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Dr. Kenneth Rosenthal
Dr. Jonathan C. O’Quinn
Dr. Michael J. Price

(252) 830-1000

Greenville, North Carolina

November 2021

Tuesday, 30 November 2021 00:00

What Is Cuboid Syndrome?

The cuboid bone is a tiny, cube-shaped (cuboidal) bone, which is one of the seven tarsal bones of the foot. It is located on the outside of the foot, roughly halfway between the pinky toe and the heel. The cuboid bone moves slightly during normal foot motion, however, forceful movements or certain positions that are maintained for prolonged periods of time can cause the cuboid bone to shift excessively and therefore it  becomes dislocated. This is known as cuboid syndrome. Symptoms may include pain and possibly swelling on the lateral (outside) part of the foot which increases when walking or standing. It may even be difficult or impossible to walk. Podiatrists may use a “whip” procedure to quickly and firmly apply force to the cuboid bone to get it back into alignment as the patient relaxes in a prone position. If you believe you may be suffering from cuboid syndrome, contact a podiatrist.

Cuboid syndrome, also known as cuboid subluxation, occurs when the joints and ligaments near the cuboid bone in the foot become torn. If you have cuboid syndrome, consult with one of our podiatrists from Eastern Carolina Foot & Ankle Specialists. Our doctors will assess your condition and provide you with quality foot and ankle treatment.

Cuboid syndrome is a common cause of lateral foot pain, which is pain on the outside of the foot. The condition may happen suddenly due to an ankle sprain, or it may develop slowly overtime from repetitive tension through the bone and surrounding structures.

Causes

The most common causes of cuboid syndrome include:

  • Injury – The most common cause of this ailment is an ankle sprain.
  • Repetitive Strain – Tension placed through the peroneus longus muscle from repetitive activities such as jumping and running may cause excessive traction on the bone causing it to sublux.
  • Altered Foot Biomechanics – Most people suffering from cuboid subluxation have flat feet.

Symptoms

A common symptom of cuboid syndrome is pain along the outside of the foot which can be felt in the ankle and toes. This pain may create walking difficulties and may cause those with the condition to walk with a limp.

Diagnosis

Diagnosis of cuboid syndrome is often difficult, and it is often misdiagnosed. X-rays, MRIs and CT scans often fail to properly show the cuboid subluxation. Although there isn’t a specific test used to diagnose cuboid syndrome, your podiatrist will usually check if pain is felt while pressing firmly on the cuboid bone of your foot.

Treatment

Just as the range of causes varies widely, so do treatments. Some more common treatments are ice therapy, rest, exercise, taping, and orthotics.

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

 

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Published in Blog
Tuesday, 30 November 2021 00:00

Cuboid Syndrome

Cuboid syndrome mostly affects athletes, although it can affect non-athletes too. It is also known as cuboid subluxation or cuboid fault syndrome.  This condition occurs when joints and ligaments near the cuboid bone of the foot are damaged, or when the cuboid bone itself is dislodged from its natural position. It is usually marked by pain on the outer side of the foot, which may be persistent or may come and go. Cuboid syndrome can be difficult to diagnose unless it becomes severe and more noticeable. Your doctor will likely ask questions about when the pain began and how long it has been present, and will put pressure on the cuboid bone to determine if that area is the origin of the pain.

Causes of Cuboid Syndrome

  • Any repetitive stresses placed on the foot due to athletic activities are a common cause of cuboid syndrome.
  • Although it develops over time, it is possible that this syndrome can occur all of sudden due to a single event or injury.
  • Over-pronation can exacerbate the condition if not corrected.

Disagreements Amongst Podiatrists Regarding Cuboid Syndrome

  • Some refer to it as the dislocation of the calcaneal-cuboid joint only.
  • Other podiatrists see it as an injury of the ligaments located nearby, which also involves the cuboid bone.

It is very important that when you experience any kind of pain on the side of your foot, you should seek medical care right away. If a subluxed cuboid is caught early, your feet may respond well to the treatment, and you can get back into sports or other activities again as soon as the pain subsides.

Published in Featured
Tuesday, 23 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 one of our podiatrists of Eastern Carolina Foot & Ankle Specialists. 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 our office located in Greenville, NC . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

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Published in Blog
Tuesday, 23 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.

