Footnotes / Blog
What is the Tarsal Tunnel?
The tarsal tunnel is a narrow space that lies on the inside of the ankle. The tunnel is covered with a thick ligament which protects the arteries, veins, tendons, and nerves in the tunnel. One of these structures is the posterior tibial nerve, which is the focus of tarsal tunnel syndrome.
What Is Tarsal Tunnel Syndrome?
Tarsal tunnel syndrome is a compression, or squeezing, on the posterior tibial nerve that produces symptoms anywhere along the path of the nerve running from the inside of the ankle into the foot.
Tarsal tunnel syndrome is similar to carpal tunnel syndrome, which occurs in the wrist. Both disorders arise from the compression of a nerve in a small space.
Causes
Tarsal tunnel syndrome is caused by anything that produces compression on the posterior tibial nerve, such as:
- Flat Feet: because the outward tilting of the heel that occurs with “fallen” arches can produce strain and compression on the nerve.
- “Space occupying lesions”: Some examples include a varicose vein, ganglion cyst, swollen tendon, and arthritic bone spur.
- An injury, such as an ankle sprain, may produce inflammation and swelling in or near the tunnel, resulting in compression of the nerve.
- Systemic diseases such as diabetes or arthritis can cause swelling, thus compressing the nerve.
Symptoms
- Tingling, burning, or a sensation similar to an electrical shock
- Numbness
- Pain (sometimes described as a shooting pain)
The symptoms described above can be felt anywhere from the ankle region to the entirety of the bottom of the foot.
Symptoms may gradually appear, but can appear suddenly. Symptoms also come and go for some patients.
Diagnosis
The podiatrists at Innovative Foot and Ankle will examine the foot to arrive at a diagnosis and determine if there is any loss of feeling. During the exam, the doctor will position the foot and tap on the nerve to see if the symptoms can be reproduced. He or she will also press on the area to help determine if a small mass is present.
A studied called “electromyography and nerve conduction velocity” (EMG/NCV)—may be ordered if the condition shows no improvement with non-surgical treatment.
Non-surgical Treatment
(Many of these are used in combination)
- Rest
- Ice
- Oral medications
- Immobilization
- Physical therapy
- Injection therapy
- Orthotics
When is Surgery Needed?
Surgery may be necessary if the conservative treatment options fail. The foot and ankle surgeon will determine if surgery is necessary and will select the appropriate procedure or procedures based on the cause of the condition.
We are all well trained in conservative and surgical treatment options for tarsal tunnel syndrome. Visit us at one of our four offices in the northern New Jersey towns of Kenilworth, Bayonne, Little Ferry, and Montclair.