Symptoms Treatment Of Tarsal Tunnel Syndrome

Symptoms & Treatment Of Tarsal Tunnel Syndrome

Tarsal tunnel syndrome is caused by the entrapment of the tibial nerve. The tibial nerve follows a long, curving route down the back of the leg to the ankle, where it turns and curls below the inside of the ankle. There are four compartments in this region. In three of them, muscles are routed from the leg to the foot. In the fourth, the tibial nerve and the posterior tibial artery are surrounded by muscles. Along the top of these structures lies the laciniate ligament, which forms the roof of the four compartments. There is little room for expansion if any of these structures becomes enlarged or if a foreign object intrudes into the area. If anything impinges on the space occupied by the tibial nerve (i.e., the tarsal tunnel), entrapment occurs.

When entrapment compresses the nerve, it causes pain, a burning sensation, and tingling on the sole of the foot. This pain usually worsens as the day progresses and can usually be relieved by rest, elevation, or massage.

Treatment begins with anti-inflammatory medications, and possibly an injection of cortisone into the area around the nerve. Orthotics and changes in footwear may also help to relieve the symptoms.

If none of these measures helps, then a procedure called a tarsal tunnel release may be necessary. This is a surgical procedure performed in the operating room and it lasts about 30 to 45 minutes. When a tarsal tunnel release is performed, an incision is made to open up the tarsal tunnel and decrease pressure on the posterior tibial nerve. This surgery is also very similar to a carpal tunnel release in the wrist.

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