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What Is Tarsal Tunnel Syndrome? Tarsal tunnel syndrome is the
name given to a painful condition involving injury, inflammation, and/or compression of
one or more of major nerves of the foot. The area where the nerve damage occurs is known
as the tarsal tunnel. This tunnel is created by a very strong ligament, the laciniate
ligament, that covers a bony canal through which pass some of the major artery, nerve,
vein, and tendons of the foot. A similar, and much more common, condition occurs in the
hand and is called carpal tunnel syndrome. Patients with tarsal tunnel syndrome report
varying types of symptoms that include electric shock-like sensations, numbness, a sense
of the foot "giving away", and pain radiating up into the leg, arch, heel,
and/or toes. Symptoms frequently happen at rest, and before trying to sleep at night. What Causes Tarsal Tunnel Syndrome? Tarsal tunnel syndrome can be caused by
1) an injury such as an ankle sprain, fracture, or even a bruise, 2) arthritis, 3)
diabetes, 4) tumors or cysts pressing on the nerve, 5) sudden unaccustomed athletic
activity, 6) varicose veins pressing on or pinching the nerve, 7) congenitally large nerve
resulting in compression of the nerve against the ligament that covers the tarsal tunnel,
8) multiple, minimal trauma such as stretching of the nerve due to flexible flat feet, 9)
by compensating for other foot or leg problems such as heel pain, short leg syndrome, hip
and knee abnormalities, 10) sometimes there is no known cause for tarsal tunnel syndrome
and it is therefore considered to be idiopathic.
How Is Tarsal Tunnel Syndrome Treated?
Mild cases of tarsal tunnel syndrome usually resolve by themselves
with rest and stopping of the causative activity. Moderate cases of tarsal tunnel
syndrome are treated with soft supportive shoes, orthotics to support the foot,
anti-inflammatory medications, and rest. Severe cases of tarsal tunnel syndrome require
aggressive treatment to prevent permanent nerve damage.
Treatment starts with testing the nerve by a neurologist to rule out
other nerve conditions and to confirm the diagnosis of tarsal tunnel syndrome.
After confirmation of the diagnosis, the treatment begins by reducing
the inflammation of the nerve with a series of cortisone injections. Occasionally
the symptoms resolve with only one injection, but most often a series of three is
necessary. Soft supportive shoes and orthotics help speed recovery during treatment
Sometimes a removable cast is used to temporarily immobilize the injured nerve.
Cases that do not respond to cortisone injections and the above
mentioned therapy require surgery to explore the tarsal tunnel and release the pinching of
the nerve by the ligament, tumor, varicose vein, bone spur, etc.
Of course no two people are the same. We would be happy to discuss
your unique foot condition. You can always reach us:
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