Tarsal tunnel syndrome is the compression of the posterior tibial nerve and is one of the most common nerve entrapments that affect the foot and ankle. The most common area of entrapment of this nerve is on the inside or medial aspect of the ankle. The nerve in this area runs through a tunnel that also houses an artery, vein, and 3 tendons. Thus any trauma or inflammation of any of the structures in that tunnel can compress the nerve and cause symptoms to of a compressed nerve to occur.
Signs and Symptoms of Tarsal Tunnel Syndrome
Patient with tarsal tunnel syndrome will often present with numbness to the bottom of the foot, and shooting or burning pain into the foot or up the leg. It is often worse with any type of pressure to the area.
Diagnosing Tarsal Tunnel Syndrome
Tarsal tunnel syndrome is often tested by percussion of the nerve in the area of compression. A positive result would result in shooting or radiating pain down into the foot or up the leg. This diagnosis is often confirmed with nerve conduction studies to measure the function of the nerves. Although there can be false negative results in terms of local compression of the nerve, these studies can help reveal or distinguish whether or not there is any lower back involvement that are causing symptoms. A magnetic resonance image (MRI) or ultrasound may be helpful in identifying any soft tissue masses or swelling in the structures in the tarsal tunnel that may be compressing the nerve.
Tarsal Tunnel Treatment Options
Tarsal tunnel syndrome is treated by removing the source of compression on the tibial nerve. Physical therapy, rest, ice and anti-inflammatory medication can help reduce swelling of the tendon sheath and reduce pressure on the nerve. Local steroid injections are often used to reduce inflammation of the nerve. Additionally, custom inserts for shoes may help reduce strain on tendons that are swelling and causing compression. Surgery may be indicated if conservative measures fail. Surgery may sometimes involve removing a soft tissue mass if that is the source of compression. The most common surgical treatment for tarsal tunnel syndrome is to release the ligament that forms the tarsal tunnel that houses the nerve, allowing more space for the structures in the tarsal tunnel and thereby reducing the compression on the nerve.
To improve the success of this procedure, a new product (amniotic membrane) is now being used to wrap around the neurovascular bundle, reducing scar tissue and inflammation after the surgery. This prevents adhesions from forming and thus would help reduce irritation of the structures in the tarsal tunnel after surgery.
Tarsal tunnel syndrome is a painful condition of the foot and ankle that can affect ambulation and gait. It is a condition that can easily be misdiagnosed as heel pain or plantar fasciitis. It is important to have your foot and ankle evaluated by a specialist in order to get the best care and appropriate treatment for your feet.
If you are in need of expert foot or ankle care, make an appointment with a doctor at one of our nine Greater Los Angeles locations. Please call 877-989-9110 or visit us at www.footankleinstitute.com
He then went on to complete his surgical reconstruction fellowship with the University Foot and Ankle Institute, one of only a few fellowships recognized by the American College Foot and Ankle Surgeons.
Now playing an integral role at the University Foot and Ankle Institute, Dr. Yau’s treats various sports injuries, including sprains, arthritis and fractures. He also is passionate about helping diabetic patients avoid amputation through correction of deformities and wound healing.
Dr. Yau is available for consultation at our Simi Valley location.
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