Tarsal tunnel syndrome is an unusual condition, where the main nerve in the foot becomes inflamed and entrapped between the structures in the foot. The tibial nerve supplies the skin and the muscles in the bottom of the foot and thus when it becomes entrapped it can cause pain in various locations on the foot. The pain (tingling, numbness or shooting pain) often radiates/moves up or down the leg and bottom of the heel and foot.
Tarsal tunnel syndrome can occur due to numerous factors including but not limited to: flat feet or fallen arches, ankle sprain/ankle swelling, arthritis, diabetes, swollen tendons, ganglion cyst, bone spurs and varicose veins. Diagnosis of this condition, requires thorough clinical testing of all structures of your foot by a Podiatrist. Imaging, including x-rays and ultrasounds do not show nerve entrapment, thus thorough clinical testing is even more important.
Some conservative or non-surgical treatment includes:
1. Injection therapy with local anesthesia for pain relief and also for diagnosis
2. Cortisone injection can also be beneficial if there is an inflammatory component associated with the entrapment.
3. Oral anti-inflammatory medications
4. Orthotic devices to assist with your foot shape and biomechanics to reduce/prevent the entrapment of the nerve between the different structures in your foot.
5. Lignocaine patches
6. Supportive footwear
When is surgery required? Surgery is required if the pain is severe and all other conservative treatment options have failed. A Podiatric surgeon will we able to determine if surgery is necessary and what procedure would be most appropriate for your condition.