Tarsal Tunnel Syndrome – Pressure on the tibial nerve in the back of the foot in a tissue tunnel under the inner ankle causes Tarsal tunnel disease. To diagnose this disease, the treating physician, after consulting with the patient, examines the cause of his pain and its characteristics. Paraclinical examinations such as nerve and muscle tape tests or imaging techniques such as MRI can help to correctly diagnose this problem.
What diseases can cause symptoms similar to Tarsal Tunnel Syndrome?
The most important of these are:
The most common of these is plantar fasciitis
Achilles tendonitis usually causes pain in the back of the heel.
Heel stress fractures
Heel pad atrophy in the elderly and obese can cause widespread pain in the heel
Intervertebral disc injury and sciatica
What is the treatment for Tarsus tunnel syndrome?
The general principles of treatment are:
Rest: Reducing foot pressure, such as standing less and reducing activities such as walking, running, or strenuous exercise for a while, can reduce nerve pressure and help the nerve heal.
Cold: Applying topical cold for 15-20 minutes can be helpful
Anti-inflammatory drugs: The use of anti-inflammatory drugs such as ibuprofen or celecoxib can reduce inflammation and swelling inside the Tarsus tunnel.
Immobilization: Sometimes immobilizing the ankle for a while by wearing a suitable brace or by plastering the foot can reduce the inflammation in the area and give the nerve a chance to regain its function.
Physiotherapy such as using ultrasound or doing appropriate exercises can be helpful.
Injecting local anesthetics or corticosteroids into the site can help reduce symptoms or reduce inflammation.
Orthosis: The use of appropriate medical shoes to reduce unwanted movements in the ankle or adjust the arch of the foot can be helpful.
Surgery: If the patient does not improve, sometimes the doctor decides to operate on the nerve to release the nerve. In this surgery, the surgeon cuts the retinaculum flexor, freeing up the tunnel space. This relieves the pressure on the nerve and eliminates the patient’s problems. Surgery improves in 90-85% of cases.
Dr. Mehrdad Mansouri “Orthopedic Specialist”
