A Step in the Right Direction

A Step in the Right Direction

Sunday, December 26, 2010

tarsal tunnel

The tarsal tunnel is a space in the foot formed between bones and overlying fibrous tissue. Within the tarsal tunnel lies a nerve called the posterior tibial nerve. The tarsal tunnel is walled on one side by sturdy bones, and on the other by tough fibrous tissue.

Tarsal tunnel syndrome results when the posterior tibial nerve is compressed within the tarsal tunnel. This is similar to carpal tunnel syndrome that you can experience in the wrist. Both of these conditions result when a nerve is pinched within a confined space. When space becomes tight, the tibial nerve is pinched.

Patients commonly complain of numbness over the bottom of the foot, as well as complaints of pain, burning, and tingling over the base of the foot and heel. It can be confused with plantar fascitis or heel spurs.

It can be caused by the result of a fracture, bone spurs, ganglion and other benign tumors, muscle impingement or foot deformities.

To diagnose this condition can be confusing. Tapping on the nerve as it passes through the tarsal tunnel, or the Tinel's Test may create the symptoms and indicate tarsal tunnel syndrome as the cause of the problem. An EMG test would show how well a pulse of electricity conducts through the nerve may help with the diagnosis.

Treatment begins with an anti-inflammatory medications and possibly a cortisone injection into the area around the nerve. Orthotics and change in footwear may also help to relieve the symptoms.

It none of these help then a surgical procedure may be necessary to release the tarsal tunnel. When this procedure is preformed an incision is made to open up the tarsal tunnel and decrease pressure on the posterior tibial nerve. This would be similar to a carpal tunnel release in the wrist.

So if you are experiencing any of the above symptoms give the office of Dr. T.F. Vail a call to see if this could be your situation. 419-423-1888



Saturday, December 11, 2010

Morton's Neuroma

Morton's neuroma is a painful condition that affects the ball of your foot, most commonly the area between your third and fourth toes. Morton's neuroma may feel as if you are standing on a pebble in your shoe or on a fold in your sock.
It involves a thickening of the tissue around one of the nerves leading to your toes. In some cases, Morton's neuroma causes a sharp, burning pain in the ball of your foot. Your toes also may sting, burn or feel numb.
It may occur in response to irritation, injury or pressure. Common treatments include changing footwear or using arch supports. Sometimes corticosteroid injections or surgery may be necessary.
You may experience a feeling as if you are standing on a pebble in your shoe, or a burning pain in the ball of your foot that may radiate into your toes and there could be tingling or numbness in your toes.
A doctor is likely to order x-rays of your foot to rule out other causes for your pain like a stress fracture. There could be an Ultrasound done to reveal soft tissue abnormalities like neuroma or a MRI is also good at visualizing soft tissues.
Arch supports or orthotics help reduce pressure on the nerve and can prescribed by your doctor. Some people are helped by injecting steroids into the painful area.
Risk factors that appear to contribute to Morton's neuroma are high heels. Wearing high heeled shoes or shoes that are tight or ill-fitting can box in your feet and place pressure on your toes. People who have bunions, hammertoes, flatfeet or excessive flexibility are at higher risk of developing Morton's neuroma.
Try to avoid activities like jogging, or aerobic exercise or dancing that subject your feet to high impact and avoid wearing high heel or tight shoes. Choose shoes with a round toe box and extra depth.
So if you feel like you have pebbles in your shoes and have burning and pain in your toes, give Dr. T. F. Vail a call at 419-423-1888

Monday, December 6, 2010

Arthritis

According to mayoclinic.com, arthritis is inflammation of one or more of your joints, such as one or both knees or wrists, or a part of your spinal column. The two most common types of arthritis are osteoarthritis and rheumatoid arthritis. Joint pain and stiffness are the main symptoms of arthritis. Less common types of arthritis may be associated with conditions that also affect other parts of your body. For example, lupus can affect the kidneys and lungs, in addition to joints, while psoriasis is primarily a skin disease that sometimes also affects joints.

Rheumatoid arthritis causes chronic inflamation of the joints. It may also cause inflamation of tissue around the joints as well as the inflamation of other organs in the body.  Rheumatoid arthritis is an autoimmune disease.  Autoimmune diseases occur when the body's tissues mistakenly attacked by their own immune system.  Rheumatoid arthritis is typically a progressive illness that has the potential to cause joint destruction and functional disability.

Symptoms of rheumatoid arthritis include:
  • Stiffness. The joint is harder to use and might have a limited range of motion. Morning stiffness is one of the hallmark symptoms of rheumatoid arthritis. While many people with other forms of arthritis have stiff joints in the morning, it takes people with rheumatoid arthritis more than an hour (sometimes several hours) before their joints feel loose.
  • Swelling. Fluid enters into the joint and it becomes puffy; this also contributes to stiffness.
  • Pain. Inflammation inside a joint makes it sensitive and tender. Prolonged inflammation causes damage that also contributes to pain.
  • Redness and warmth. The joints may be somewhat warmer and more pink or red than the neighboring skin.
If you are experiencing any of the symptoms in your feet, schedule an appointment with your podiatrist. Also, visit our product store at vailfoot.com for great doctor approved products to relieve pain including Biofreeze gel. Biofreeze Pain Reliever breaks the cycle of pain with Cryotherapy, The Cold Method®.  Its cold application reduces the sensation of pain and inflammation, while the cold and re-warming stimulates the healing of tissue.

Saturday, December 4, 2010

Ganglion cyst


A ganglion cyst is a sac filled with a jellylike fluid that originates from a tendon sheath or joint capsule. The word ganglion means knot because it looks like a knot-like mass or lump that forms below the surface of the skin.
They are the most common benign soft-tissue masses. They mostly occur on the wrist but they also can develop on the foot usually on top. Sometimes they disappear altogether but will eventually reappear.
The exact cause of the ganglion is unknown. Most often it is from trauma.
A ganglion is associated with one or more of the following symptoms: A noticeable lump which can be the only symptom. There can be tingling or burning if the cyst is touching a nerve. There can be a dull pain or ache which means the cyst is pressing against a tendon or joint. Or difficulty wearing shoes because of irritation between the lump and the shoe.
To diagnose a ganglion the podiatrist will press a certain way and it should move freely underneath the skin. An x-ray or additional imaging may be needed.
Sometimes an aspiration is needed to drain the fluid and then inject a steroid into the mass to shrink it. But in many cases it will come back. Or the Doctor will just monitor it if the cyst does not cause any pain and does not interfere with walking. The Doctor may decide it is best to just monitor it over a period of time.
When other treatment options fail the cyst may need to be surgically removed. While the recurrence rate associated with surgery is much lower than the aspiration there are still cases where the ganglion returns.
So if you have noticed a lump on your foot and not sure what it is, give Dr. T. F. Vail a call at 419-423-1888 to have it checked before it gets to the point where it is painful.