The tarsal tunnel which occurs in the foot is similar to carpal tunnel in the wrist. The tarsal tunnel is a narrow tunnel that runs along the inside of the ankle. There are tendons, nerves, arteries and veins that run along this tunnel. The tunnel is protected and supported by a thick ligament called the flexor retinaculum. The nerve that courses along the tunnel is called the posterior tibial nerve, this nerve when irritated can cause this syndrome.
The most common cause is compression along the tunnel which increases pressure on the posterior tibial nerve.
Trauma or injury to the foot due to an sprains and strains
Individuals with a flatfoot are more prone to this syndrome due to added stress to the ligament which compressive the nerve
Individuals with systemic inflammatory disease arthritis or diabetes may also develop tarsal tunnel syndrome
Sharp shooting pain, tingling, and/or burning sensation along the bottom of the foot.
Diagnosis is made clinically on examination, which will allow the foot and ankle surgeon to evaluate the posterior tibial nerve and the severity of the condition. Advance imaging may be ordered if there is suspicion of a soft tissue mass which may be causing the syndrome. Electromyography and nerve conduction velocity (EMG/NCV) may also be used to evaluate the severity of damage that may have occurred.
Alleviating the compression along the tarsal tunnel is the key to improvement. Conservative treatment options may consist of:
Custom orthotic devices Rest, Ice, Immobilization Anti inflammatory treatment Physical therapy Advanced laser therapy.
Non-conservative options are only recommended when conservative options do not completely resolve your symptoms, our foot and ankle surgeons will recommend the best treatment plan for you.
MLS Laser Therapy
Multi-Wave Locked System – MLS is a cutting edge patented FDA approved laser used to treat pain, inflammation, and edema. The MLS laser uses a specific blend of wavelengths to produce antiedemic, antiinflammatory and analgesic properties that treat many causes of pain. MLS is painless with absolutely no thermal damage to the skin, providing instant results helping you get back to what you love. Our foot and ankle surgeons will be glad to discuss if this treatment option is for you.