
Causes and Definition of Tarsal Tunnel Syndrome

Tarsal tunnel syndrome, a condition affecting the inner ankle and foot, arises from compression of the tibial nerve within the tarsal tunnel. This tunnel, enclosed by bone and soft tissues, houses nerves, arteries, and tendons. When pressure on the tibial nerve increases, it can result in tarsal tunnel syndrome. Causes vary, with one primary factor being overuse, leading to inflammation and swelling within the tunnel. Flat feet or conditions altering foot biomechanics may contribute by narrowing the tunnel and compressing the nerve. Ankle injuries, cysts, or tumors within the tunnel can exacerbate the compression, as can systemic conditions like diabetes or arthritis. Symptoms encompass tingling, burning sensations, and pain radiating to the arch, heel, or toes. Recognizing these indicators and understanding the diverse causes of tarsal tunnel syndrome is vital for timely intervention. If you have foot pain, it is strongly suggested that you schedule an appointment with a podiatrist who can diagnose and treat tarsal tunnel syndrome.
Tarsal tunnel syndrome can be very uncomfortable to live with. If you are experiencing tarsal tunnel syndrome, contact Darren Day, DPM of Hawaii. 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 offices located in Honolulu and Kahuku, HI . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
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.
Complications of Gout

Gout, a form of inflammatory arthritis, can lead to several complications if not properly managed. Chronic gout can cause persistent pain and swelling in the joints, significantly affecting mobility and quality of life. Over time, the buildup of uric acid crystals in the joints can lead to tophi, which are lumpy deposits that can be felt under the skin. These tophi can become inflamed or infected, causing further discomfort and complications. Repeated gout attacks can also lead to joint damage and deformity, particularly in the big toe, feet, ankles, and knees. This damage can be debilitating, leading to reduced joint function and chronic pain. Moreover, gout is often associated with other serious health conditions, including kidney stones as a result of excess uric acid. It can also increase the risk of cardiovascular diseases and chronic kidney disease. These complications underscore the importance of making an appointment with a podiatrist. If you have developed gout, it is strongly suggested that you are under the care of this type of doctor who can offer you relief and preventive options.
Gout is a painful condition that can be treated. If you are seeking treatment, contact Darren Day, DPM from Hawaii. Our doctor will treat your foot and ankle needs.
What Is Gout?
Gout is a form of arthritis that is characterized by sudden, severe attacks of pain, redness, and tenderness in the joints. The condition usually affects the joint at the base of the big toe. A gout attack can occur at any random time, such as the middle of the night while you are asleep.
Symptoms
- Intense Joint Pain - Usually around the large joint of your big toe, and it most severe within the first four to twelve hours
- Lingering Discomfort - Joint discomfort may last from a few days to a few weeks
- Inflammation and Redness -Affected joints may become swollen, tender, warm and red
- Limited Range of Motion - May experience a decrease in joint mobility
Risk Factors
- Genetics - If family members have gout, you’re more likely to have it
- Medications - Diuretic medications can raise uric acid levels
- Gender/Age - Gout is more common in men until the age of 60. It is believed that estrogen protects women until that point
- Diet - Eating red meat and shellfish increases your risk
- Alcohol - Having more than two alcoholic drinks per day increases your risk
- Obesity - Obese people are at a higher risk for gout
Prior to visiting your podiatrist to receive treatment for gout, there are a few things you should do beforehand. If you have gout you should write down your symptoms--including when they started and how often you experience them, important medical information you may have, and any questions you may have. Writing down these three things will help your podiatrist in assessing your specific situation so that he or she may provide the best route of treatment for you.
If you have any questions, please feel free to contact our offices located in Honolulu and Kahuku, HI . We offer the newest diagnostic and treatment technologies for all your foot care needs.
