October 2018

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.

A common cause of the condition that is referred to as tarsal tunnel syndrome may occur as a result of constant overuse of the ankle. The most common reason for this to happen may be from power walking, frequent running, or standing for the majority of the day. It typically affects the nerve that is on the inside of the foot and ankle, and when this becomes damaged, inflammation and tenderness may occur. Research has shown the importance of treating tarsal tunnel syndrome promptly to avoid the possibility of permanent nerve damage from developing. Treatment options may begin with resting and elevating the foot, which may reduce inflammation, in addition to taking anti-inflammatory medications, which may help in alleviating a portion of the pain that often accompanies this condition. If you feel you may have tarsal tunnel syndrome, please speak to a podiatrist as quickly as possible for a proper evaluation and to discuss the best treatments techniques for you.

Tarsal tunnel syndrome can be very uncomfortable to live with. If you are experiencing tarsal tunnel syndrome, contact Dr. Amy Dunetz of Florida. Our doctors can provide the care you need to keep you pain-free and on your feet.

Tarsal Tunnel Syndrome

Tarsal tunnel syndrome, which can also be called tibial nerve dysfunction, is an uncommon condition of misfiring peripheral nerves in the foot. 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 damaged, causing problems with movement and feeling in the foot of the affected leg.

Common Cause of Tarsal Tunnel Syndrome
- Involves pressure or an injury, direct pressure on the tibial nerve for an extended period of time, sometimes caused by other body structures close by or near the knee.
- Diseases that damage nerves, including diabetes, may cause tarsal tunnel syndrome.
- At times, tarsal tunnel syndrome can appear without an obvious cause in some cases.

The Effects of Tarsal Tunnel Syndrome
- Different sensations, an afflicted person may experience pain, tingling, burning or other unusual sensations in the foot of the affected leg.
- The foot muscles, toes and ankle become weaker, and curling your toes or flexing your foot can become difficult.
- If condition worsens, infections and ulcers may develop on the foot that is experiencing the syndrome.

A physical exam of the leg can help identify the presence of tarsal tunnel syndrome. Medical tests, such as a nerve biopsy, are also used to diagnose the condition. Patients may receive physical therapy and prescriptive medication. In extreme cases, some may require surgery.

If you have any questions please feel free to contact one of our offices located in Aventura and Davie, FL. We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Have your child's feet been examined lately?

Shockwave therapy is one treatment option for plantar fasciitis, a condition that causes heel and foot inflammation and pain. This type of injury is often caused by overworking the feet. Heel pain is most common in people that exercise often, individuals who are overweight, and people whose profession require them to stand for long periods of time.

Heel pain can be caused by a number of problems including ill-fitting shoes, strenuous exercise routines or work hazards. Simple treatment options involve buying new shoes, taking ibuprofen, doing heel and foot exercises, and resting your feet. For severe cases, shockwave therapy can be considered a more viable form of treatment.

Shockwave therapy should be considered for patients that have had unsuccessful treatment or whose heel pain has lasted for more than six months. In shockwave therapy, a device delivers shockwaves to the patient’s body, which jumpstart the body’s repair mechanisms. These mechanisms then begin working more effectively to repair damage done to the heel area.

Shockwave therapy also helps eliminate pain in the heel area. When the body’s natural repair mechanisms are triggered, tissue healing in the body is sped up. This leads to pain reduction after pain transmission nerves are stimulated.

Shockwave therapy eliminates the risk factors associated with surgery, such as the use of anesthetics, and is less invasive. Since this technique also helps improve the body’s natural healing techniques, recovery time should be shorter than surgical procedures.

Discomfort issues can also be a side effect of treatment. Short-term issues normally include skin bruising, minor pain during and after treatment, swelling of the heel, and discolored tissue. However, these side effects of shockwave therapy usually disappear after a few days. The fast recovery time of shockwave therapy makes it easy for patients to return to their daily routines.

Like most types of treatments, surgeries, and medications, shockwave therapy is not for everyone. Potential patients with heart conditions and people with pacemakers should not be considered for this technique. People on certain types of medications, usually medications affecting blood clotting, would be ineligible for shockwave therapy. Children and pregnant women should avoid this treatment option as well.

Overall, shockwave therapy could be a great option for heel pain. It is less invasive than surgery, helps trigger natural healing mechanisms, and should be considered by people who have had long bouts of heel pain or tried conventional treatment options that were unsuccessful.

