TARSAL TUNNEL SYNDROME

Tarsal tunnel syndrome is a condition that occurs when you have a damaged or compressed tibial nerve. The tibial nerve is a nerve in your ankle. It runs through the tarsal tunnel, a passage on the inside of your ankle made up of bones and ligaments.

It is not known exactly how many people have tarsal tunnel syndrome. Many people who have tarsal tunnel syndrome don’t get a formal diagnosis.

Causes of tibial nerve damage can include:

• Flat feet
• Injuries, such as an ankle sprain or fracture
• Ganglion cysts or bone spurs from ankle arthritis and masses such as lipomas or tumours near your tibial nerve
• Body-wide (systemic) conditions, such as underactive thyroid or diabetes

This syndrome usually causes pain on the inside of your ankle or the sole of your foot. You may also experience:

• Burning sensations
• Numbness
• Tingling or “pins and needles” sensations
• Weakness in your foot muscles

Often, symptoms worsen during or after physical activity and in the early stages are intermittent. If the condition is severe or long-lasting, you may experience symptoms all the time.

The diagnosis of tarsal tunnel syndrome starts with describing your symptoms followed by examination of your ankle and foot.

Further investigations may be needed:

• Nerve conduction studies – measuring the nerve function
• Ultrasound or MRI –  imaging of the nerve structures surrounding it in your ankle

Mild symptoms of tarsal tunnel syndrome can be treated conservatively by:

• Resting – staying off of your foot for a few days or weeks can often improve symptoms
• Nonsteroidal anti-inflammatory medications (NSAIDs) – over-the-counter NSAIDs such as ibuprofen may decrease pain and inflammation
• Orthotics – you may use custom-made shoe inserts (orthotics). Orthotics can help your foot maintain a proper arch. This position reduces the movements that cause nerve compression.
• Physical therapy – a physical therapist prescribes exercises and stretches to improve your strength and range of motion.

In many patients the conservative measure are sufficient to treat the condition. However, if symptoms are severe and don’t respond to conservative measures, surgery may be recommend to release the tibial nerve or widen the tarsal tunnel. If a mass is putting pressure on your nerve, it will be removed during the operation.

Discussion with Mr Tomas Madura is important to answer any questions that you may have. Please contact us for more information about any specific conditions not featured on the website.