Gout
Gout is a form of arthritis that is caused by a buildup of uric acid crystals in the joints. This considered to be one of the most frequently recorded medical illnesses throughout history. Gout occurrences in the US have risen within the past twenty years and the condition now affects 8.3 million people which is 4% of all Americans. Researchers have found that gout affects men more than women and African-American men more than white men.
Symptoms of gout are warmth, swelling, discoloration, and tenderness in the affected joint area. The small joint on the big toe is the most common place for a gout attack to occur.
People who are obese, gain weight excessively, drink alcohol heavily, have high blood pressure, or have abnormal kidney function are more likely to develop gout. Furthermore, certain drugs and diseases are likely to increase levels of uric acid in the joints which eventually leads to gout. You are also more likely to develop gout if you eat a lot of meat and fish.
Many who experience gout attacks will experience repeated attacks over the years. Some people who have gout symptoms, may never have them again, but others may experience them several times a year. If you have gout symptoms throughout the year, you may have recurrent gout. Those who have gout should also be careful about their urate crystals collecting in their urinary tract, because this may lead to kidney stones.
Diagnosis for gout is done by checking the level of uric acid in the joints and blood. Your podiatrist may also prescribe medicine to reduce uric acid buildup in the blood, which will help prevent any gout attacks.
To treat gout, your podiatrist may also prescribe you Anti-inflammatory medication (NSAIDs) which will relieve the pain and swelling of a gout episode and it can also shorten a gout attack. Maintaining a healthy diet is also a proven method to prevent gout attacks.
Laser Treatment for Fungal Toenails

Fungal nail infections, medically known as onychomycosis, can be stubborn and challenging to treat. Traditional methods consisting of topical antifungal creams or oral medications may not always provide the desired results. In such cases, laser treatment for fungal nails has emerged as an alternative solution. Laser treatment, often referred to as laser therapy or laser fungal nail treatment, is a non-invasive procedure designed to target and eradicate the fungal infection in toenails or fingernails. During the procedure, a specialized laser emits a focused beam of light, which generates heat that penetrates the infected nail and the underlying fungal structures. This controlled heat effectively kills the fungus without causing damage to surrounding tissues. Laser treatment for fungal nails is considered a safe and efficient option, particularly for individuals who are reluctant to use or cannot tolerate traditional medications. If you have developed toenail fungus, it is suggested that you schedule an appointment with a podiatrist who can determine if laser treatment is right for you.
Laser treatment can be an effective way to get rid of toenail fungus. If you have any questions about laser treatment, consult with Darren Day, DPM from Hawaii. Our doctor will assess your condition and provide you with quality treatment for fungal nails.
What Are Toenail Fungal Infections?
Onychomycosis, or fungal infection of the nail, is a relatively common and non-serious condition. Around 10 percent of U.S. citizens are afflicted with fungal nails. Common forms of fungus that infect the nail include dermatophytes, yeasts, and molds.
Symptoms of Toenail Fungal Infections Include:
- Nail thickening
- Brittleness of the nail
- Discoloration of the nail
Diagnosis for Fungal Nails
Fungal infections are diagnosed by fungal culture and microscopy. This will rule out any other conditions such as nail trauma, psoriasis, lichen planus, and onychogryphosis.
What Is Laser Treatment?
Laser treatment is a non-invasive, safe, quick, and painless procedure that uses the heat from a laser to kill fungus in the nail. Each infected nail is targeted with a laser for several minutes. The treatment is usually utilized several different times over a select period. During this time, a podiatrist will keep an eye on the infection.
If you have any questions, please feel free to contact our offices located in Honolulu and Kahuku, HI . We offer the newest diagnostic and treatment technologies for all your foot care needs.
Laser Treatment for Fungal Nails
A new treatment for fungal nails, or onychomycosis, which has grown in popularity in recent years, is laser treatment. Laser treatment involves the use of a laser that kills fungus in the toenail with heat. Laser therapy causes no side effects and does not affect nearby healthy tissue.
