Tarsal tunnel syndrome (TTS) describes the painful entrapment/compression of a nerve (called the tibial nerve) as it passes through a narrow tunnel on the inside of the ankle (called the tarsal tunnel) which is created by the position of the bones and connective tissue.
The tarsal tunnel is located just below the bony bump (medial malleolus) on the inside of the ankle, towards the back of the heel. It is a channel for tendons, arteries and nerves to pass through, and is secured by a connective tissue sheath called the flexor retinaculum that covers the top of the channel.
The tibial nerve, one of the nerves that provides sensation to the feet, passes through this tunnel and splits into two branches - the medial and lateral plantar nerves.
Sometimes, tarsal tunnel syndrome can have no specific cause. Usually, however, it can be attributed to one or more of the following:
On the inside of the ankle, as well as the heel and buttom of the foot, those with TTS may experience:
Symptoms may be sudden or gradual, and are often aggravated by movement. Because the tibial nerve (and its branches) give sensation to the heel and the bottom of the foot, this is where neural symptoms (burning, tingling, numbness) are experienced. Pain can radiate into the arch and present as heel pain. Being able to pinpoint the symptomatic areas are helpful in identifying the point at which the nerve is compressed and help make treatment more precise.
Initially, to manage the painful symptoms, we recommend resting and elevating the affected foot, as well as using ice and anti-inflammatories.
The treatment of tarsal tunnel syndrome involves treating the particular cause of the nerve compression. We conduct a thorough biomechanical examination to assess the function and characteristics of your feet and legs to deduce the likely causes of your TTS. Your treatment plan may include:
Because permanent nerve damage can occur if proper care is not taken, it is important to seek treatment if you suspect you may have tarsal tunnel syndrome.
Two weeks with Calcaneal Spur and finally got to see Doc. He sent me to Kevin @ Eleven and with One Appointment, he had me walking without Crutches. Yes! It still hurt. Did the Stretching, Rolling my Foot on a Spikey ball and Iced it occasionally. Return visit, after he had his Holiday, and I' am walking fine. They do NOT want to see me again, unless it deteriorates. Which it has not :-)