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November 2021

Tuesday, 30 November 2021 00:00

Posterior Tibial Nerve Neuralgia

Posterior tibial nerve neuralgia, also known as tarsal tunnel syndrome, is a nerve disorder that is caused by compression of the posterior tibial nerve. This nerve runs through the tarsal tunnel, an area along the inside of the ankle that houses nerves, blood vessels, and tendons. When the posterior tibial nerve is compressed, it causes symptoms such as foot, ankle, and toe pain, a pins and needles sensation in the foot, and numbness. Conservative treatments such as resting and icing the foot, wearing orthotics, and taking pain medications can help relieve symptoms. For more information about tarsal tunnel syndrome and to discover the best course of treatment for you, please consult with a podiatrist. 

Tarsal tunnel syndrome can be very uncomfortable to live with. If you are experiencing tarsal tunnel syndrome, contact William Urton, DPM of British Columbia. Our doctor 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 our office located in Langley, BC . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Read more about Tarsal Tunnel Syndrome
Tuesday, 30 November 2021 00:00

Tarsal Tunnel Syndrome

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.

Tuesday, 23 November 2021 00:00

Treating Toenail Fungus

Fungal infection of the toenail, or onychomycosis, typically appears as a gradual change in a toenail’s texture and color that involves brittleness and darkening.  The fungal infection itself occurs beneath the surface of the nail.  Aside from discoloration, other symptoms include the collection of debris beneath the nail plate, white marks on the nail plate, and a foul odor emanating from the nail.  If ignored, the infection can spread into other nails and the skin; in severe cases, it can hinder one’s ability to work or walk. 

The toenails are particularly vulnerable to contracting infection in moist environments where people are likely to be walking barefoot, such as around swimming pools, public showers, and locker rooms.  Fungal infection may also be more likely to occur in nail beds that have been injured, and sufferers of chronic diseases such as diabetes, circulatory problems, or immunodeficiency conditions are particularly prone to developing fungal nails. 

Fungal nails can be primarily prevented by practicing proper hygiene and regularly examining the feet and toes.  Carefully washing the feet with soap and water and thoroughly drying the feet afterwards are essential.  Other tips include wearing shower shoes in public areas, changing shoes and socks daily, keeping toenails clipped at a short length, wearing breathable shoes that fit properly, wearing moisture-wicking socks, and disinfecting home pedicure tools and instruments used to cut nails.

Fungal nail treatment may vary between patients and the severity of the condition.  Your podiatrist may suggest a daily routine of cleansing that spans over a period of time to ease mild infections.  Over-the-counter or prescription antifungal agents may also be prescribed, including topical and/or oral medications.  Debridement, or the removal of diseased nail matter and debris, may also be performed.  In more severe cases, surgical treatment may be needed.  In some instances, the temporary removal of the fungal nail allows for the direct application of a topical antifungal to the nail bed.  In other cases, a chronically painful fungal nail that has not responded to other treatments may be permanently removed; this allows the infection to be cured and avoids the growth of a deformed nail.  

Tuesday, 23 November 2021 00:00

Signs You May Have a Fungal Toenail Infection

A fungal nail infection occurs when the nail is invaded by a fungus. As the fungus multiplies, the infected toenails begin to undergo changes. They may become thickened, brittle, crumbly, and discolored. In more severe cases, the nail can become misshapen and may begin to separate from the nail bed, causing pain and emitting a foul odor. The infection can spread from nail to nail, and surrounding skin can also become infected. A combination of topical and oral medications is often prescribed to treat toenail fungus. Laser therapy can also be a potential treatment option. To learn more, please consult with a podiatrist. 

For more information about treatment, contact William Urton, DPM of British Columbia. Our doctor can provide the care you need to keep you pain-free and on your feet.

Toenail Fungus Treatment

Toenail fungus is a condition that affects many people and can be especially hard to get rid of. Fortunately, there are several methods to go about treating and avoiding it.

Antifungals & Deterrence

Oral antifungal medicine has been shown to be effective in many cases. It is important to consult with a podiatrist to determine the proper regiment for you, or potentially explore other options.

Applying foot powder on the feet and shoes helps keep the feet free of moisture and sweat.

Sandals or open toed shoes – Wearing these will allow air movement and help keep feet dry. They also expose your feet to light, which fungus cannot tolerate. Socks with moisture wicking material also help as well.

If you have any questions please feel free to contact our office located in Langley, BC . We offer the newest diagnostic tools and technology to treat your foot and ankle needs.