Toenail fungus afflicts almost 10 percent of the U.S. population and is more common among the elderly. The most common symptom of toenail fungus is the discoloration and thickening of the nail. The nail can also become brittle and a foul smell may be produced. In rare cases, pain might be present. While it is not a serious condition, it can lead to a perception of disgust amongst those it affects. There are several different fungi that cause fungal infections. These include dermatophyte, yeast, and mold. The most common of these is dermatophyte.
Diagnosis for fungal nails involves a podiatrist utilizing microscopy and fungal cultures. This will allow the doctor to determine whether it is a fungus or another condition, such as lichen planus, psoriasis, nail damage, and onychogryphosis.
Fungus in the nails can be hard to get rid of with over-the-counter drugs. This is due to the nail being hard and protective, with fungus able to slip between the nail bed and plate. Furthermore the slow growth of the nail increases the difficulty of fungus going away. Laser treatment seeks to get around this by directly penetrating through the nail and killing the fungus. The laser is used on each infected nail for a couple of minutes. Patients then typically return several weeks or months later for another laser treatment. During this time the podiatrist will routinely observe the foot and infection. It is also recommended to wear clean socks and shoes and allow the feet to dry and breathe to prevent toenail fungus.
Laser treatment is still a relatively new treatment and not all podiatrists have laser machines. Ask your podiatrist if they do laser treatment for toenail fungus and if it is right for you.
Pediatric Podiatry

Podiatrists are healthcare specialists trained to care for foot and lower leg issues. They assist in easing foot pain, enhancing mobility, and offering care before and after foot surgery. They are also skilled in handling foot-related sports injuries and wounds affecting adults as well as children. They work in various healthcare environments, including private practice, clinics, and hospitals. Podiatrists are important to visit for children who are experiencing foot pain from conditions such as Sever’s disease, arthritis, and sports injuries. Additionally, skin issues including warts, calluses, and ingrown toenails can warrant a visit to the podiatrist. This type of doctor can also help with balance and walking issues, such as frequent tripping or unusual gait, in addition to advising on suitable footwear. If your child is experiencing foot issues, it is suggested that you make an appointment with a podiatrist who will collaborate with you and your child, devise a plan to address the problems, and help your child remain active and healthy.
If you are dealing with pain in your feet and ankles, you may want to seek help from a podiatrist. Feel free to contact Darren Day, DPM from Hawaii. Our doctor can provide the care you need to keep you pain-free and on your feet.
What Is a Podiatrist?
A podiatrist is a doctor of podiatric medicine who diagnoses and treats conditions of the foot, ankle, and related structures of the leg. Your podiatrist may specialize in a certain field such as sports medicine, wound care, pediatrics, and diabetic care. Podiatrists have the ability to become board certified through training, clinical experience, and then taking an exam.
What Do Podiatrists Do?
On a daily basis, a podiatrist may perform the following activities:
- Diagnose foot ailments such as ulcers, tumors, fractures, etc.
- Use innovative methods to treat conditions
- Use corrective orthotics, casts, and strappings to correct deformities
- Correct walking patterns and balance
- Provide individual consultations to patients
It is very important that you take care of your feet. It’s easy to take having healthy feet for granted, however foot problems tend to be among the most common health conditions. Podiatrists can help diagnose and treat a variety of feet related conditions, so it is crucial that you visit one if you need assistance.
If you have any questions please feel free to contact our offices located in Honolulu and Kahuku, HI . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
What is a Podiatrist?
A podiatrist is a Doctor of Podiatric Medicine who treats the foot, ankle, and related structures of the leg. If you are having any pain, injuries, or abnormalities in these areas, it is best that you seek help from a podiatrist.
Podiatrists complete four years of training in a podiatric medical school. Their training is like that of other physicians, and they may go on to complete a fellowship training after a residency training. Some podiatrists are board certified meaning they have advanced training, clinical experience, and have taken an exam to prove their skills. Certifying boards for podiatry are the American Board of Foot and Ankle Surgery and the American Board of Podiatric Medicine. Podiatrists may work in private practices, hospitals, clinics, or they may even become professors at colleges of podiatric medicine.
