Tarsal Tunnel Syndrome: Symptoms, Causes & Complications

Tarsal Tunnel Syndrome (TTS) affects the tibial nerve as it travels through the tarsal tunnel, a narrow space inside the ankle. This syndrome can cause pain, tingling, and numbness in the foot and significantly impact daily activities. In this article, we will delve into the symptoms, diagnosis, causes, and various treatment options for TTS.

What is Tarsal Tunnel Syndrome?

Tarsal Tunnel Syndrome is a nerve compression disorder that affects the tibial nerve, one of the major nerves of the leg. The tibial nerve runs down the back of the leg, passes behind the medial malleolus (the bony bump on the inside of the ankle), and enters the foot through the tarsal tunnel. When this nerve is compressed or pinched within the tunnel, it leads to Tarsal Tunnel Syndrome.

What are the Symptoms of Tarsal Tunnel Syndrome?

Tarsal tunnel syndrome produces symptoms of nerve discomfort. TTS typically produces pain in the inside of the ankle or the bottom of the feet. You might also experience:

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Burning sensations.
Numbness.
Tingling or "pins and needles" sensations.
Weakness in the foot muscles.
Physical exercise is frequently associated with worsening symptoms. If TTS is severe or long-term, you may have symptoms all the time.

What are the causes of Tarsal Tunnel Syndrome?

Tarsal tunnel syndrome develops when anything destroys your tibial nerve. Causes of tibial nerve injury may include:

Flat feet.
High arches.
Injuries like an ankle sprain or fracture.
Irregular growths include ganglion cysts, bone spurs, and varicose veins.
Lipomas and tumours around the tibial nerve.
Systemic conditions include hypothyroidism, diabetes, and arthritis.

Tarsal tunnel syndrome is often the result of an overuse injury. More than half of all persons with tarsal tunnel syndrome have had previous injuries, such as ankle sprains. A sprained ankle is an injury to the ankle ligaments.

How do you diagnose Tarsal Tunnel Syndrome?

Your doctor can diagnose tarsal tunnel syndrome and ask you to describe your symptoms. They may also inspect your ankle and look for any injuries.

Your healthcare provider could too use the following:

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Tinel's test: Your healthcare provider lightly taps your tibial nerve. Pain or tingling that mimics your symptoms may indicate TTS.
Electromyogram (EMG): This two-part test employs an electrical impulse to assess nerve and muscle function.
MRI: MRIs employ magnets and radio waves to provide comprehensive images of soft tissue and bones within your body. Your healthcare professional may request an MRI to assess an injury, nerve damage, or a mass pressing on your tibial nerve.

What are the Treatment Options for Tarsal Tunnel Syndrome?

Conservative Treatments

Rest & Immobilization: Avoid activities that worsen symptoms; use a brace or splint to reduce nerve pressure.
Anti-inflammatory Medications: NSAIDs like ibuprofen help reduce pain and swelling.
Physical Therapy: Strengthening and stretching exercises improve flexibility and relieve nerve pressure.
Orthotic Devices: Custom shoe inserts provide support and reduce strain on the tibial nerve.
Corticosteroid Injections: Reduce inflammation and offer temporary pain relief.
Surgery: In severe cases, tarsal tunnel release or decompression surgery relieves nerve compression.

What are the Complications of Tarsal Tunnel Syndrome?

If ignored, tarsal tunnel syndrome may cause the following:

Foot deformities range from modest to severe.
Movement loss in the toes (partial or complete
Repeated or undetected leg injuries
Partial or full loss of sensation in the toes or foot.

How can I Avoid Tarsal Tunnel Syndrome?

Tarsal tunnel syndrome cannot be prevented in all cases. To reduce your risk of acquiring TTS, rest between sessions and avoid overuse injuries.
Stretch your feet and ankles regularly.
Warm up before you start exercising.
Wear well-fitting, supportive footwear.

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Frequently Asked Questions

Treatment includes anti-inflammatory medications, physical therapy, and in severe cases, surgical decompression to relieve pressure on the nerve.

Wearing supportive shoes and avoiding repetitive foot strain can help prevent tarsal tunnel syndrome. Early treatment of flat feet and other foot issues also plays a role in prevention.

Calf stretches, ankle rotations and toe flexes help relieve nerve pressure and improve flexibility. Strengthening foot muscles also enhances support and mobility.

The Tinel’s Sign Test involves tapping the tibial nerve at the ankle to check for tingling or pain. Nerve conduction studies or MRIs may be used for confirmation.

Recovery Time for Tarsal Tunnel Syndrome: Mild cases improve in a few weeks with rest and therapy, while severe cases or surgery may take months. Early treatment helps speed up recovery.

Natural Remedy for Tarsal Tunnel: Ice packs, turmeric, and Epsom salt soaks help reduce inflammation and pain. Supportive footwear and gentle stretching also provide relief.