There are an array of causes that have been associated with the tarsal tunnel syndrome, resulting in the constriction of the posterior tibial nerve or one of its braches within the tarsal canal. Space occupying lesions as a causative factor of tarsal tunnel syndrome are well documented. These lesions may be the result of post-traumatic, neoplastic or inflammatory factors.
Post-traumatic factors include bone fractures resulting in tibial nerve compression. Half of the patients who present with tarsal tunnel syndrome relate history of a previous sprain, ankle fracture, crash injury, flatfoot or fracture dislocation about the foot or ankle.
An array of symptoms described as insidious in onset have been documented, these include; longitudinal arch pain, plantar anaesthesia or paraesthesia or a sharp electric shock type of pain. The pain may radiate from the ball of the foot to the posterior aspect of the leg or may be localised to the heel area. The pain may be present at rest but often the patient describes a pain that exacerbates with activity or post prolonged ambulation.
The podiatric practitioner may implement conservative measures in the initial treatment stages of a suspect tarsal tunnel syndrome case, and later seek referral for surgical intervention if symptoms persist.
Non surgical treatment includes; orthotic therapy, physical therapy modalities, non steroidal anti-inflammatory, corticosteroid injections.
Ice therapy and wearing wider shoes to allow the metatarsals to spread. Intrinsic forefoot exercises may also be helpful. Tarsal Tunnel Syndrome has been defined as an extrinsic or intrinsic compression neuropathy of the posterior tibial nerve or one of its branches.
There are some very tight structures in this area, so there is very little room for expansion if any of these structures becomes inflamed or enlarged. This inflammation or enlargement of the nerve in this area causes the entrapment.
The posterior tibial nerve becomes impinged as it passes under the deep fascia of the leg and the abductor hallucis muscle.
Tarsal tunnel syndrome is similar to the carpal tunnel syndrome seen in the wrist, however far less common.
Pain of this type may also benefit from the use of a pain relieving gels or LIFESOLES which can be found in our shop.