Tarsal Tunnel Syndrome

What Is Tarsal Tunnel Syndrome?

Tarsal tunnel syndrome describes painful sensations in the foot caused by constriction and compression of the tibial nerve. The tibial nerve runs from the lower leg into the foot. It runs behind the medial malleolus, where it is guided by a ligamentous structure along with other structures (tendons, blood vessels).

The nerve mainly supplies the lower and inner side of the foot, so weakness and insensitivity can occur there. As a result, tarsal tunnel syndrome is much less common than carpal tunnel syndrome, which describes a similar mechanism in the hand.

Causes and Symptoms

A narrowing of the nerve described in this way can occur for various reasons. After an injury, a general swelling reaction can put pressure on the nerve. There is also an increased tendency to swelling during pregnancy due to metabolic diseases or in case of severe overweight. Incorrect footwear and constant incorrect loading (for example, in the case of a foot deformity such as talipes valgus) can also lead to symptoms.

Patients report tingling sensations and pain in the heel area and inner foot. As it progresses, there may also be muscle weakness and decreased muscle mass in the foot.

Diagnosis: How Is Tarsal Tunnel Syndrome Diagnosed?

The basis for diagnosis is a detailed interview with the patient and a thorough clinical examination. If tarsal tunnel syndrome is suspected, an X-ray (for the bone structure) and an ultrasound (for the soft tissues) can be carried out. Magnetic resonance imaging (MRI) and an instrument-guided neurological examination (myography, nerve conduction velocity) may also be considered for a more detailed assessment.

Of course, other possible diagnoses that may have arisen from the examination and medical history (e.g., herniated disc) must also be excluded during the examination.

Treatment: What Helps for Nerve Pain in the Foot?

The primary goal of treatment should be to eliminate the causes. For this and the symptoms, various measures can be considered.

Conservative Therapy:

Conservatively, as a first step, decongestion and pain relief can be achieved by cooling and medication. Rest is especially important if an overuse reaction is suspected. In the case of foot malposition, wearing shoe insoles and targeted physiotherapy can eliminate the discomfort.

In extreme cases, an injection with decongestant and analgesic agents can also be considered (this is not a permanent solution, however, as these agents can damage the tendons). If conservative therapy fails, surgery is the next step that can be considered.

Tarsal Tunnel Surgery

In tarsal tunnel syndrome surgery, the main goal is to remove pressure from the nerve. In most cases, this results in immediate pain relief—the specialist cuts through the connective tissue structure overlying the canal. Then, the surgery can be carried out under local anesthesia. Afterward, patients should take it easy for a few days and regularly elevate the foot. The foot surgeon agrees with the patient on the intervals for changing the bandages and on follow-up appointments.

Course and Prognosis of the Disease

The earlier tarsal tunnel syndrome is treated, the better the chances that the nerve will recover. On the other hand, if the nerve is already too badly damaged, the damage cannot be reversed in some cases.

Which Doctor Diagnoses and Treats Tarsal Tunnel Syndrome?

You can best contact your general practitioner or an orthopedic surgeon, who can guide the diagnosis and provide therapy.

We will help you find an expert for your condition. All doctors and clinics listed have been reviewed by us for their outstanding specialization in tarsal tunnel syndrome and are awaiting your inquiry or treatment request.

Sources:

flexikon.doccheck.com/de/Tarsaltunnelsyndrom

www.gesundheit.gv.at/krankheiten/gehirn-nerven/nervenschmerzen/tarsaltunnelsyndrom

orthinform.de/lexikon/tarsaltunnelsyndrom