While in college, those who want to be podiatrists often take biology, chemistry, and physics classes in preparation for podiatry school. In podiatry school, students study how the bones, nerves, and muscles work together to help you move around. Additionally, they study injuries and how to properly diagnose and treat them. Admittance into podiatric medical school requires the completion of 90 semester hours of undergraduate study with a good grade point average, and acceptable scores on the MCAT (Medical College Admission Test)
Podiatrists treat many different conditions such as: aching feet, ankle pain, bunions, corns, hammertoes, fungus, ingrown toenails, plantar fasciitis, sprains and more. Common forms of treatment for these conditions are physical therapy, drugs, or surgery. Podiatrists may also recommend corrective shoe inserts, custom-made shoes, plaster casts, and strappings to correct deformities.
Even if you are someone whose feet are in generally good condition, you should still visit a podiatrist to have your feet properly exfoliated and maintained, or to make sure you are looking after your feet properly.
Symptoms and Treatment of Freiberg's Disease

Freiberg's disease, a condition affecting the bones in the ball of the foot, often near the base of the big toe, can cause substantial pain and discomfort. It is more apt to affect runners, dancers, and women who wear high heels. Freiberg's disease sometimes affects people with a short big toe and a longer second toe. It is characterized by the death of tissue in the foot's bones, primarily the second metatarsal head. Symptoms can include persistent pain, described as a sharp, aching discomfort. Swelling and stiffness in the affected joint can hinder mobility. The pain worsens during weight-bearing activities, especially when pushing off of the foot and wearing high-heeled shoes. Freiberg's disease is more prevalent in adolescent girls experiencing rapid growth, or people with specific bone structure issues. Diagnosis by a podiatrist involves taking X-rays to confirm and assess the condition's severity. Treatment options include corticosteroid injections to help manage pain and inflammation during flare-ups. Footwear modifications, including low-heeled shoes with thicker soles and rounded heels, can help redistribute pressure across the foot. Custom orthotics also can relieve pressure on affected joints. Surgery, which is rarely required, may involve removing the second metatarsal bone for unmanageable, persistent pain. If you suspect you may be suffering from Freiberg's disease, it is suggested that you make an appointment with a podiatrist for an accurate diagnosis and personalized treatment plan.
Some foot conditions may require additional professional care. If you have any concerns, contact Darren Day, DPM of Hawaii. Our doctor can provide the care you need to keep you pain-free and on your feet.
Rare Foot Conditions
The majority of foot conditions are common and can be treated by a podiatrist. Standard diagnostic procedures are generally used to identify specific conditions and treatment can be rendered. A podiatrist also treats rare foot conditions which can be difficult to diagnose and may need extra attention and care.
There are many rare foot conditions that can affect children. Some of these can include:
- Freiberg’s disease
- Kohler’s disease
- Maffucci syndrome
Freiberg’s disease - This can be seen as a deterioration and flattening of a metatarsal bone that exists in the ball of the foot. It typically affects pre-teen and teenage girls, but can affect anyone at any age. Symptoms that can accompany this can be swelling, stiffness, and the patient may limp.
Kohler’s disease - This often targets the bone in the arch of the foot and affects younger boys. It can lead to an interruption of the blood supply which ultimately can lead to bone deterioration. The patient may limp or experience tenderness, swelling, and redness.
Maffucci syndrome - This affects the long bones in a child’s foot leading to the development of abnormal bone lesions. They are benign growths and typically develop in early childhood and the bones may be susceptible to breaking.
A podiatrist can properly diagnose and treat all types of rare foot conditions. If your child is affected by any of these symptoms or conditions, please don’t hesitate to call our office so the correct treatment method can begin.
If you have any questions please feel free to contact our offices located in Honolulu and Kahuku, HI . We offer the newest diagnostic tools and technology to treat your foot and ankle needs.