Table of Contents
What's the Problem?
Tarsal tunnel syndrome is a chronic injury caused by compression or squeezing of the nerve that provides sensation to the bottom of your foot. This nerve is called the Posterior Tibial Nerve and passes through a fibrous tunnel located behind the bone on the inside of your ankle, known as the Tarsal Tunnel. This syndrome is similar to the Carpal Tunnel Syndrome, a painful condition which affects the wrists of so many computer typists. Our podiatrist in Wichita explains everything you need to know below.
How Does Tarsal Tunnel Syndrome Feel?
This nerve is very sensitive to pressure once it becomes compressed or squeezed and can cause a variety of sensations or feelings. Often times, the feeling of "pins and needles", burning or numbness may be felt. Pain may be felt when the area behind the inside ankle bone is pressed. The feeling of pain and numbness may also be felt when running or standing for long periods of time or even wearing tight shoes. These painful feelings or sensations are often worse at night.
In addition to pain directly over the nerve patients often experience pain, tingling, burning or other unusual sensations through the arch, around to the bottom of the foot or radiating to the toes.
Let's Do a Test!
Tarsal Tunnel Syndrome may be diagnosed by a careful history and physical examination by your doctor. They may touch the course of the nerve with a vibrating tuning fork, or tap the nerve gently with a rubber percussion hammer. If a tingling or shooting pain is felt moving towards the toes, this is called a positive Tinel's Sign and is a positive indication that a nerve compression is present. Your doctor may utilize more sophisticated tests to help determine if you have this syndrome. Such tests may include a Nerve Conduction Velocity Test (NCV), that measures the speed of conduction of nerve signals as they pass through the tunnel. In the case of Tarsal Tunnel Syndrome, the nerve impulses pass through the tunnel more slowly than normal. Magnetic Resonance Imaging( MRI) may also be done, to provide an accurate image of the nerve in the tunnel.
What Causes Tarsal Tunnel Syndrome?
The Posterior Tibial Nerve, along with the artery and vein, course behind the inside ankle bone, in a tunnel formed by bone (your heel bone) and a fibrous band (the Flexor Retinaculum). This tunnel is called the Tarsal Tunnel. Since the Posterior Tibial Nerve is very sensitive, especially to pressure, it can become compressed within this tunnel. Tarsal Tunnel Syndrome may occur after an injury to your foot or ankle. Such injuries include ankle sprains or fractures of certain foot bones. The compression of the Posterior Tibial Nerve may also occur with certain illnesses such as diabetes or rheumatoid arthritis. Varicose veins in the Tarsal Tunnel may also compress the nerve. An excess of a certain otherwise normal motion of your foot, called pronation, where your feet roll towards each other, stretch and flatten, may also compress or stretch this nerve.
What Can I Do For Tarsal Tunnel Syndrome?
Rest and over-the-counter anti-inflammatory medication, like ibuprofen, may help calm the inflamed nerve. Over-the-counter shoe inserts may also help control any excessive motion of your foot that is contributing to the injury. Avoiding certain types of shoes that may be too tight or too flimsy may also help.
What Will My Podiatrist Do for Tarsal Tunnel Syndrome?
Your podiatrist will carefully examine the cause of compression of the nerve and direct treatment toward reducing or eliminating that pressure. Treatment recommendations may vary based on the underlying cause of your symptoms, the severity of the nerve irritation, and how long you have been experiencing pain.
At Central Kansas Podiatry, treatment options for tarsal tunnel syndrome may include:
- Prescription-strength anti-inflammatory medication. Medication may be recommended to help reduce inflammation around the posterior tibial nerve and relieve pain.
- Custom molded orthotics. If abnormal foot motion is contributing to nerve compression, custom orthotics may be provided to improve foot mechanics, support the arch, and reduce strain on the affected nerve.
- Shockwave therapy. Shockwave therapy may be used to stimulate healing, improve circulation, and help reduce pain and inflammation in the affected area.
- Remy laser therapy. Remy laser therapy may help decrease inflammation, improve blood flow, and provide pain relief while supporting the body’s natural healing process.
- DPMX therapy. DPMX may be incorporated into your personalized treatment plan to help manage discomfort and support recovery.
- Liposana treatment. Liposana may be recommended as part of a comprehensive approach to reducing nerve irritation and promoting healing of affected tissues.
- Surgery. If conservative treatments fail to provide relief, surgery may be recommended to release the posterior tibial nerve and reduce compression.
