Tarsal Tunnel Syndrome
Tarsal tunnel syndrome occurs when the tibial nerve, which runs through the ankle, becomes squeezed or is under abnormal pressure and it becomes inflamed.
It's kind of like carpal tunnel syndrome - which is a wrist disorder - of the foot.
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.
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.
Dr. Freels and Dr. Carter 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.
- Applying ice
- Anti-inflammatory medications
- Possibly using a cast that will immobilize your foot so it can heal properly.
- It’s important to properly support the arch, so we often will recommend orthotics, which will give you long-term relief.
- We might also send you for physical therapy.
- Use injections to relieve the pain and inflammation.
- Fit you with a brace that will relieve pressure from the foot.
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.