced at the back of the heel and the inability to put any weight on the heel. This forces the child to bear weight on their toes while walking. When a toe gait develops, the child must change the way they walk to avoid placing weight on the painful heel. If this is not properly addressed, this can lead to further developmental problems.
The most common symptom of Sever's disease is acute pain felt in the heel when a child engages in physical activity such as walking, jumping or running. Children who are active athletes are among the group most susceptible to experiencing Sever's disease. This is due to the extreme stress and tension placed on their growing feet. The rolling movement of the foot during walking or running and obesity are both additional conditions linked to causing Sever's disease.
The first step in treating Sever's disease is to rest the foot and leg and avoid physical activity. Over the counter pain-relieving and anti-inflammatory medications can be helpful for reducing the amount of heel pain. A child with Sever's disease should also wear shoes that properly support the heel and the arch of the foot. Consider purchasing orthotic shoe inserts which can help support the heel and foot while it is healing. Most patients with Sever's disease symptoms report an eventual elimination of heel pain after wearing orthotic insoles that support the affected heel.
Sever's disease may affect either one heel or both. It is important for a child experiencing heel pain to be examined by a foot doctor who can apply the squeeze test. The squeeze test compresses both sides of the heel in order to determine if there is intense pain. Discourage any child diagnosed with Sever's disease from going barefoot as this can intensify the problem. Apply ice packs to the affected painful heel two or three times a day for pain relief.
Exercises that help stretch the calf muscles and hamstrings are effective at treating Sever's disease. An exercise known as foot curling has also proven to be very effective at treating Sever's disease. When foot curling, the foot is pointed away from the body, then curled toward the body to help stretch the muscles. The curling exercise should be done in sets of 10 or 20 repetitions and repeated several times throughout the day.
Treatment methods can continue for at least 2 weeks and as long as 2 months before the heel pain completely disappears. A child can continue doing daily stretching exercises for the legs and feet to prevent Sever’s disease from returning.
Heel spurs are calcium deposits that cause bone protrusions on the heel bone. Heel spurs are usually associated with plantar fasciitis, which occurs when the plantar fasciitis in the foot becomes inflamed. Typically, heel spurs don’t cause any symptoms. However, they can produce chronic or intermittent heel pain. Those who have had the condition often describe the irritation as a stabbing pain.
There are risk factors that may make you more likely to develop heel spurs. People who have abnormal walking gaits, run and jog on hard surfaces, are obese, or wear poorly fitting shoes are more likely to develop heel spurs.
Fortunately, there are precautions you can take to avoid developing heel spurs. One of the best ways to do this is by wearing well-fitting shoes with shock-absorbent soles. Another preventative technique is to choose running shoes if you plan on running, and walking shoes if you plan on walking. Shoes are made for different activities and it is important to research a shoe before you purchase a pair.
The pain associated with heel spurs often decreases the more you walk. However, a recurrence of pain after an extended period of rest or walking is likely to occur with this condition. Those with severe heel spur pain may opt to go the surgical route for treatment. However, more than 90% of those with the condition get better without surgical treatment. If you have a heel spur and want to know if surgery is right for you, you should go to your podiatrist and he or she will be able to conduct a pre-surgical test or exam to determine if you are an optimal candidate for surgery.
While proper foot care is important for everybody, senior citizens have the tendency to be more susceptible to certain foot conditions. The elderly should therefore be well informed about any problems that may arise and about what they can do to properly avoid or treat them.
Some of the most common foot problems seniors are susceptible to include foot ulcers, ingrown toenails, fallen arches, and fungal nails. A foot ulcer is an open sore on the foot and can be a result of diabetes and decreased sensation in the feet. An ingrown toenail is defined as when the nail grows into the side of the toe. Fallen arches are indicated by the instep of the foot collapsing. A fungal nails is a condition that results in deformed and discolored toenails.
In order to avoid these conditions it is recommended that the feet be inspected by the patient on a regular basis. If these inspections are carried out routinely, there is a good likelihood that problems can be identified before they become severe, or can even be avoided altogether. If any abnormality is discovered, it is important that the individual consult a podiatrist for diagnosis and information on treatment options.
Proper foot hygiene is also important. Making sure that you always have clean, dry socks on can be a major deterrent to many different problems including bacterial infections, foot odor, and certain types of fungus. Wet feet are a major cause of many of these problems. If your socks get wet, it is important to change them. Walking around in wet socks may not only lead to various infections, but can irritate the skin and result in a number of various complications. Clean, dry feet are less likely to be affected by fungal and other infections.