Published in Featured
Tuesday, 23 November 2021 00:00

Gout Pain Can Be Managed

Gout is a painful, inflammatory form of arthritis. Those affected will typically feel an intense stiffness in the joints of their feet, particularly in the big toe. Schedule a visit to learn about how gout can be managed and treated.

Published in Blog
Tuesday, 16 November 2021 00:00

The Three Types of Sesamoid Injuries

The sesamoids are two small, pea-shaped bones located just beneath the base of the big toe. These bones are responsible for helping the big toe move normally and provide leverage when the big toe pushes off while walking or running. The sesamoid bones can become injured from excess pressure on the balls of the foot. There are three main types of sesamoid injuries. Turf toe occurs when the soft tissue surrounding the big toe joint is injured and causes immediate sharp pain and swelling. A fracture occurs when a sesamoid bone breaks. Sesamoiditis occurs when the sesamoid bones and surrounding tendons become inflamed. If you are experiencing foot pain, it is strongly suggested that you seek the care of a podiatrist.

Sesamoiditis is an unpleasant foot condition characterized by pain in the balls of the feet. If you think you’re struggling with sesamoiditis, contact one of our podiatrists of Eastern Carolina Foot & Ankle Specialists. Our doctors will treat your condition thoroughly and effectively.

Sesamoiditis

Sesamoiditis is a condition of the foot that affects the ball of the foot. It is more common in younger people than it is in older people. It can also occur with people who have begun a new exercise program, since their bodies are adjusting to the new physical regimen. Pain may also be caused by the inflammation of tendons surrounding the bones. It is important to seek treatment in its early stages because if you ignore the pain, this condition can lead to more serious problems such as severe irritation and bone fractures.

Causes of Sesamoiditis

  • Sudden increase in activity
  • Increase in physically strenuous movement without a proper warm up or build up
  • Foot structure: those who have smaller, bonier feet or those with a high arch may be more susceptible

Treatment for sesamoiditis is non-invasive and simple. Doctors may recommend a strict rest period where the patient forgoes most physical activity. This will help give the patient time to heal their feet through limited activity. For serious cases, it is best to speak with your doctor to determine a treatment option that will help your specific needs.

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

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Published in Blog
Tuesday, 16 November 2021 00:00

Sesamoiditis

Sesamoiditis is a condition in which the sesamoid bones in the forefoot become inflamed from physical activity. Sesamoid bones are bones that are not connected to other bones but are located in tendons or muscle. Two of these sesamoid bones are very small and located on the underside of the foot near the big toe. Athletes such as runners, baseball and football players, and dancers are likely to experience sesamoiditis. Those with high arched feet, flat feet, or runners who run on the ball of their foot are also prone to suffer from sesamoiditis.

Symptoms include pain or throbbing on the ball of the foot near the big toe. The pain generally starts with a mild throbbing but gradually builds up to shooting pain. Bruising, swelling, and redness are possible, but in most cases, these symptoms are not present. However, moving the big toe can result in pain and difficulty.

To conduct a diagnosis, the podiatrist will examine the ball of the foot and big toe. They will look for any outliers and check the movement of the toe. X-rays will be taken to rule out any other conditions and ensure that it is sesamoiditis.

Treatment for sesamoiditis is generally mild and includes rest, anti-inflammatory and pain medication, and ice treatments to deal with the swelling and pain. Orthotics may be needed with people who have flat or high arched feet to relieve pressure off the bones. In some cases the toe will be taped and immobilized to allow healing. The podiatrist may also decide to use a steroid injection to help with swelling as well. If you have sesamoiditis, you shouldn’t engage in any intensive activity, as it may inflame the area and worsen your pain. If the sesamoid bone has fractured, surgery may be required to remove the sesamoid bone.

If you are suffering from sesamoiditis or are experiencing symptoms similar to sesamoiditis, you should stop all physical activity that puts strain on the area. Furthermore you should see a podiatrist for a diagnosis to see if you have sesamoiditis.

Published in Featured
Tuesday, 09 November 2021 00:00

Symptoms of Psoriatic Arthritis in the Feet

Psoriatic arthritis (PsA) is a chronic autoimmune disease that affects the joints, including those on the feet. It typically affects people who have a skin condition called psoriasis. When PsA affects the feet, it produces symptoms such as painful toe swelling, joint stiffness, pain in the heels and soles of your feet, and dented or crumbling toenails. The condition has a pattern of flaring up and then subsiding. Your podiatrist can be an important part of your healthcare team when it comes to dealing with PsA in the feet. A podiatrist can help you find comfortable shoes and orthotics, maintain your mobility, and relieve symptoms during a flare up. To learn more, speak to a podiatrist today. 

