TARSAL TUNNEL SYNDROME

 Tarsal tunnel?  Sounds like carpal tunnel doesn’t it?  This condition is obviously not as common as carpal tunnel, but the symptoms have a lot in common.  The burning of tingling and painful sensations that he may be feeling on the bottom of one or both feet may be related to this condition.  Mind you, anyone experiencing these symptoms should be evaluated by a podiatrist.

Tarsal tunnel syndrome is a condition where the nerve innervating the bottom of the foot,  known as the posterior tibial nerve, is being compressed.  This compression is located along the inside portion of your ankle.  Along with the artery, veins and tendons running in the same tight location, the posterior tibial nerve is in constant competition for space.  When the space gets tights, symptoms such as shooting pain, numbness, tingling or burning can be experienced along the inside of the ankle and or the bottom of the foot.  If the symptoms are bad enough, pain can extend from the heel to the toes, and even up to the calf.  Any of these symptoms can come on very gradually to very suddenly and the pain can be debilitating.

Who runs the risk of developing tarsal tunnel syndrome?  Anybody with a flat-foot type can develop this condition by the abnormal biomechanics involved here.  When the foot rolls outward as seen in a flat-foot, increased compression of the nerve occurs as it runs along the inside portion of the ankle.  This is also seen in people who are overweight as any increased weight causes increased flattening of the foot.  Any space occupying lesion can also cause tarsal tunnel to develop.  This includes people with varicosities, which are commonly seen wrapping around the area of nerve involvement.  Other space occupying lesions can include any soft tissue mass or, even in some cases, increased musculature (known as an accessory muscle} along the inside portion of the arch.  In some cases, an injury with excessive torque on the ankle can produce the type of compression needed to inflict tarsal tunnel.

Tarsal tunnel is typically diagnosed clinically and confirmed with neurological testing known as “nerve conduction velocity” testing.  Once diagnosed, treatment usually begins very conservatively through alteration of activities, physical therapy, functional orthotics or even cortisone injections.  Severe cases of tarsal tunnel may require surgery. 

Surgical intervention involves releasing of any tight structures surrounding the nerve, and/or removing any of the space occupying lesions. 

Needless to say, this is not one of those conditions that can be treated with BenGay and Dr. Scholls inserts.  Please feel free to make an appointment for proper diagnosis and treatment. We are here to help.