|
Nov 16, 2007 - Tarsal Tunnel SyndromeBack
TARSAL TUNNEL SYNDROME
Definition :
The tarsal tunnel is located on the inner side of the ankle joint, just below and behind the ankle bone. A ligament passes from the inner part of the ankle bone to the back of the heel forming a tunnel through which pass a number nerves and blood vessels supplying the foot. One such nerve is the posterior tibial nerve. If it becomes inflamed or ‘trapped’ it will cause symptoms in the foot and ankle. This condition is called tarsal tunnel syndrome. Symptoms range from mild ache located at the site of the nerve to extreme discomfort which radiates into the foot and occasionally up the leg. The pain is often described as a tingling or sharp shooting pain and follows the course of the nerve or its branches. When it affects the calcaneal branch (heel bone branch) the symptoms may mimic plantar fasciitis leading to a mis-diagnosis.
Pain is aggravated by activity and often improved by rest although severe cases can also give rise to pain at rest.
A similar and more common condition affects the hand and is called Carpel Tunnel Syndrome.
Cause:
Tarsal tunnel syndrome may occur as a result of any condition that causes a disruption of the anatomy of the tarsal tunnel. Examples include fractures of the ankle joint, talus or calcaneus (heel bone). Symptoms may arise immediately following trauma or many years after. Other conditions which may disrupt or traumatize the anatomy are severe ankle sprains, arthritis and over pronation. With over pronation the structures on the inner border of the foot are stretched and compressed. With years of severe pronation the nerve may get inflamed and cause pain – however symptoms associated with over pronation only tend to be of a low grade variety where as those associated with direct trauma or fractures tend to be high grade symptoms.
Treatment & Prevention:
Early treatment to reduce your symptoms can be achieved by limiting activity to control the pain and swelling. Stay off your feet a few days, and then slowly increase your activity. Rest allows the tissues in your tissues to heal. Applying ice will also help by allowing the inflammation in the nerve to subside. If this is not adequate then conservative (non-surgical treatments) treatments may need to be considered.
Conservative treatments include use of prescription foot orthoses that controls foot pronation to reduce strain on the post tibial nerve and prevent excessive stretching of the associated structures. The use of stable footwear to help restrict motion of the ankle joint can also be effective.
If left untreated or where conservative measures fail to address the problem surgical decompression of the nerve may be warranted.
|
|
|
 |
|
