Tarsal tunnel syndrome

You’ve probably heard the term carpal tunnel syndrome; well, tarsal tunnel syndrome (TTS) is very similar to this condition, only it takes place in the ankle. The tarsal tunnel is a narrow space that lies on the inside of the ankle near the ankle bones. Covering this tunnel is a thick ligament that protects and maintains the structure of the nerves, tendons, arteries, and veins that are present here. One such nerve, called the posterior tibial nerve, is the victim of tarsal tunnel syndrome. Learn about what tarsal tunnel syndrome is, the symptoms, causes, and treatment.

What is tarsal tunnel syndrome?
As mentioned above, the posterior tibial nerve is the problem when it comes to tarsal tunnel syndrome. The syndrome occurs when this nerve is compressed or squeezed anywhere along the nerve path (which runs from the ankle into the foot), resulting in painful symptoms.

Causes
For many people, the exact cause of tarsal tunnel syndrome is unknown; however, the ultimate cause of tarsal tunnel syndrome is a compression or squeezing of the posterior tibial nerve. Unfortunately, this compression can result from various things, and so it is difficult to determine the exact cause. Those with flat feet are at a greater risk for getting tarsal tunnel syndrome because when the heel tilts outward it can cause strain and compression; an enlarged or abnormally present structure can cause this nerve to become compressed, such as a varicose vein, bone spur, or swollen tendon; an injury, like a sprained ankle, can cause inflammation and swelling around the posterior tibial nerve, eventually causing the nerve to become compressed. Some diseases—diabetes and arthritis—can cause swelling and, therefore, a squeezed nerve. People who put a lot of stress on the feet, such as athletes or those who stand a lot, are also at a greater risk for TTS.

Symptoms
The symptoms of tarsal tunnel syndrome can include: tingling, burning, or a sensation similar to that of an electric shock, in or around the ankles and toes; numbness; pain; swelling of the feet; painful burning or numbing sensations in the lower legs that may get worse with activity and better with rest; pain radiating up the leg; hot and cold sensations in the feet; pain while operating a vehicle; and a “pins and needles” feeling in the feet.

Treatment
Fortunately, there are different treatment options available for tarsal tunnel syndrome; surgery is usually a last resort, which is good for many people who don’t like to jump right to that option.

Rest
If you give your feet time to rest, you’re giving your feet time to heal. The more you can stay off your feet, the better off you’ll be. Obviously, this isn’t at all plausible for some people, and so it might not work for everyone. However, giving yourself a jumpstart for a few days to heal, you’d be doing yourself a big favor in the long run.

Immobilization
A little easier to handle than completely staying off the foot, immobilizing the foot and restricting its movement, is often a necessary step to allow the nerve and the foot to heal.

Ice
Ice packs are great for many things. Try applying an ice pack to your foot, placing a thin towel between the pack and your skin; do this for about 20 minutes, and wait about an hour before reapplying.

Oral medications
Certain over-the-counter oral medications—nonsteroidal anti-inflammatory drugs (NSAIDs)—can help reduce the pain and inflammation.

Physical therapy
Certain exercises may be recommended to help you bring back range of motion and reduce pain in the foot.

Injection therapy

Injections can be of help in tarsal tunnel syndrome. A local anesthetic can provide pain relief and a corticosteroid injection can reduce inflammation.

Orthotic devices and supportive shoes
Orthotics can be made to mold exactly to your foot. This will help provide support in the places where it is needed the most. The orthotics can help maintain the arch and limit the amount of motion your foot does. Certain shoes can be used for this same reason.

Bracing
Those who have a flat foot or very severe nerve compression may be fitted with a brace to reduce compression of the nerve and the pain associated with it.

Surgery
Sometimes, surgery is necessary. This decision will be made based on the advice of a foot doctor and a personal need. The surgeon will recommend a surgery that suits an individual’s exact needs.

Last updated on Nov 14th, 2010 and filed under Neurological Disorders. Both comments and pings are currently closed.

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