Tarsal Tunnel
Tarsal tunnel syndrome occurs when the tibial nerve, which runs through the ankle, becomes squeezed or is under abnormal pressure and it becomes inflamed.
Tarsal tunnel syndrome occurs when the tibial nerve, which runs through the ankle, becomes squeezed or is under abnormal pressure and it becomes inflamed.
There are a few potential causes of tarsal tunnel, such as soft tissue masses or inflamed vessels (spider veins around the ankle), flat feet, over-pronation (the foot rolls inward when you walk), high arches and ankle joint instability, a sprained ankle, diabetes and arthritis.
It can also be caused by nearby foot problems that can add pressure to the nerve, like a bone spur, ganglion cyst, tendonitis or an inflamed tendon.
Diagnosing
We'll examine the foot and ankle carefully and perform a comprehensive gait analysis. There's a simple way to tap on part of the foot where the nerve lies, and if it hurts, there's a good chance it's tarsal tunnel.
We may also order an in-house (or refer out) Nerve Conduction Velocity (NCV) test which confirms tarsal tunnel, or will rule out any nerve entrapment.
Symptoms
Symptoms can include a burning pain in the arch, heel and maybe the toes, a tingling or numbness in the bottom of the foot, and pain when running, standing or laying down.
The symptoms can even feel like a searing sharp "knife-like" feeling in the bottom of the heel or that radiates upward towards the calf.
Sometimes the pain may come on suddenly, and other times it might be brought on by overuse like working out or standing for a long time, especially on hard surfaces. Pain while sitting is often mentioned by patients.
We often have patients that are misdiagnosed with plantar fasciitis and and have been treated with multiple steroid injections, physical therapy, custom orthotics, immobilizing boots, even surgery and the pain still won't go away.
Our providers treat tarsal tunnel daily, which is one of the most commonly missed diagnoses. You will get a rapid diagnosis on your first visit. Comprehensive and aggressive treatment plans are designed to significantly reduce your pain levels in just a few weeks.
Treatment
When treating tarsal tunnel syndrome, we begin with nonsurgical approaches to reduce inflammation and relieve pressure on the tibial nerve. We bein with resting, icing, taking NSAIDs, and using custom orthotics or splints.
If conservative methods fail, we can discuss steroid injections, regenerative therapies, or outpatient surgery to decompress the nerve.
Prevention
You cannot always prevent Tarsal Tunnel Syndrome, especially if it results from conditions like arthritis or a ganglion cyst. However, you can lower your risk of nerve compression by modifying daily habits.
Wear Supportive Footwear: Choose shoes with adequate cushioning and medial arch support. Avoid tight shoes and high heels that strain the ankle and foot.
Correct Foot Mechanics: Use custom orthotics or quality arch supports if you have flat feet or overpronation to align your foot and reduce tibial nerve strain.
Stretch and Strengthen: Perform exercises to strengthen lower leg muscles, especially the tibialis posterior, and include calf stretches and nerve gliding exercises to enhance flexibility and reduce nerve friction.
Manage Your Activity Levels: Avoid overworking your feet and ankles. Take breaks if standing for long periods or doing heavy activities. Gradually increase training intensity and use ankle braces on uneven surfaces.