As people age, the fat present on your feet begins to deteriorate. The protective nature of this fat keeps the feet healthy by providing a barrier between your bones and the ground. This also aids in giving the skin on the feet a certain amount of elasticity. This is one factor that causes elderly people to develop some serious foot issues. Foot moisturizers can be helpful to avoid certain problems associated with this. However, water-based moisturizers do not work as well for elderly people as they do for the young. Instead, it is more effective to use an emollient instead. An emollient is effective because it binds the water in the foot, keeping it from becoming absorbed too readily which will result in dry skin. Emollients also have a special property called occlusion, which provides a layer of oil on the skin. This layer prevents the foot from drying up and can be very effective in treating dry skin disorders. If you can keep the skin on your feet healthy, this will substantially reduce the number of foot problems you will encounter in old age.
Proper footwear is another way to keep feet healthy. Shoes that fit well and provide proper support help prevent ingrown toenails and fallen arches.
Certain medical conditions such as diabetes or poor blood circulation increase the risk for foot issues. For individuals with any of these conditions it is extremely important to conduct regular foot inspections to make sure that there are no sores or infections present.
Ankle sprains occur when ligaments that support the ankle stretch beyond their limits and tear. These types of injuries are very common and can occur in people of all ages. Sprains may range from mild to severe, depending on how much damage is done to the ligaments. If a sprain goes untreated, a more severe sprain may occur which can further damage the ankle. Repeated ankle sprains can lead to chronic ankle pain.
There are some risk factors that can increase your risk of suffering a sprained ankle. Those who participate in sports, walk on uneven surfaces, have a prior ankle injury, are in poor physical condition, or wear improper shoes are more likely to get a sprained ankle.
There are a few symptoms to look out for if you suspect you are suffering from a sprained ankle. Some common symptoms are swelling, bruising, tenderness, and instability of the ankle. In cases where the tearing of the ligaments is severe, there may be a “popping” sound when the strain occurs.
The RICE method is proven to be effective in treating ankle sprains. RICE stands for Rest, Ice, Compression, and Elevation. Rest is important for treatment especially within the first 24 to 48 hours. You should also ice your sprained ankle for the first 48 hours for 20 minutes at a time. A small piece of cloth should be placed between the ice and the affected area. For the compression step, you should wear a brace that is snug, but not too tight that it cuts off circulation. When choosing a brace, be sure to choose one that is suitable for the type of ankle sprain you have. Lastly, you should elevate your foot above the heart as often as possible.
After you treat a sprain, you should go through rehabilitation to prevent the injury from occurring again. There are three phases to the rehab process. The first phase involves resting, protecting and reducing the swelling of the injury. The second phase consists of restoring the ankles flexibility, range of motion, and strength. The third phase consists of slowly returning to activity and maintenance exercises.
If you suspect you have an ankle sprain, you shouldn’t hesitate to consult with your podiatrist. Your podiatrist will be able to give you a proper diagnosis and a suitable treatment option for your condition.
Corns are hard and thick areas of skin that form as a result of constant rubbing, friction, or pressure on the skin. They are patches of dead skin with a small plug toward the center. They may appear on the tops and sides of toes and can make walking painful.
Soft corns are typically thinner with a white color and rubbery texture. Soft corns tend to appear between the toes. Seed corns are another type of corn that appear in clusters and can be tender if they are on a weight-bearing part of the foot. Seed corns usually appear on the bottom of the foot and are likely caused by a blockage in sweat ducts.
While corns and calluses are somewhat similar, calluses are a bit different. Calluses are a patch of dead skin that can occur anywhere on the body. In comparison to corns, calluses are usually a bit larger in size. However, both corns and calluses are caused by increased friction on the skin.
There are some risk factors that may increase your chances of developing corns and calluses. If you have bunions, hammertoe, or a bone spur, you are more likely to develop a corn or callus on your foot.
While Corns and Calluses tend to disappear when the friction to the affected area ceases, the help of a podiatrist may be useful in the removal process. It is important to remove the dead skin around the area and this may be done in a few different ways. Moisturizing creams may be helpful in softening and removing the dead skin around the callus. You should never use razors or other pedicure equipment to remove your corns. Doing this may worsen your corn or callus and cause infection.
In some cases, corns and calluses may be caused by abnormal foot structure or walking motion. In such a case, you should seek a podiatrist’s assistance in order to correct the issue.
