Tarsal Tunnel Syndrome
What is Tarsal Tunnel Syndrome?
Tarsal Tunnel Syndrome is a condition caused by the compression of the posterior tibial nerve as it passes through the tarsal tunnel, located on the inner side of the ankle. The tarsal tunnel is a narrow space formed by bones and soft tissues. Similar to carpal tunnel syndrome in the wrist, TTS can cause pain, numbness, and tingling in the affected area. The condition occurs when the posterior tibial nerve is pinched or squeezed due to swelling or abnormalities within the tunnel.
Causes of Tarsal Tunnel Syndrome
Tarsal Tunnel Syndrome can result from various factors, including:
- Injury: Ankle sprains, fractures, or any trauma to the area can lead to swelling and subsequent compression of the nerve.
- Flat Feet: People with flat feet are at higher risk due to the outward tilting of the heel, which can stretch and compress the nerve.
- Medical Conditions: Conditions such as arthritis, diabetes, or thyroid dysfunction can increase the risk of TTS by causing swelling or inflammation around the nerve.
- Overuse: Activities that involve repetitive foot movements, such as running or prolonged standing, can contribute to nerve compression.
- Abnormal Growths: Tumours, cysts, or varicose veins in the tarsal tunnel area can put pressure on the nerve.
Symptoms
Symptoms of Tarsal Tunnel Syndrome may include:
- Pain and Burning Sensation: Pain along the inner ankle or foot, often described as a burning or tingling sensation, which can radiate into the toes.
- Numbness or Tingling: Numbness or a “pins and needles” sensation in the sole of the foot.
- Swelling: Swelling in the ankle area, which can exacerbate nerve compression.
- Weakness: Weakness in the foot muscles, making it difficult to walk or stand for long periods.
- Worsening Symptoms: Symptoms typically worsen with activity, especially prolonged standing or walking, and improve with rest.
Recognising these symptoms early can lead to more effective treatment and better outcomes.
Diagnosis
Diagnosing Tarsal Tunnel Syndrome typically involves:
- Physical Examination: A podiatrist will examine the foot and ankle, checking for tenderness, swelling, and the Tinel’s sign (a tingling sensation when the nerve is tapped).
- Imaging Tests: X-rays can help rule out other conditions like fractures, while MRI or ultrasound can provide detailed images of soft tissue structures to identify abnormalities such as cysts or inflammation.
- Nerve Conduction Studies: These tests measure the electrical activity of the nerves and muscles, helping to confirm nerve compression and assess its severity.
Early diagnosis is essential to prevent further damage and to start appropriate treatment.
Treatment Options
Treatment for Tarsal Tunnel Syndrome can vary based on the severity of the condition.
Non-Surgical Treatments:
- Rest and Ice: Reducing activity and applying ice to the affected area can help alleviate symptoms if not for a temporary basis.
- Exercises: Exercises to strengthen and stretch the muscles around the ankle can provide relief by reducing pressure on the nerve.
- Medications: Sometimes anti-inflammatory medications, such as ibuprofen, can reduce pain and swelling. In some cases, corticosteroid injections may be used to reduce severe inflammation. At RS Podiatry Clinic we specialise in non-invasive and non-drug based alternatives with high success rates.
- Orthotic Devices: Orthotics can provide support and reduce strain on the foot, helping to alleviate symptoms, especially in patients with flat feet.
Surgical Treatments:
- If non-surgical treatments are ineffective, surgery may be considered. Surgical options include:
- Tarsal Tunnel Release: This procedure involves making an incision to release the ligament compressing the nerve, thereby relieving pressure.
- Removal of Abnormal Growths: If cysts, tumours, or varicose veins are causing the compression, they may be surgically removed.
Prevention Tips
Preventing Tarsal Tunnel Syndrome involves:
- Wearing Proper Footwear: Shoes with good support and cushioning can prevent undue stress on the feet, especially for those with flat feet.
- Avoiding Overuse: Taking breaks during repetitive activities, such as standing or walking for long periods, can help prevent overuse injuries.
- Maintaining a Healthy Weight: Excess weight can increase pressure on the feet and ankles, contributing to nerve compression.
- Managing Underlying Conditions: Proper management of conditions like diabetes, arthritis, and thyroid disorders can reduce the risk of developing TTS.
Questions to Ask Your Healthcare Provider
When discussing Tarsal Tunnel Syndrome with your healthcare provider, consider asking the following questions:
- What is the most probable cause of my tarsal tunnel syndrome?
- What exercises can I do at home help alleviate my foot pain?
- What treatment options are available for TTS?
- At what point should I consider surgery for tarsal tunnel syndrome?
- How can I prevent the symptoms of TTS from recurring after treatment?
When to See a Podiatrist
It is advisable to consult a podiatrist if you experience persistent symptoms of Tarsal Tunnel Syndrome. Signs that you need professional help include:
- Pain that doesn’t improve with rest and over-the-counter medications
- Persistent numbness or tingling in the foot
- Swelling that doesn’t go down
- Weakness in the foot or ankle
- Difficulty walking or standing for prolonged periods
- Tried other treatment options
At RS Podiatry Clinic, we offer specialised care to diagnose and treat Tarsal Tunnel Syndrome effectively. Our team of experts is dedicated to providing personalised treatment plans to help you get back on your feet.
Our goal is to help you maintain optimal foot health and overall well-being.