What Is Tarsal Tunnel Syndrome?
Tarsal tunnel syndrome is a condition in which a nerve in the foot is compressed. This nerve is called the tibial nerve, and it is a branch of the sciatic nerve, one of the largest nerves in the body. The tibial nerve gives feeling to the bottom of the foot. It branches from the sciatic nerve near the knee and runs down the tibia, or shinbone.
When the tibial nerve arrives at the ankle, it passes—along with a number of blood vessels and tendon—through the tarsal tunnel, a narrow space created by a ligament and several bones. If this space becomes narrowed or some of the tissues inside it are inflamed and swollen, pressure is placed on the tibial nerve, resulting in pain.
Though tarsal tunnel syndrome is uncommon, it has a number of potential causes, such as:
- An ankle sprain, which can cause swelling that compresses the nerve
- Chronic conditions, such as arthritis or diabetes, that can cause swelling
- Flat feet or fallen arches, which can put pressure on the nerve
- Structural deformities, like cysts or bone spurs, that press on the nerve
Symptoms of tarsal tunnel syndrome include:
- Burning or tingling sensation
Diagnosing tarsal tunnel syndrome is usually a matter of a medical history and physical exam. Sometimes electromyography (EMG), which measures how well the nerve conducts impulses, is used to determine if nerve damage is present. Imaging studies such as X-rays and magnetic resonance imaging (MRI) scans can also help determine the cause of tarsal tunnel syndrome (e.g., bone spurs, cysts or inflammation).
Tarsal tunnel syndrome can often be treated without surgery. Some of these conservative treatments include:
- Anti-inflammatories and painkillers
- Orthotics such as braces, splints and shoe inserts
Surgical treatments are aimed at relieving the pressure on the nerve. Sometimes this is done by removing any bone spurs or other structures pressing on the nerve, and sometimes with tarsal tunnel release surgery. In tarsal tunnel release surgery, the ligament that makes up a portion of the tarsal tunnel is cut and divided, creating more space in the tunnel and relieving the pressure on the nerve. The tibial tunnel is explored and mobilized to remove any compressing tissue.
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