Tarsal Tunnel Syndrome
Tarsal tunnel syndrome involves the compression or squeezing of the posterior tibial nerve that results in numbness, shooting pain, burning pain and tingling sensation of the inside ankle, or bottom of the feet. The symptom is triggered by activity, or weight bearing.
Tarsal tunnel is a narrow space on the inside of the ankle that is covered by a thick ligament. Contained in the tunnel are the arteries, veins, tendons and nerves to the feet. One of the nerves is the posterior tibial nerve. When it is compressed, it elicits symptoms of tarsal tunnel syndrome.
Causes:
Tarsal tunnel syndrome can be caused by flat feet, or enlarged or abnormal structure within the tarsal tunnel. For example, varicose veins, ganglion cysts, arthritic bone spurs or swollen tendons can cause the impingement of the nerve. Other causes include acute ankle injuries, direct trauma to the tarsal tunnel, or systemic diseases such as diabetes or arthritis.
Diagnosis:
A thorough foot and ankle examination can assist a physician to arrive at the diagnosis. Tapping on the nerve at the tarsal tunnel site to reproduce the shooting pain can indicate whether tarsal tunnel syndrome is present or not. Advanced imaging can also be ordered to further visualize the site for any impingement from abnormal masses, or swelling of neighboring tendons. Other studies such as electromyography and nerve conduction studies can be helpful.
Treatments:
Conservative treatments for tarsal tunnel syndrome include rest, ice, oral medication, immobilization, physical therapy, injection therapy, orthotic devices, shoes and bracing. If conservative treatment is ineffective, surgical treatment can involve decompression of the impingement site within the tarsal tunnel.
Tarsal tunnel syndrome involves the compression or squeezing of the posterior tibial nerve that results in numbness, shooting pain, burning pain and tingling sensation of the inside ankle, or bottom of the feet. The symptom is triggered by activity, or weight bearing.
Tarsal tunnel is a narrow space on the inside of the ankle that is covered by a thick ligament. Contained in the tunnel are the arteries, veins, tendons and nerves to the feet. One of the nerves is the posterior tibial nerve. When it is compressed, it elicits symptoms of tarsal tunnel syndrome.
Causes:
Tarsal tunnel syndrome can be caused by flat feet, or enlarged or abnormal structure within the tarsal tunnel. For example, varicose veins, ganglion cysts, arthritic bone spurs or swollen tendons can cause the impingement of the nerve. Other causes include acute ankle injuries, direct trauma to the tarsal tunnel, or systemic diseases such as diabetes or arthritis.
Diagnosis:
A thorough foot and ankle examination can assist a physician to arrive at the diagnosis. Tapping on the nerve at the tarsal tunnel site to reproduce the shooting pain can indicate whether tarsal tunnel syndrome is present or not. Advanced imaging can also be ordered to further visualize the site for any impingement from abnormal masses, or swelling of neighboring tendons. Other studies such as electromyography and nerve conduction studies can be helpful.
Treatments:
Conservative treatments for tarsal tunnel syndrome include rest, ice, oral medication, immobilization, physical therapy, injection therapy, orthotic devices, shoes and bracing. If conservative treatment is ineffective, surgical treatment can involve decompression of the impingement site within the tarsal tunnel.