Tarsal tunnel syndrome is a compression, or squeezing, on the posterior tibial nerve that produces symptoms anywhere along the path of the nerve running from the inside of the ankle into the foot.
The tarsal tunnel is found along the inner leg behind the medial malleolus (bump on the inside of the ankle). The tunnel is covered with a thick ligament (the flexor retinaculum) that protects and maintains the structures contained within the tunnel — arteries, veins, tendons, and nerves. Within the tarsal tunnel lies a nerve called the posterior tibial nerve. Tarsal tunnel syndrome, or TSS, results when the posterior tibial nerve is compressed within the tarsal tunnel.
Tarsal tunnel syndrome is similar to carpal tunnel syndrome, which occurs in the wrist, as both disorders arise from the compression of a nerve in a confined space.
Causes
Tarsal tunnel syndrome can be caused by injury, disease or anything that produces compression on the posterior tibial nerve, such as:
- Having flat feet or fallen arches, which can produce strain or compression on the tibial nerve.
- An injury, such as an ankle sprain, may produce inflammation and swelling in or near the tunnel, resulting in compression of the nerve.
- Systemic diseases such as diabetes or arthritis can cause swelling, thus compressing the nerve.
- An enlarged or abnormal structure, such as a varicose vein, ganglion cyst, swollen tendon, or bone spur compressing the nerve.
Symptoms
The symptoms of tarsal tunnel syndrome are typically felt on the inside of the ankle and/or on the bottom of the foot. In some people, a symptom may be isolated and occur in just one spot. In others, it may extend to the heel, arch, toes, and even the calf.
These symptoms may include:
- Shooting pain in the foot
- Numbness
- Tingling or burning sensation
These symptoms are often brought on or aggravated by overuse of the foot, such as in prolonged standing, walking or exercising.
Non-surgical Treatment
A variety of treatment options, often used in combination, are available to treat tarsal tunnel syndrome. These include:
- Rest: As with most injuries to the foot and ankle, the more time you spend off your feet, the faster the affected area should heal.
- Ice: Apply an ice pack to the affected area, placing a thin towel between the ice and the skin, to reduce swelling and inflammation.
- Oral Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can help reduce the pain and inflammation.
- Physical Therapy: Physical therapy may be prescribed to reduce symptoms both before and after surgery.
- Injection Therapy: An injected corticosteroid may sometimes be used to treat inflammation.
- Orthotics: A custom-made shoe inserts may be prescribed by a podiatrist to help properly maintain the arch and limit excessive motion that can cause compression of the nerve.
- Bracing: Patients with flatfoot or those with severe symptoms and nerve damage may be fitted with a brace to reduce the amount of pressure on the foot.
Surgical Treatment
In many cases, surgery is often the the best option for treating tarsal tunnel syndrome. Only be visiting your local podiatrist will you know if surgery is necessary and it is important to seek help if you believe you are suffering from any of the aforementioned symptoms.
Dr. Goldbaum’s Take
At Delray Beach Podiatry we actually do nerve conduction velocities studies to actually see if the patient is experiencing tarsal tunnel syndrome. The condition is extremely painful as patients will often get a shooting nerve impulse that can soot all the way to the ends of the toes at times.
A lot of times, a patient’s foot is pronating, which is stretching on that nerve, so it gets caught and we have to release it in order to relieve the pain. We have to surgically go in and release all the tissue around that area that is compressing onto the nerve.
Once we do the surgery, patients do really well. We put them into physical therapy afterwards and also follow up to make sure there is no scar formation.
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The content on this website is for informational purposes only. Do not rely or act upon information from www.DelrayBeachPodiatry.com without seeking professional medical advice. If you live in South Florida and would like a consultation with Dr. Ian Goldbaum, a podiatric physician and surgeon with over 30 years of experience, please see our contact information below:
BOCA/DELRAY
16244 S. Military Trail #290, Delray Beach, FL 33445
561-499-0033
BOYNTON BEACH
8198 Jog Road #100, Boynton Beach, FL 33472
561-499-0033
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