Arthritis can be a difficult condition to live with. If you are seeking treatment, contact one of our podiatrists from Eastern Carolina Foot & Ankle Specialists. Our doctors can provide the care you need to keep you pain-free and on your feet.

Arthritic Foot Care  

Arthritis is a term that is commonly used to describe joint pain.  The condition itself can occur to anyone of any age, race, or gender, and there are over 100 types of it.  Nevertheless, arthritis is more commonly found in women compared to men, and it is also more prevalent in those who are overweight. The causes of arthritis vary depending on which type of arthritis you have. Osteoarthritis for example, is often caused by injury, while rheumatoid arthritis is caused by a misdirected immune system.

Symptoms

  • Swelling
  • Pain
  • Stiffness
  • Decreased Range of Motion

Arthritic symptoms range in severity, and they may come and go. Some symptoms stay the same for several years but could potentially get worse with time. Severe cases of arthritis can prevent its sufferers from performing daily activities and make walking difficult.

Risk Factors

  • Occupation – Occupations requiring repetitive knee movements have been linked to osteoarthritis
  • Obesity – Excess weight can contribute to osteoarthritis development
  • Infection – Microbial agents can infect the joints and trigger arthritis
  • Joint Injuries – Damage to joints may lead to osteoarthritis
  • Age – Risk increases with age
  • Gender –Most types are more common in women
  • Genetics – Arthritis can be hereditary

If you suspect your arthritis is affecting your feet, it is crucial that you see a podiatrist immediately. Your doctor will be able to address your specific case and help you decide which treatment method is best for you.

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

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Published in Blog
Tuesday, 09 November 2021 00:00

Arthritic Foot Care

During your lifetime, you will probably walk about 75,000 miles, which is quite a lot of stress to put on your feet. As you get older, the 26 bones and 30 joints in each of your feet will lose flexibility and elasticity. Your foot’s natural shock absorbers will wear down as well. Having arthritis added to this mix only makes matters worse. Your joints will become distorted and inflamed, which is why arthritic foot care needs to be something to think about every day.

When dealing with arthritis, having additional foot complications, such as bunions, hammertoes, or neuroma, can be a serious detriment. To avoid these, buy well-fitting shoes with a lower heel and good support. Arthritis causes you to lose your arch, so having shoes with good arch support is also highly recommended.

Aside from getting good arch support, the shoes need to fit comfortably and properly as well. A good place to start is by leaving a finger width between the back of the shoe and your foot to gauge proper size. It is also helpful to have a square or rounded toe box in the front to provide even more comfort. Another thing to look for is a rubber sole that can provide a cushion and absorb shock as you walk. This adds flexibility to the ball of your foot when you push off your heel to walk.

Exercise is another key aspect of arthritic foot care. Exercise not only strengthens and stretches your muscles and joints, but helps to prevent further injury and pain as well. Stretching the Achilles tendon, the tendon located in the back of your heel, will give you added mobility and reduce pain due to stress. Another thing you can do is massage your feet, kneading the ball of your foot as well as your toes from top to bottom.

Stretching the Achilles tendon is a simple exercise that you can do at home anytime. Lean against the wall with your palms flat against the surface while placing one foot forward, towards the wall, and one foot behind you. Bend your forward knee towards the wall while keeping your back knee locked straight, and make sure both your heels are completely touching the ground at all times. This will stretch your Achilles tendon and calf muscles as well. You will feel the stretch almost immediately. You can also stretch your toes in a couple ways. One involves taking a rubber band and wrapping it around both your big toes while your heels remain together. Then, pull them apart to stretch your big toe. You can also place a rubber band around all the toes of one of your feet. Then, try to separate each individual toe, stretching them all.

A final step you can take to help your arthritis is taking non-steroid, non-inflammatory drugs or topical medicines with capsaicin. Unfortunately, there is no complete way to remove all of your arthritic pain. However, following some of this advice can go a long way in staying as pain-free as possible.

Published in Featured
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, an 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 warmth 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 causing 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. 

Depending on the severity of your ankle pain and the condition behind it, recovery from ankle pain may take some time.

Consult with your foot and ankle doctor to best determine the cause of your ankle pain and the appropriate treatment.

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