Read more about Treating Toenail Fungus
Tuesday, 16 November 2021 00:00

What to Do After a Stress Fracture

The long metatarsal bones of the foot connect the ankle to the toes. Excessive running, jumping, dancing, or other repetitive activities can cause hairline fractures in these bones, causing a condition known as a stress fracture. This is different from an acute break, caused by a fall or other sudden or traumatic injury. Stress fractures can also be the result of osteoporosis, or thinning of bones, arthritis, or nerve damage due to diabetes. Some ways to ease the pain include resting the foot, keeping it elevated, using a walker or crutches, and taking over-the-counter pain medication. You can return to normal activities when pain is no longer present. However, stress fractures can last from four to six weeks. If pain worsens or persists, please consult a podiatrist for further treatment.

Stress fractures occur when there is a tiny crack within a bone. To learn more, contact William Urton, DPM from British Columbia. Our doctor 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 our office located in Langley, BC . We offer the newest diagnostic and treatment technologies for all your foot care needs.

Read more about Stress Fractures of the Foot and Ankle
Tuesday, 16 November 2021 00:00

Stress Fractures of the Foot and Ankle

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 are suffering from tenderness, pain, or stiffness in the joints of your feet or ankles, call us to schedule an appointment.

Tuesday, 09 November 2021 00:00

Do I Need Toe Surgery?

There are a variety of deformities, joint pain or pain in the ball of the foot that can impact the toes and lead to surgery. Toes can move out of position and deform from factors, such as arthritis or tendons that are tight or out of balance. There are a variety of conservative treatments to help patients with toe-related problems. These include orthotics, strapping and padding the toes, and wearing comfortable shoes with a wide toe box. However, in extreme situations, surgery may be necessary to straighten out the toes. Your podiatrist will have a variety of options, such as releasing or lengthening tendons, putting the joints back in place, or realigning the toes. If you have problems with your toes, and they need to be straightened, please consult a podiatrist to find the best course of treatment.    

Foot surgery is sometimes necessary to treat a foot ailment. To learn more, contact William Urton, DPM of British Columbia. Our doctor will assist you with all of your foot and ankle needs.

When Is Surgery Necessary?

Foot and ankle surgery is generally reserved for cases in which less invasive, conservative procedures have failed to alleviate the problem. Some of the cases in which surgery may be necessary include:

  • Removing foot deformities like bunions and bone spurs
  • Severe arthritis that has caused bone issues
  • Cosmetic reconstruction

What Types of Surgery Are There?

The type of surgery you receive will depend on the nature of the problem you have. Some of the possible surgeries include:

  • Bunionectomy for painful bunions
  • Surgical fusion for realignment of bones
  • Neuropathy decompression surgery to treat nerve damage

Benefits of Surgery

Although surgery is usually a last resort, it can provide more complete pain relief compared to non-surgical methods and may allow you to finally resume full activity.

Surgical techniques have also become increasingly sophisticated. Techniques like endoscopic surgery allow for smaller incisions and faster recovery times.

If you have any questions please feel free to contact our office located in Langley, BC . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Read more about Foot Surgery
Tuesday, 09 November 2021 00:00

Foot 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. 

Tuesday, 02 November 2021 00:00

Ankle Pain

Pain experienced in the ankle can be caused by a multitude of conditions. While the most common cause is an ankle sprain, other possible problems can include arthritis, gout, ankle instability, ankle fracture, nerve compression, or tendinitis. In more serious cases, ankle pain can be a sign of improper alignment of the foot or an infection.

Ankle pain can often be accompanied by symptoms such as redness, swelling, stiffness and warm in the affected area. Pain can be described differently depending on the condition; short, stabbing pain and a dull ache are some examples. If such symptoms are persistent and do not improve after time, be sure to schedule an appointment with your local podiatrist.

Depending on the condition behind your ankle pain, different treatments may be prescribed by your podiatrist. For ankle sprains, the first step in treatment involves rest, ice, elevation, and compression. Be sure to avoid placing pressure on the ankle, use an ice pack several times a day, and use a compression bandage and elevation to reduce swelling. Other more serious conditions may require the assistance of certain drugs and medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, or even cortisone injections.

Consult with your foot and ankle doctor to best determine the cause of your ankle pain and the appropriate treatment. Depending on the severity of your ankle pain and the condition behind it, recovery from ankle pain may take some time.

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