Tarsal Tunnel Syndrome
The foot is an extraordinarily complex piece of engineering consisting of bones, muscles, ligaments, nerves and tendons.
Tarsal tunnel syndrome is an example of how a seemingly minor foot problem can have a huge impact on our activity and cause a lot of pain.
The tarsal tunnel sits on the inside of the ankle and runs down to the beginning of the arch. Through this tunnel run some vital arteries, veins, nerves and tendons, which are protected by a thick ligament known as the flexor retinaculum. Pressure in this area can be seriously debilitating.
What Is It ? What Causes It?
Tarsal tunnel syndrome refers to a painful nerve condition that arises as a result of compression of the Posterior Tibial Nerve. The Posterior Tibial Nerve is one of those critical nerves that run through the Tarsal tunnel. This nerve is particularly important because it provides sensory feedback from the inside and outside of the foot and the heel.
Over pronation is one of the most common causes of Tarsal Tunnel Syndrome as it can cause nerve compression and constriction in the Tarsal Tunnel area. Other causes of Tarsal Tunnel Syndrome can include:
- Abnormal tissue formation (arthritis, benign tumours, cysts, inflamed tendons)
- Ankle sprains or fractures triggering inflammation
- Diabetes can cause swelling that constricts the nerve
- Repetitive strenuous activities such as running or jumping
- Flat feet and over pronation can cause compression in this area
- Neurofibromatosis—fibrous growths
Tarsal Tunnel Syndrome can be extremely painful and cause permanent nerve damage if left untreated. A similar condition, Carpal tunnel syndrome, can occur in the hands and wrist.
What Are The Symptoms Of Tarsal Tunnel Syndrome?
Compression of posterior tibial nerve can trigger a range of symptoms in the feet, ankles and lower legs including:
- Tingling and dull aches
- Shooting pains
- Muscle weakness
Tarsal tunnel symptoms may arise suddenly or gradually. Tarsal tunnel symptoms might be restricted to a single area of the foot or spread higher up the calf and lower leg.
Some people report that symptoms are worse at night; for others during and after exercise is the worst time. It will depend on what is triggering your particular Tarsal tunnel pain.
You should seek help if you experience any of these symptoms. Correct diagnosis by an experienced podiatrist is important because the wide-ranging symptoms can be similar to other conditions. Any confusion could delay getting the right treatment and your rapid recovery.
A physical examination may include tapping around the nerve area. Recording the patient history will also help with diagnosis. Ultrasound imaging or X-rays may be necessary to rule out fractures or other issues.
What’s The Best Tarsal Tunnel Treatment?
Rest and ice are usually very helpful for relieving symptoms. Apply ice for no more than 20 minutes at a time to the affected area. Nonsteroidal anti-inflammatory drugs, such as Ibuprofen, can help reduce the pain and swelling in the inflamed area.
Tarsal Tunnel syndrome can lead to permanent nerve damage so you should see a podiatrist as soon as possible to ensure a rapid and full recovery and to avoid any ongoing problems.
Recommended treatment will depend on the cause of the nerve compression. Physical therapy and massage can help relieve pressure, pain and inflammation. Supportive footwear with foam cushioning will help stabilise the foot and reduce pressure in the affected area.
Custom orthotics are particularly effective in cases where visual gait analysis shows that over pronation or other mechanical misalignment is triggering significant pressure on the Tarsal Tunnel and the posterior tibial nerve.
More Treatment Options
Custom orthotics not only alleviate the pressure on the Posterior Tibial Nerve by stabilising your feet and promoting healthier function and movement in your feet, ankles, knees and legs.
Ultrasound therapy and strapping may also reduce tarsal tunnel syndrome symptoms. Immobilisation with a foot brace can promote healing in the posterior tibial nerve and surrounding tissue and may be useful in severe tarsal tunnel syndrome cases.
Shockwave therapy or dry needling services are gentle healing therapies that can stimulate blood circulation, and reduce bruising, inflammation, and recovery time.
If you’re feeling down at your heels and in pain then come and talk with us. The friendly expert and experienced staff at Erica Dash Podiatry are committed to helping you to get back in action.
Shockwave is a great alternative to treatments such as dry needling if you’re needle phobic and not keen on dry needling. We also have effective treatment offers for kids.