Tarsal tunnel syndrome is a compression neuropathy of the posterior tibial nerve as it passes in the anatomical tarsal tunnel, which lies posterior to the medial malleolus and beneath the retinaculum of the flexor muscles of the foot.
- When entrapment compresses the nerve, it causes ankle pain and a burning sensation, numbness and tingling on the sole of the foot. Symptoms are usually on one foot.
- Symptoms may be worse at night.
- The pain tends to be aggravated by prolonged standing or walking, normally worsens as the day progresses and can usually be relieved by rest, elevation or massage.
- Pain may radiate along the sole of the foot, sometimes up into the calf.
- Pain may be aggravated when the ankle is placed in extreme dorsiflexion.
Medical therapy for tarsal tunnel syndrome may consist of local injection of steroids into the tarsal canal. An acceptable conservative approach in the early treatment of tarsal tunnel neuropathy includes the use of local anesthetics and soluble steroids, which may aid in the reduction of the patient’s pain. Patient with intense pain could be put in a CAM walker to decreased pressure in the tarsal tunnel. Physical therapy may be of some value in reducing local soft-tissue edema, thereby easing pressure on the compartment.
Also, in symptomatic patients who exhibit a contracture of the gastrocnemius muscle of the achilles tendon, stretching exercises that are designed to improve the flexibility of the gastrocnemius should be initiated. In cases in which the patient has a flat foot type, a well-designed custom foot orthosis may reduce tension on the tibial nerve by decreasing the load on the medial column. When all conservative treatments have failed surgery is explored by the foot & ankle surgeon.
We treat all foot and ankle ailments in Phoenix, Scottsdale, Paradise Valley, Peoria, Tempe, Glendale. To make an appointment with your Foot & Ankle Specialists call 480-253-9996 or visit us at www.phxfootankle.com.