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Tarsal Tunnel Syndrome

What is tarsal tunnel syndrome?

The tarsal tunnel is a space in the ankle that contains important arteries, nerves and ligaments. The walls of the tunnel consist of bone and fibrous tissue. When the posterior tibial nerve gets compressed within the tunnel, this results in pain, numbness and tingling.

What causes tarsal tunnel syndrome?

There are various causes for tarsal tunnel syndrome. Fractures, foot deformity (flatfeet), ganglion cysts, benign tumors, bone spurs, tendon inflammation, varicose veins (in rare cases) and swollen tissues can all contribute to tarsal tunnel syndrome. The resultant increased pressure on the nerve creates the symptoms on tarsal tunnel syndrome. There is also correlation between tarsal tunnel syndrome and lower back pain, especially in patients with issues with vertebrae L4, L5 and S1.

What are the symptoms of tarsal tunnel syndrome?

The symptoms of tarsal tunnel syndrome include pain, numbness, burning, tingling and swelling of the ankle.

How is tarsal tunnel syndrome diagnosed?

Tarsal tunnel syndrome is diagnosed with physical examination including the Tinel’s test. MRI imaging is often ordered as part of the diagnosis. Nerve conduction studies may also be useful.

How is tarsal tunnel syndrome treated?

Nonsurgical treatment

Conservative treatment includes anti-inflammatory medications, physical therapy, orthotics, cortisone injections to reduce swelling in the tunnel.

Surgical treatment

In severe cases, surgery can be performed to release the pressure in the tunnel. If present, benign tumors, bone spurs, cysts, and scar tissue can be removed. However surgery is used as a last resort in tarsal tunnel syndrome due to risk of recurrence.