Diagnosis and Treatment of Tarsal Tunnel Syndrome in Wake County

What is Tarsal Tunnel Syndrome?

Tarsal tunnel syndrome is a compression, or squeezing, on the posterior tibial nerve. The tibial nerve branches off of the sciatic nerve and runs into the foot. It passes through the tarsal tunnel, which is a narrow passageway on the inside of the ankle next to the ankle bones. 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 confined space.

What Causes Tarsal Tunnel Syndrome?

Tarsal tunnel syndrome is caused by anything that produces compression on the posterior tibial nerve. These issues can include:

  • Flat Feet: A person with flat feet is at risk for developing tarsal tunnel syndrome because the outward tilting of the heel that occurs with fallen arches can produce strain and compression on the nerve.
  • Bony growths in the tarsal tunnel: An enlarged or abnormal structure that occupies space within the tunnel can compress the nerve. Some examples include a varicose vein, ganglion cyst, swollen tendon, or arthritic bone spur.
  • Injury: An injury such as an ankle sprain may produce inflammation and swelling in or near the tarsal tunnel, resulting in compression of the nerve.
  • Systemic diseases: Conditions such as diabetes or arthritis can cause swelling, thus compressing the nerve.

Symptoms of Tarsal Tunnel Syndrome

Symptoms of tarsal tunnel syndrome are typically felt on the inside of the ankle and/or on the bottom of the foot. In some people, a symptom may be isolated and occur in just one spot. In others, it may extend to the heel, arch, toes, and even the calf. Sometimes the symptoms of the syndrome appear suddenly. They are often brought on or aggravated by overuse of the foot, such as during prolonged standing, walking, exercising, or beginning a new exercise program. Patients with tarsal tunnel syndrome experience one or more of the following symptoms:

  • Pain, including sharp, shooting pain
  • Tingling, or an electric shock or burning sensation
  • Numbness, pins and needles

How is Tarsal Tunnel Syndrome Diagnosed?

To diagnose tarsal tunnel syndrome, your healthcare provider will start by asking you to describe your symptoms and looking at your ankle for potential injuries. They may conduct Tinel’s Test, where the doctor taps your tibial nerve looking for pain or tingling that resembles your symptoms. An electromyogram (EMG) can also be used to diagnose tarsal tunnel syndrome. During this test, electrical impulses are used to measure nerve and muscle function. Another test a doctor may use to diagnose tarsal tunnel syndrome is an MRI. An MRI captures detailed images of the soft tissue and bones in the body.

Treatment Options for Tarsal Tunnel Syndrome at Raleigh Orthopaedic

Treatment for tarsal tunnel syndrome depends on the patient’s symptoms and the underlying cause of their pain.

Nonsurgical Treatment

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Non-surgical treatment options for tarsal tunnel syndrome include:

  • Rest: Staying off the foot prevents further injury and encourages healing.
  • Ice: Apply an ice pack to the affected area, placing a thin towel between the ice and the skin. Use ice for 20 minutes and then wait at least 40 minutes before icing again.
  • Anti-inflammatory medications: Nonsteroidal anti-inflammatory medications such as ibuprofen and naproxen can reduce inflammation, which may alleviate compression of the tibial nerve.
  • Injections: Steroid injections may be applied to the affected area to reduce swelling
  • Orthotic devices: Custom shoe inserts may be prescribed to help maintain the arch and limit excessive motion that can cause compression of the nerve. Supportive shoes may also be recommended.
  • Bracing/Splinting: Patients with flatfoot or those with severe symptoms and nerve damage may be fitted with a brace to reduce the amount of pressure on the foot.

Surgical Treatment Options

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Sometimes surgery is the best option for treating tarsal tunnel syndrome. If surgery is necessary, the best method is determined after an examination by one of Raleigh Orthopaedic’s foot and ankle specialists based on the underlying cause of the condition.

Recovery from Tarsal Tunnel Syndrome Surgery

It will likely take between nine and twelve months to fully recover from surgery to correct tarsal tunnel syndrome. After release from the hospital, you may feel mild pain for two weeks. You should be able to resume most activities after three months of recovery. Swelling will likely go away between six and twelve months. Contact your healthcare provider if you feel severe pain in the weeks after surgery.

Prevention of Tarsal Tunnel Syndrome

There is no way to fully prevent tarsal tunnel syndrome, however, there are measures you can take to reduce your risk. Resting between workouts can prevent overuse of the muscles in the foot. It is important to regularly stretch your feet and ankles, especially before and after a workout. Warming up and cooling down before and after exercise can be very beneficial in preventing all types of orthopedic injuries. Finally, wearing proper footwear that provides support throughout the day and while working out can also help to prevent foot injuries.

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Your well-being is important to us. Raleigh Orthopaedic is Wake County’s oldest and most experienced orthopedic practice, serving the Triangle and surrounding regions of central North Carolina with comprehensive orthopedic care since 1919. To schedule an appointment with one of our specialists, please give us a call or book online today. We look forward to helping you live and move more comfortably!