If you have ever experienced the pain of plantar fasciitis, you may want to consider the option of having shockwave therapy performed. This treatment may consist of electromagnetic pulses, which convert to shock waves and this is aimed at the affected tendons. Shock wave treatments that are low-energy is spread out over a series of treatments, and minimal pain is often associated with this form of therapy. If you choose to have a high-energy treatment, it is typically given in one session, and may produce considerable pain. Research has shown these treatments may begin to start a healing response in the body, and this may help in relieving some of the pain associated with plantar fasciitis. If you would like additional information about shockwave therapy, please consult with a podiatrist who can properly help you to decide if this treatment technique is correct for you.

Shockwave therapy is a treatment commonly used to treat various injuries and conditions, particularly plantar fasciitis in the feet. To learn more, consult with Dr. Amy Dunetz from Florida. Our doctors can provide the care you need to keep you pain-free and on your feet.

Shockwave Therapy

Shockwave therapy is a new treatment option designed to treat bone conditions such as tennis elbow, shoulder pain, and others. Shockwave therapy uses high intensity sound waves that are directed to the affected tissues of the body with pinpoint accuracy. The effects are very beneficial, leading to a production of collagen fibers, eliminating inflammation.

Who Benefits from Shockwave?

Shockwave is recommended for patients suffering from heel pain and associated problems. Heel pain is a common condition which can be caused by obesity, overexertion, and spending a substantial amount of time on hard floors with your feet exposed and unsupported.

Fast and Easy

The therapy is actually a simple process that can leave patients feeling better the very next day. Shockwave therapy is not as dramatic as it sounds. It enables more blood flow to effected areas, addressing the source of the problem and allowing treatment to last for a long time.

Treatment & Recovery Time

Shockwave treatment will enable your feet to recover quickly. This is especially important since surgery is not required. It is cost effective and does not require the use of anesthesia. This treatment is a better option to surgery, since it is proven safe.

If you have any questions, please feel free to contact one of our offices located in Aventura and Davie, FL. We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Although rheumatoid arthritis attacks multiple bones and joints throughout the entire body, ninety percent of people who actually develop this condition usually do so in the foot or ankle area. Those who develop this kind of arthritis in the feet usually develop symptoms around the toes and forefeet first, before anywhere else. Rheumatoid arthritis appears to have a genetic component. If it runs in the family, then you will be more likely to develop it as well.

Rheumatoid arthritis is an autoimmune disorder in which the body’s own immune system attacks the lining of the membranes surrounding the joints. This causes inflammation of the membrane lining, and the gradual destruction of the joint’s cartilage and even bone.

Some of the most common symptoms that are associated with RA include pain and swelling of the feet. Stiffness in the feet is also another common symptom that people experience. Those who have RA in the feet usually feel the pain in the ball or sole of their feet. This can get to be very painful at times. A person's joints can even shift and become deformed after a period of time.

In order to properly diagnose RA in the feet it is usually necessary for a doctor or podiatrist to evaluate the area. Your doctor will also question you about your medical history, occupation, etc., to determine whether anything in your lifestyle may have triggered the condition. There are a number of tests that may be performed to help diagnose RA, such as a rheumatoid factor test. There is, however, no one single test that will tell you for sure if you have RA. There are different X-rays that can be taken as well to determine if a person has RA in their feet.

There is a range of treatment options for rheumatoid arthritis. Treatment of RA is usually a lifelong process that includes a variety of methods of treatment and therapy. Your doctor can prescribe special shoes that should help with arch support as well as heel support. A physical therapist can help those with this condition learn exercises which will keep their joints flexible. Surgery may be needed to correct some of the issues with the feet, such as bunions, and hammertoes. Fusion is usually the most successful surgical option for rheumatoid arthritis. However, people need to keep in mind that there are some risks associated with these surgeries.

The condition known as rheumatoid arthritis is a painful ailment that typically affects the muscles and joints. When this occurs in the feet, the toenails may become affected in addition to the patient possibly experiencing pain and stiffness. The discomfort is generally felt in the smaller joints in the feet, and this can possibly lead to the formation of corns and bunions. In severe cases, the toes may curl and hammertoe may develop as a result of this. This particular form of arthritis occurs when the body’s immune system is compromised. The ability to fight infection is diminished, and this may cause pain and swelling to gradually develop. If you are afflicted with rheumatoid arthritis in the joints of the feet, it’s strongly suggested that you consult with a podiatrist, so correct treatment can commence.

Because RA affects more than just your joints, including the joints in your feet and ankles, it is important to seek early diagnosis from your podiatrist  if you feel like the pain in your feet might be caused by RA. For more information, contact Dr. Amy Dunetz of Florida. Our doctors will assist you with all of your podiatric concerns.

What Is Rheumatoid Arthritis?

