Tarsal tunnel syndrome (TTS) is a condition characterized by compression or irritation of the tibial nerve as it passes through the tarsal tunnel—a narrow passageway located on the inside of the ankle, just behind the medial malleolus (the bony bump on the inner side of the ankle). Similar to carpal tunnel syndrome in the wrist, TTS involves the entrapment of a major nerve, leading to pain, tingling, and other symptoms in the foot.
The tibial nerve, a branch of the sciatic nerve, provides sensation to the bottom of the foot and controls certain muscles involved in foot movement. When the tibial nerve becomes compressed within the tarsal tunnel, it can result in a range of symptoms, from mild discomfort to severe pain and dysfunction.
Diagnosis:
Diagnosing TTS typically involves a thorough clinical examination along with various diagnostic tests. A healthcare provider may assess the patient's medical history, conduct a physical examination to evaluate symptoms and pinpoint areas of tenderness, and may recommend imaging studies such as an MRI or nerve conduction studies to confirm the diagnosis.
Symptoms
The symptoms of tarsal tunnel syndrome can vary in severity and may include:
- Pain or burning sensation along the inside of the ankle and sole of the foot
- Numbness or tingling in the toes or bottom of the foot
- Weakness in the muscles of the foot
- Radiating pain that travels up the leg
- Increased symptoms with prolonged standing or walking
Treatment
Treatment for tarsal tunnel syndrome aims to relieve pressure on the tibial nerve and alleviate symptoms. Depending on the severity of the condition, treatment options may include:
- Rest and Activity Modification: Avoiding activities that exacerbate symptoms and providing adequate rest to the affected foot can help reduce irritation of the nerve.
- Immobilization: Immobilizing the foot with a brace or splint may help reduce pressure on the nerve and promote healing.
- Physical Therapy: Stretching and strengthening exercises prescribed by a physical therapist can help improve flexibility, reduce inflammation, and alleviate symptoms.
- Orthotic Devices: Custom orthotic inserts or supportive footwear can help redistribute pressure on the foot and provide relief.
- Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroid injections may be prescribed to reduce pain and inflammation.
- Surgery: In severe cases where conservative treatments fail to provide relief, surgical decompression of the tarsal tunnel may be recommended to release pressure on the nerve.
Recovery
Recovery from tarsal tunnel syndrome varies depending on the individual and the chosen treatment approach. In many cases, conservative treatments such as rest, physical therapy, and orthotic devices can effectively manage symptoms and promote healing within a few weeks to months. However, for those who require surgery, recovery may take longer, and rehabilitation may be necessary to regain strength and function in the affected foot.
General Considerations:
It's essential for individuals with symptoms of tarsal tunnel syndrome to seek prompt medical evaluation and treatment to prevent the condition from worsening. Additionally, maintaining a healthy lifestyle, including regular exercise, proper footwear, and avoiding activities that exacerbate symptoms, can help reduce the risk of developing or aggravating TTS. Early intervention and appropriate management can significantly improve outcomes and enhance quality of life for individuals affected by tarsal tunnel syndrome.
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