Tarsal Tunnel Syndrome

Prevention

Reduce your risk.

Prevention of tarsal tunnel syndrome is largely based on avoiding stress or injury to the tibial nerve and reducing the possibility of aggravating the blood vessels and tendons that accompany the nerve in the tarsal tunnel.Prevention suggestions include:

• Rest your foot in between long bouts of walking by sitting down occasionally, as well as changing your standing position frequently after long standing durations.
• Properly warm your muscles up before partaking in any strenuous workout to reduce the chance of injury.
• Wear properly fitted shoes and tie them correctly.
• Use a wrap or brace when participating in athletic activities, especially if uneven surfaces or sudden direction changes are involved.
• Engage in a good strength program to keep the supporting muscles of the lower leg strong.
• Stretch frequently to maintain muscle flexibility, which keeps the foot in proper alignment and reduces any pull on the tendons.

Symptoms

Pinpoint your pain.

Symptoms of tarsal tunnel syndrome may develop suddenly or progress gradually. Individuals may experience a range of symptoms:

• Sharp, shooting pain along their tibial nerve
• Radiating pain that can’t be localized to one spot
• Presence of numbness, burning or a tingling sensation commonly described as ‘pins and needles’ in a specific area

Symptoms are often worsened by prolonged standing or walking, and after an active day. Though rest often alleviates symptoms, individuals with more severe cases of tarsal tunnel syndrome have reported that their pain is persistent even after rest, and is still present at night while he or she attempts to sleep.

Diagnosis

Get the answers you need.

Tarsal tunnel syndrome diagnosis requires a physical examination, where a physician will evaluate an individual’s symptoms, review the patient’s medical history, and perform a thorough clinical evaluation and a variety of specialized tests, such as an MRI or nerve conduction study.A simple, yet efficient test that a physician will perform is the Tinel’s sign test, where a doctor will tap or apply pressure to the tibial nerve. If this contact stimulates a tingling or ‘pins and needles’ sensation in the foot or toes, the patient is deemed to have tarsal tunnel syndrome.

Treatment

Life’s too short to put up with pain.

A variety of non-surgical treatment options are often used to reduce or eliminate symptoms, including:

• Rest up. Staying off your foot and ankle alleviates pressure from standing and walking, and is an efficient way to promote healing.
• Consistently apply ice. Applying ice to the affected area reduces swelling and temporarily alleviates pain.
• Take oral medications. Over-the-counter and prescription anti-inflammatory drugs help to reduce pain and inflammation in the ankle area, which lessens the pressure on the tibial nerve.
• Use orthotic devices to limit mobility. Braces and wraps help to restrict movement of the ankle and foot, while reducing the pressure severity and promoting the healing of the tibial nerve.
• Home exercises and physical therapy. Physical therapy exercises and at-home practices will increase the strength and flexibility of the ankle and foot, which will help to decrease pressure and reduce other associated symptoms.
• Doctor-administered therapy. Corticosteroid injections will reduce inflammation in the tarsal tunnel, while anesthetic injections may alleviate pain symptoms.
• Wearing proper shoes with custom inserts. Supportive shoes, along with custom shoe inserts, help to maintain the arch in the foot and limit excessive motion. Sometimes simply changing to looser or larger footwear may lead to reduced pressure on the foot and relieve pain.

When non-surgical treatments fail to alleviate or cure tarsal tunnel syndrome, the physicians at Kayal Orthopaedic Center will determine if surgery is necessary, and then select the appropriate procedure based on each individual’s condition.