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TARSAL TUNNEL
Tarsal tunnel syndrome is a condition where the tibial nerve (the largest nerve to enter the foot) is compressed, causing pain and numbness. The compression of the nerve occurs at the tarsal tunnel, a canal formed at the inner part of the ankle, just behind the medial malleolus, that large bony bump on the inside part of the ankle.
CAUSES
Tarsal tunnel syndrome can be caused by injury, disease, or due to the natural shaping of the foot. Causes include:
- Flat feet or fallen arches, which can produce strain or compression on the tibial nerve
- Swelling caused by an ankle sprain which then compresses on the nerve
- Diseases such as arthritis or diabetes that can cause swelling, thus resulting in compression of the tibial nerve
- A space-occupying lesion, i.e., an enlarged or abnormal structure, such as a varicose vein, ganglion cyst, swollen tendon, or bone spur that might compress the nerve
SYMPTOMS
- Pain and tingling around the ankle
- Swelling in the foot
Pain radiating up into the leg or down into the ankle and foot with a pins and needles feeling in the foot.
WHEN YOU SHOULD SEEK CARE WITH US:
Patients who notice new evidence of numbness and tingling in the foot with radiation in the leg should see our office for a proper diagnosis. Our office will perform a full musculoskeletal examination and neurological examination. We may order additional non-invasive tests to develop an accurate diagnosis.
TYPES OF TREATMENT WE OFFER:
Tarsal tunnel syndrome can be treated conservatively; however, surgical intervention may be warranted. The goal of conservative therapy is to reduce the swelling in the ankle that causes compression of the nerve.
Conservative Options
Anti-Inflammatory Medication—Early treatment may involve oral or injectable anti-inflammatory medication to reduce the swelling in the inner ankle area
Rest and Icing—Used to relieve pain and reduce swelling
Bracing and Strapping—May be used for correcting biomechanical imbalance, controlling excessive pronation, and supporting the ligaments and tendons attached to the heel bone. This helps reduce motion at the ankle that can cause compression of the nerve.
Custom-Molded Orthotics—These custom-made shoe inserts are useful in controlling foot function and to relieve pressure from the inner ankle.
Surgical Treatment
For more serious cases of tarsal tunnel syndrome, surgical intervention to reduce the underlying cause of the compression may be needed. In such cases the surgeon would decompress the nerve and relieve it of any impingements that may cause compression.
