Today, I’m going to talk about a condition called tarsal tunnel syndrome. Now, many of you have heard about the condition carpal tunnel syndrome which involves the nerves that go from the arm into the wrist. You have a similar condition that can involve the foot called tarsal tunnel syndrome.
The name and location where the nerve that’s involved passes through around the ankle is something called the tarsal tunnel. That’s where it gets its name from. There are many nerves that are found inside the foot but one nerve in particular, a very big nerve called the posterior tibial nerve. It is a nerve that crosses around the ankle joint and into the foot. It splits into two different parts that basically give you sensation in each different side of the foot.
Now, this particular nerve runs around the side of the ankle where the big toe joint is located. As this nerve runs around the ankle bone, it goes through a small area or a small tunnel called the tarsal tunnel oftentimes due to many different reasons. This area where the nerve passes through can become either inflamed or restrictive or there could be something inside that tunnel that can push against the nerve. Eventually, this is going to create a situation in which the nerve is irritated because of the pressure against it.
You could develop a wide variety of different symptoms as a result of that which can include pain in the heel, pain in the bottom of the foot. It could be a sharp pain. It can be numbness or burning or tingling or just an electrical like sensation whenever the side of that ankle is tapped against. This is basically due to damage that’s occurring to the outer layer of the nerve as there is pressure being applied against it either from scar tissue inside this tunnel.
Sometimes there’s a vein that runs next to it that has varicose branches that are engorged and pushing against the nerve or you can simply develop other issues such as inflammation from chronic stretching of the fiber surrounding that tarsal tunnel because of the way your foot is shaped such as in people who have flat feet in which the ankle bends outward a bit and that creates a lot of pressure against the side of the tissue that covers over the top of the tarsal tunnel. All these different conditions and reasons can cause this thing called tarsal tunnel syndrome.
How to treat tarsal tunnel syndrome
Now, it’s a fairly easy condition to treat but it can have some challenges depending on how severe it is. Treatment usually starts off with simple things like an injection of medication or something we call corticosteroids which try to reduce the inflammation surrounding the nerve and get the area to calm down and become healthy again. Physical therapy can also be helpful in this instance and as well as immobilizing the foot to decrease the strain that’s occurring to the foot as a result of all the mechanics that are causing this condition in the first place.
However, there are a number of instances in which you actually have to go in surgically and free the nerve up. This surgery is somewhat similar to carpal tunnel release in which you have to make an incision and find where the nerve is and find the tissue that’s covering the nerve and just make an incision in that tissue and release it. Now, there are a lot of branches that can sometimes pass off from this nerve and these individual branches may need to be found and any scar tissue or other things that are constricting against the nerve also need to be addressed.
Additionally, if you have a lot of varicose veins that are acting against the nerve, these need to be removed off of the main vein branch that also follows the nerve in the same tunnel as well. All these treatments are fairly successful. Occasionally, people do have scar tissue that reforms as a result of the surgery and more surgery is necessary but in general, this condition is fairly easy to treat when it’s properly recognized and when it’s not ignored for many years.