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Tarsal Tunnel Syndrome

SUMMARY

Causes

  • Overpronation
  • Fallen arch (flat feet)
  • Previous injury i.e. ankle sprain causing compression of the nerve
  • Underlying health issues such as diabetes or arthritis

Symptoms

  • Burning pain in the foot arch, heel and toes
  • Pins and needles sensation
  • Numbness

Treatment

  • RICE method
  • Rest
  • Bracing and supports

What is Tarsal Tunnel Syndrome?

The space located on the inside of the ankle next to the ankle bones is known as the tarsal tunnel. The tunnel comprises of a thick ligament which maintains the soft tissue and nerves. Tarsal tunnel syndrome occurs when the posterior tibial nerve located in the tunnel becomes trapped or compressed. This is usually as a result of overpronation in which the patient has a tendency to roll the foot when walking or running.

This injury is also common in patients who have a fallen arch or ‘flat feet’ due to the way in which the fallen arch placing strain on the nerve.

Patients who have sustained an injury previously such as an ankle sprain which has in turn caused swelling and inflammation to the area are also at risk of compressing the nerve resulting in tarsal tunnel syndrome. This is also a similar case for those who suffer from diseases such as diabetes and arthritis which again can cause swelling and therefore compression to the nerve.

Tarsal Tunnel Syndrome Symptoms

Patients who suffer tarsal tunnel syndrome will often complain of a burning sensation and pain on the inside of the ankle and bottom of the foot which can sometimes spread further through the foot and calf. A feeling or pins and needles is also a common symptom of this injury and sometimes a patient may feel complete numbness.

Pain can either be a gradual build up of pain or a sudden onset depending on how the injury was sustained and is most likely aggravated when continuing with activities such as standing, walking and running.

Tarsal Tunnel Syndrome Diagnosis

In order to diagnose peroneal tendonitis a doctor will give a full examination of the area including a number of tests which will be undergone to check the amount of damage to the nerve by tapping the foot to see the amount of response and feeling in the area.

Tarsal Tunnel Syndrome Treatment

In order to treat this injury, rest is crucial so to not cause any further damage to the injury and to stay away from any activity that could aggravate the area or causes any pain or discomfort to the area. Continuing any strenuous activity or resuming sport will not only hinder the healing process, it could lead to further damage.

Applying ice to the area is also an important aspect of recovery as it will minimize any swelling and inflammation of the area. Following the RICE method (Rest, Ice, Compression, Elevation) when the injury first occurs and within the following 72 hours will ensure no further damage is caused to the area and prevent any further swelling of the injury which may come from resuming activity. Anti-Inflammatory medications may be taken to relive the pain of the injury and also to minimize any swelling.

Some patients may find it beneficial to wear a plaster case or brace in order to immobilize the injury and ensure no weight it placed on the ankle. Other less drastic measures may be to invest in shoe inserts which can support the arch and restrict excessive movement, Arch supports or insoles with specific arch supports can help.

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