Hyperhidrosis of the feet, also termed plantar hyperhidrosis, is characterized by excessive sweating of the feet that can be onset by any cause, such as exercise, fever, or anxiety. Most people suffering from hyperhidrosis of the feet also experience hyperhidrosis of the hands, or palmar hyperhidrosis. Approximately 1-2% of Americans suffer from this disorder.
Sweating is a healthy process utilized by the body in order to cool itself and maintain a proper internal temperature, which is controlled by the sympathetic nervous system. In individuals with hyperhidrosis, the sympathetic nervous system works in "overdrive", producing far more sweat than is actually needed.
Plantar hyperhidrosis is considered primary hyperhidrosis. Secondary hyperhidrosis refers to excessive sweating that occurs in an area other than the feet, hands, or armpits, and this indicates that is related to another medical condition, such as menopause, hyperthyroidism, or Parkinson's disease.
Symptoms of hyperhidrosis of the feet can include foot odor, athlete's foot, infections, and blisters. Because of the continual moisture, shoes and socks can rot which creates an additional foul odor and can ruin the material, requiring shoes and socks to be replaced frequently. In addition to the physical symptoms, emotional health is often affected as this disorder can be very embarrassing.
If left untreated, hyperhidrosis will usually persist throughout an individual's life. However, there are several treatment options available. A common first approach to treating hyperhidrosis of the feet is a topical ointment. Aluminum chloride, an ingredient found in antiperspirants, can be effective at treating hyperhidrosis if used in high concentration and applied to the foot daily. Some individuals can experience relief this way, while others encounter extreme irritation and are unable to use the product. Another procedure is the use of Botulinum Toxin A, commonly referred to as Botox. This is injected directly into the foot, and is effective at minimizing the sweat glands in the injected area. These injections must be repeated every 4 to 9 months.
If these treatments are ineffective, oral prescription medications may be taken in an effort to alleviate the symptoms. Again, some will experience relief while others do not. Going barefoot reportedly provides relief for most sufferers.
A final approach to combating hyperhidrosis of the feet is through surgery. Surgery has been less successful on patients with plantar hyperhidrosis than on those with palmar hyperhidrosis. It is only recommended when sweating is severe and other treatments have failed to work. This kind of surgery usually involves going into the central nervous system, and cutting nerves to stop the transmission of signals telling the foot to sweat.
Bunions are large bony bumps at the base of the big toe. Medically known as hallux valgus, a bunion is a misalignment of the metatarsophalangeal joint, or big toe joint. The misalignment will generally worsen with time if left untreated.
The exact cause of bunions is unknown, with genetics seen as a potential cause. High heels and poorly-fitted footwear, rheumatoid arthritis, and heredity all seem to be potential factors behind the exacerbation of bunions. Women have been found to be more likely to develop bunions in comparison to men.
Bunions do not always produce symptoms. The best way to tell is if the big toe is pushing up against the next toe and there is a large protrusion at the base of the big toe. You may or may not feel pain. Redness, swelling, and restricted movement of the big toe may be present as well.
Podiatrists use a variety of methods to diagnose bunions. If there are symptoms present, podiatrists will first consider that it is a bunion. If not, a physical examination will be conducted to check function of the big toe. Finally, an X-ray may be taken to view the extent of the bunion and confirm it is a bunion.
Typically, nonsurgical methods are used to treat bunions, unless the bunion has become too misaligned. Orthotics, icing and resting the foot, roomier and better fitted shoes, taping the foot, and pain medication are usually utilized first. If the bunion doesn’t go away or causes extreme pain, surgery may be required. Surgeons will either remove part of the swollen tissue or bone to straighten the toe out.
If you have a bunion, it is recommended to see a podiatrist. The longer it is left untreated, the worse it may get. Podiatrists can properly diagnose and treat a bunion before it gets worse.
Flatfoot is classified as having the entire sole of the foot in contact or near contact to the ground while standing. The disorder is also known as fallen arches, because those affected have no arch in their feet. Flexible flatfoot and rigid flatfoot are the two types of flatfoot.
A person has flexible flatfoot if when sitting or standing on their toes, they have an arch that disappears when they stand with the entire foot on the ground. Flexible flatfoot may also be called “pediatric flatfoot” because the condition first appears in childhood. It is common among infants because the arch does not develop until the age of 5 or 6 years. Rigid flatfoot is not as common in children as it is with adults. This type of flatfoot is developed due to the weakening of tibialis posterior muscle tendon, a major supporting structure of the foot arch. Development of this deformity is progressive and shows early signs of pain and swelling that begins at the inside arch of the foot and moves to the outside of the foot below the ankle. More severe cases can possibly lead to arthritis of the foot and ankle joints.
