Fighting Back Against Tarsal Tunnel Syndrome

You may be suffering from a neurological problem known as tarsal tunnel syndrome. Let's take a closer look at this annoying, possibly debilitating problem, along with some possible solutions to get you back on your feet.

What Is Tarsal Tunnel Syndrome?

Tarsal tunnel syndrome is to the ankle and foot what carpal tunnel is to the wrist and hand - a form of nerve compression that can cause pain, tingling, numbness, and other issues. The tarsal tunnel is a narrow passage between the ankle bones and a neighboring ligament called the flexor retinaculum. This space accommodates some important blood vessels and nerves, including the posterior tibial nerve. Below the ankle, the posterior tibial nerve branches off into different nerves that serve different areas of the foot. If any part of this nerve tissue becomes pinched, it can sustain damage and start to malfunction. The uncomfortable result is called tarsal tunnel syndrome.
Why does this nerve compression happen? In some people, pronation (flat feet) puts unnatural stress on the nerve fibers. Other potential causes include tumors, varicose veins, an injury, or localized swelling that presses on the posterior tibial nerve or its branches. If you have an underlying health problem such as diabetes, you may be especially vulnerable to nerve damage in this region.

Know the Symptoms

Tarsal tunnel syndrome typically causes symptoms such as burning, shooting, or "electric" pains in the ankle, heel or foot. You may also experience loss of sensation (numbness) or tingling sensations, either in an isolated spot or across a large portion of the foot. You need to get these symptoms checked by our podiatrist as soon as they appear -- partly to eliminate other possible causes, and partly to get the proper treatment before the nerve damage has a chance to become permanent.

Conservative Treatments to Relieve Your Discomfort

Our podiatrist, Dr. Velimir Petkov, can evaluate your symptoms and X-ray your ankle to look for signs of inner structural abnormalities compressing the nerve tissue. We also perform a test called Tinel's Test, tapping on the area to see if it reproduces your symptoms. Depending on what we find, we may recommend a number of non-invasive techniques to help you heal. If you have flat feet, orthotic insoles can correct your weight distribution and take stress off of the nerve. Your condition may also respond to strengthening, balance, or "nerve gliding" exercises that normalize your stance and gait. If inflammation is squeezing the nerve, we may use corticosteroid injections to get the swelling down.

Another Option: Tarsal Tunnel Release Surgery

If conservative techniques can't resolve your symptoms, we may recommend a procedure called tarsal tunnel release surgery. An incision is made in the side of the ankle so we can go in and release the flexor retinaculum (and any other tissues that are pinching the posterior tibial nerve tissue). You'll be on crutches for up to 6 weeks afterward to prevent putting any weight on the foot - but the long-term relief you experience should be well worth it. Be aware, however, that the syndrome may return unless you've dealt with the underlying issues that made you vulnerable to it in the first place.
Don't let tarsal tunnel syndrome turn standing or walking into a dreaded chore. Contact us to schedule your evaluation in our Clifton, NJ office and get the treatment you need!

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