What is Tarsal Tunnel Syndrome?
The tarsal tunnel is a narrow space that lies on the inside of the ankle next to the ankle bones. 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. One of these structures is the posterior tibial nerve, which is the focus of tarsal tunnel syndrome
What is Tarsal Tunnel Syndrome?
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.
Tarsal tunnel syndrome is similar to carpal tunnel syndrome, which occurs in the wrist. Both disorders arise from the compression of a nerve in a confined space.
What are the symptoms of Tarsal Tunnel Syndrome?
Signs and symptoms of Tarsal Tunnel Syndrome may include:
- Vague pain in the sole of the foot
- Tingling, burning or numbness anywhere from the inside of your ankle, down to your arch, and into the bottom of your foot
- The sensation may feel like standing on pins and needles, shooting pain, or electric shocks.
- Pain may improve with rest and elevation
What are the causes of Tarsal Tunnel Syndrome?
The causes of tarsal tunnel are not fully understood. It is thought that tarsal tunnel syndrome may appear as a result of irritation, pressure, or an injury to one of the digital nerves that lead to the toes. And that the body’s response to this injury may involve a thickening the nerve tissue in that area.
Other causes of tarsal tunnel syndrome may include:
- Wearing high heel shoes or shoes that are tight fitting, including shoes that put pressure on your toes
- Strenuous or high impact athletic activities, such as running may make your feet susceptible to repetitive trauma
- Foot injuries
- Certain foot deformities such as hammertoes, bunions, flatfeet or extreme flexibility
- In other cases, there is no clear determinant of pressure or irritation.
How is Tarsal Tunnel diagnosed?
- Physical Examination:Dr Kevin Yip will examine the foot to arrive at a diagnosis and determine if there is any loss of feeling. During this examination, he will position the foot and tap on the nerve to see if the symptoms can be reproduced. He will also press on the area to help determine if a small mass is present.
- MRI: MRI to get a look at the soft tissues in the region to see if there’s a small mass in the tarsal tunnel, although it won’t show any damage to the nerve.
- Nerve Conduction Test:This test measures how fast nerve impulses travel along a nerve. If the test shows that the impulses are travelling slowly across the ankle, this may confirm a diagnosis of tarsal tunnel syndrome.
What are the treatments for Tarsal Tunnel Syndrome?
- Oral Medications: Pain relief and anti-inflammatory medications
- Anti-Inflammatory Injections: Cortisone injections
- Immobilization: Restricting movement of the foot by wearing a cast is sometimes necessary to enable the nerve and surrounding tissue to heal.
- Physical therapy: Ultrasound therapy, exercises, and other physical therapy modalities may be prescribed to reduce symptoms.
- Surgery: Procedure called Tarsal Tunnel Release. This is a surgical procedure performed in the operating room and it lasts about 30 to 45 minutes. When a tarsal tunnel release is performed, an incision is made to open up the tarsal tunnel and decrease pressure on the posterior tibial nerve.
NOTE: It is very important to seek early treatment if any of the symptoms of tarsal tunnel syndrome occur. If left untreated, the condition progresses and may result in permanent nerve damage. In addition, because the symptoms of tarsal tunnel syndrome can be confused with other conditions, proper evaluation is essential so that a correct diagnosis can be made and appropriate treatment initiated. Call now (65) 64762106 or fill out our Consultation request form for an appointment.
- Posterior Tibial Neuralgia: Tarsal Tunnel Syndrome