Although most cases of flatfoot involve people born with the condition, some less common causes are obesity, diabetes, pregnancy, and osteoporosis. In some cases, flatfoot may come with no symptoms at all and does not require any type of treatment. With other cases though, symptoms may include pain in the shin, knee, hips and lower back. If a person with flatfeet experiences such symptoms, a health care provider may suggest using orthotic devices or arch supports, which may reduce the pain. Wearing supportive shoes can also prove more comfortable with flatfeet and staying away from shoes with little support such as sandals. Other methods to relieve pain also include stretching the Achilles tendon properly and using proper form when doing any physical activity. In addition, losing weight can reduce the stress on your feet and reduce the pain.
Our feet are arguably one of the most important parts of the body. When it comes to health and beauty routines, the feet and toenails are usually ignored. You should always practice proper footcare to avoid any fungal infections or ailments that can not only ruin the appearance of your feet, but also cause pain. Ignoring any foot problems could potentially lead to an expensive doctor’s visit.
The most important step in proper foot care is to wash your feet daily. You should wash them with soap and water. Doing this will cleanse your feet of dirt, sweat and bacteria. It is crucial that you clean between the toes and pat your feet dry with a towel afterward. Your toenails are also an important part of the feet and you may find that they get dirtier in the summer when you wear sandals. It is important that you practice proper toenail care in addition to cleaning the rest of your feet. When trimming your nails, you should always trim straight across instead of in a rounded shape. Trimming in a curved shape may lead to ingrown toenails.
Moisturization is also important for foot care, and you should be moisturizing your feet every day. The best way to prevent dry feet is to rub lotion or petroleum jelly on your clean feet at night and put socks over them. In the morning, your feet should be soft and moisturized.
Another crucial step in proper foot care is to wear the right shoes for whichever activity you are going to partake in. In warmer weather, you should wear shoes that allow your feet to breathe. It is best to avoid shoes such as flip-fops that do not provide arch support. Tight shoes may also be harmful, and they may even cause you to develop bunions.
If you plan on taking a shower in a public area, you should be especially careful, so you do not pick up any fungi. Showers are prone to harboring different types of bacteria and fungi. You should always wear shower shoes or flip flops when walking around in locker rooms and public showers. Avoid sharing shoes with other people because this is another way that fungus may be spread.
If you are experiencing any problems with your feet you should speak with your podiatrist to determine the best method of treatment for you.
Sever’s disease, also known as calcaneal apophysitis is a common bone disorder that occurs during childhood. The disease is defined as an inflammation of the growth plate in the heel. When a child has a growth spurt, his heel bone grows faster than the muscles, tendons, and ligaments in his leg. This disease is a result of overuse. The people who are most likely to be affected by this disease are children who are in a growth spurt, especially boys who are from the ages of 5 to 13 years old. 60% of children with Sever’s disease have both heels involved.
Symptoms of this disease are heel pain that intensifies during running and jumping activities. The pain is typically localized to the posterior part of the heel. Symptoms may be severe, and they can easily interfere with daily activities. Children who play soccer, baseball, and basketball are more likely to develop Sever’s disease.
Your doctor will diagnose your child based on his or her symptoms, x-rays are generally not helpful in diagnosing this disease. Your doctor may examine both heels and ask your child questions about his or her activity level in sports. Your doctor may then use the squeeze test on your child’s heel to see if there is any pain. Nevertheless, some doctors might still use x-rays to rule out any other issues such as fractures, infections, and tumors.
Sever’s disease can be prevented by maintaining good flexibility while your child is growing. Another prevention method is to wear good-quality shoes that have firm support and a shock-absorbent sole. Sever’s disease can be treated by ceasing any activity that causes heel pain. You should apply ice to the injured heel for 20 minutes 3 times a day. Additionally, orthotics should be used for children who have high arches, flat feet, or bowed legs.
If you suspect your child has Sever’s disease, you should make an appointment with your podiatrist to have his or her foot examined. Your doctor may recommend nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen to relieve pain. In more severe cases, your child may need a cast to rest his or her heel. Fortunately, Sever’s disease does not cause long-term foot problems. After treatment, your child should start to feel better within two weeks to two months.
