Tarsal Tunnel Syndrome is caused by the compression of the posterior tibial nerve as it travels through the tarsal tunnel, a narrow space on the inside of the ankle. This compression can result from various factors, including injury, inflammation, or structural abnormalities such as varicose veins, ganglion cysts, or bone spurs. The compression leads to nerve irritation, which can cause pain, tingling, and numbness in the foot.
Clinical Evaluation
Patient History: Inquiry about symptoms, activities, and any prior injuries or conditions that may contribute to nerve compression.
Physical Examination: Assessment of tenderness, swelling, and areas of pain along the tibial nerve. Tinel's sign (tapping over the nerve to elicit tingling or pain) may be positive.
Imaging Studies
Ultrasound: To visualize the structures around the tarsal tunnel and detect any abnormalities such as cysts or varicose veins.
MRI: To provide detailed images of the soft tissues and confirm the diagnosis by identifying any structural causes of compression.
X-Ray: To rule out bone abnormalities that may be contributing to the condition.
Pain, tingling, or numbness in the foot, particularly on the inner side and the sole.
Symptoms that worsen with prolonged standing, walking, or physical activity.
Burning or shooting pain that may radiate up into the leg.
Swelling around the ankle.
Weakness in the muscles of the foot, leading to difficulty with certain movements or activities.
Treatment for Tarsal Tunnel Syndrome aims to relieve compression on the tibial nerve and manage symptoms:
Rest: Avoiding activities that exacerbate symptoms to allow the nerve to heal.
Ice Therapy: Applying ice packs to the affected area to reduce swelling and pain.
Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain and reduce inflammation.
Orthotics: Custom orthotic devices to support the foot and reduce pressure on the tibial nerve.
Physical Therapy: Exercises to strengthen the muscles around the ankle, improve flexibility, and reduce nerve compression.
Injections: Corticosteroid injections to reduce severe inflammation and pain.
Surgery: In cases where conservative treatments fail, surgical intervention may be necessary to release the tarsal tunnel and alleviate nerve compression.