Rheumatoid Arthritis (RA) is an autoimmune disorder in which the body’s own immune system attacks the membranes surrounding the joints. Inflammation of the lining and eventually the destruction of the joint’s cartilage and bone occur, causing severe pain and immobility.

Rheumatoid Arthritis of the Feet

Although RA usually attacks multiple bones and joints throughout the entire body, almost 90 percent of cases result in pain in the foot or ankle area.

Symptoms

• Swelling and pain in the feet
• Stiffness in the feet
• Pain on the ball or sole of feet
• Joint shift and deformation

Diagnosis

Quick diagnosis of RA in the feet is important so that the podiatrist can treat the area effectively. Your doctor will ask you about your medical history, occupation, and lifestyle to determine the origin of the condition. Rheumatoid Factor tests help to determine if someone is affected by the disease.

If you have any questions please feel free to contact one of our offices located in Aventura and Davie, FL. We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Our bones are important aspects of our body and they are constantly changing. The heavier the workload for a bone, the more likely it is that calcium will be placed in it. When a bone isn’t used often, there won’t be much calcium within it. When stress from repetitive loads prevent the bone from being able to repair itself, cracks will start to form. Stress fractures are defined as cracks in a bone that result from repetitive force, such as overuse.

The most common cause of stress fractures is a sudden increase in intensity and duration of physical activity. For example, if you begin to run long distances without working your way into doing so, you will be more likely to develop a stress fracture.

Common symptoms of stress fractures are pain and swelling near the weight bearing area on the injured bone. When initial x-rays are performed, it is possible that the fracture will not show up. However, once the stress on the area continues, the damage will increase, and the fracture will be severe enough to show up on an x-ray. Certain parts of the foot are more likely to develop stress fractures than others. Areas that typically have these fractures are: the metatarsals, the navicular bone, the calcaneus, tibia, and fibula.

Since women are at an increased risk of developing osteoporosis, they are twice as likely as men to sustain a stress fracture. Additionally, old age causes a decrease in bone mineral density which is why elderly people are also likely to develop these fractures.

It is important for you to be professionally diagnosed by a podiatrist if you suspect you have a stress fracture, because there are other injuries that can easily be mistaken for a fracture.  Sprains, strains, shin splints, plantar fasciitis, and Morton’s neuroma can all easily be mistaken for stress fractures in the foot. Your podiatrist will likely ask you a series of questions to determine what type of pain you are experiencing. These questions will help your doctor identify whether you have a stress fracture.

The best method of treatment for a stress fracture is rest. Additionally, a walking boot, cast, or crutches, will help rest the area that is injured. The typical healing time for stress fractures is 4-12 weeks, however this depends on which bone is involved.

If you enjoy the sport of running or jogging, you may develop a stress fracture. This may gradually occur from the frequent repetitive motion that accompanies this type of activity. Despite the fact that many people who engage in sports may endure the discomfort of a stress fracture, certain individuals may be prone to developing this ailment. This may include having a medical condition that may weaken the bones, or experiencing a disorder that may affect the nerves. This may result in a loss of feeling. The pain that is associated with this condition may not be felt. The noticeable symptoms may include pain and discomfort and may be more intense in one foot. After an MRI or bone scan is performed, the proper treatment options can be discussed, such as possibly wearing a cast or boot or taking certain medications. Please consult with a podiatrist if you have endured a stress fracture and would like information about correct treatment techniques that are right for you.

Stress fractures occur when there is a tiny crack within a bone. To learn more, contact Dr. Amy Dunetz from Florida. Our doctors can provide the care you need to keep you pain free and on your feet.

How Are They Caused?

Stress fractures are the result of repetitive force being placed on the bone. Since the lower leg and feet often carry most of the body’s weight, stress fractures are likely to occur in these areas. If you rush into a new exercise, you are more likely to develop a stress fracture since you are starting too much, too soon.  Pain resulting from stress fractures may go unnoticed at first, however it may start to worsen over time.

Risk Factors

• Gender – They are more commonly found in women compared to men.
• Foot Problems – People with unusual arches in their feet are more likely to develop stress fractures.
• Certain Sports – Dancers, gymnasts, tennis players, runners, and basketball players are more likely to develop stress fractures.
• Lack of Nutrients – A lack of vitamin D and calcium may weaken the bones and make you more prone to stress fractures
• Weak Bones – Osteoporosis can weaken the bones therefore resulting in stress fractures

Stress fractures do not always heal properly, so it is important that you seek help from a podiatrist if you suspect you may have one. Ignoring your stress fracture may cause it to worsen, and you may develop chronic pain as well as additional fractures.

If you have any questions, please feel free to contact one of our offices located in Aventura and Davie, FL. We offer the newest diagnostic and treatment technologies for all your foot care needs.