Posted on March 18, 2008 in Latest News
Tarsal Tunnel Syndrome is one of the various diseases of the feet. The tarsal tunnel is a narrow space which is found on the inside of the ankle next to the ankle bones. Covered with a thick ligament (the flexor retinaculum), it is the tarsal tunnel that protects and maintains the parts contained within the tunnel—arteries, veins, tendons, and nerves. One of these structures is the posterior tibial nerve, which is the focus of tarsal tunnel syndrome.
Tarsal tunnel syndrome is a condition that occurs from abnormal pressure on a nerve in the foot. It is caused by compression of the tibial nerve or its associated branches as the nerve passes underneath the flexor retinaculum at the level of the ankle or distally. The nerve passes into the foot from around the inside of the ankle just below the ankle bone. Just beyond this point, the nerve enters the foot by passing between a muscle and a bone in the foot. This area is the Tarsal Tunnel.
This nerve supplies most of the sensation to the bottom of the foot and the muscles in the bottom of the foot. When pressure is placed on this nerve, a burning or numbness will be experienced on the bottom of the foot. The area of the bottom of the foot that is affected can be variable. Most commonly, it affects the outside portion of the bottom of the foot. It can also affect the toes.
Causes
The most common cause of Tarsal Tunnel Syndrome is a flat foot or a foot in which the arch flattens excessively while walking. Over time, this causes the nerve to stretch or become compressed in the area of the tarsal tunnel. The condition is slowly progressive and occurs more commonly after 30 ﾖ 40 years of age. Other causes of Tarsal Tunnel Syndrome are the formation of soft tissue masses such as ganglions, fibromas, or lipomas that may occur in the Tarsal Tunnel and cause compression of the nerve. Also, small varicose veins may form around the nerve that can also cause compression of the nerve.
Treatment
Anti-inflammatory medication and rest may be suggested to control the symptoms initially. These medications help reduce the inflammation and swelling of the tissues around the tibial nerve in the tarsal tunnel and may ease the irritation on the nerve. In severe cases, the patient may not respond to conservative treatment and may need surgical treatment or tarsal tunnel release surgery. The incision is made behind the ankle bone and then down towards but not as far as the bottom of foot.
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