Jane was a 35-year-old woman who had been suffering from pain and numbness in her foot for several months. The pain was worse at night and made it difficult for her to sleep. She also had difficulty walking and standing for long periods of time.
Jane went to see a doctor, who diagnosed her with tarsal tunnel syndrome. Tarsal tunnel syndrome is a condition that occurs when the tibial nerve, which runs through the ankle, is compressed. This can cause pain, numbness, and tingling in the foot.
The doctor recommended that Jane try non-surgical treatments, such as rest, ice, and over-the-counter pain medication. However, these treatments did not relieve Jane’s symptoms.
After several months, Jane decided to have surgery to relieve the pressure on the tibial nerve. The surgery was successful, and Jane’s symptoms were relieved. She was able to return to her normal activities, including walking, standing, and playing sports.
Tarsal tunnel syndrome is a treatable condition. If you are experiencing pain, numbness, or tingling in your foot, it is important to see a doctor to get a diagnosis and treatment.
What Is the Tarsal Tunnel?
The tarsal tube is a small space next to the ankle bones on the inside of the foot. The tunnel is surrounded by a thick ligament called the flexor retinaculum, which covers and takes care of the arteries, veins, muscles, and nerves that are inside the tunnel. The posterior tibial nerve is one of these elements, and tarsal tunnel syndrome is all about it.
What Is Tarsal Tunnel Syndrome?
The posterior tibial nerve is squeezed in tarsal tunnel syndrome, which causes pain anywhere along the nerve’s path from the inside of the ankle to the foot.
Tarsal Coalition, When the two tarsal bones in the back of the foot grow together in an abnormal way, is like tarsal tunnel syndrome. Both conditions happen when a nerve is squished in a small spot.
Causes
Tarsal tunnel syndrome is caused by anything that puts pressure on the posterior tibial nerve, such as:
- A person with flat feet is more likely to get tarsal tunnel syndrome because their “fallen” arches cause their heels to turn outward. This can put pressure on the nerve and make it hurt.
- When an abnormal or larger structure takes up room in the tube, it can put pressure on the nerve. Varicose veins, ganglion cysts, swollen tendons, and bone spurs caused by arthritis are all examples.
- A sprained ankle, for example, can cause swelling and inflammation in or near the tunnel. This can put pressure on the nerve.
- Systemic diseases like diabetes or arthritis can lead to swelling, which can put pressure on a nerve.
Symptoms
When a person has tarsal tunnel syndrome, they may have one or more of the following signs:
- A feeling like an electric shock, tingling, or burning.
- Numbness
- Pain, including pain that shoots
Most of the time, symptoms are felt on the inside of the ankle or on the bottom of the foot. Some people may only have one spot where a sign shows up. In some people, it can reach the heel, the arch, the toes, and even the leg.
Sometimes, the syndrome’s signs show up all at once. Most of the time, they happen because the foot is used too much, like when you stand for a long time, walk a lot, exercise, or start a new exercise program.
Diagnosis
The foot and ankle surgeon will look at the foot to figure out what’s wrong and to see if the foot has lost feeling. During this test, the surgeon will place the foot in a certain way and tap on the nerve to see if the symptoms can be made to happen again. He or she will also press on the area to help figure out if there is a small lump.
Advanced imaging tests may be done if a mass is suspected or if the symptoms don’t get better after the first treatment. Electromyography and nerve conduction velocity (EMG/NCV), which are used to analyze nerve problems, may be ordered if the situation doesn’t get better with non-surgical treatment.
Non-surgical Treatment
Tarsal tunnel syndrome can be treated with a number of different methods, which are often used together. These things are:
- Rest. Staying off the foot keeps it from getting hurt more and helps it heal.
- Ice. Place an ice pack on the hurt area and put a small towel between the ice pack and the skin. Use ice for 20 minutes, then wait at least 40 minutes before icing again.
- Oral medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, help lower pain and swelling.
- Immobilization. Sometimes a cast is needed to stop the foot from moving so that the nerve and the muscle around it can heal.
- Physical therapy. Symptoms can be lessened with ultrasound treatment, movements, and other types of physical therapy.
- Injection therapy. Local numbing injections take away the pain, and cortisone injections may help treat the redness.
- Orthotic devices. Custom shoe patches may be given to help keep the arch and stop the foot from moving too much, which can put pressure on the nerve.
- Shoes. Some people may suggest shoes with good support.
- Bracing. Patients with flatfoot or serious complaints and nerve damage may be given a brace to lessen the amount of pressure on the foot.
When is Surgery Needed?
When it comes to healing tarsal tunnel syndrome, surgery is sometimes the best way to go. The foot and ankle surgeon will decide if surgery is needed and, if it is, will choose the right treatment or procedures based on what is wrong.