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Tarsal Tunnel Syndrome

Tarsal tunnel syndrome is a condition that is caused by compression of the tibial nerve or its branches. Tarsal tunnel syndrome is analogous to carpal tunnel syndrome of the wrist. The tarsal tunnel is a narrow space that lies on the inside of the ankle. The tunnel is covered with a thick ligament called the flexor retinaculum.

Structures within the tarsal tunnel include:

Tarsal tunnel syndrome is a compression on the posterior tibial nerve.
This syndrome produces symptoms anywhere along the path of the nerve.

Possible symptoms include:
-Shooting pain

Contribute Factors to Tarsal Tunnel:
-Soft tissue masses:
Lipomas-is a benign tumor composed of fatty tissue
-Tendon Sheath Ganglia:
Neoplasms- is an abnormal mass of tissue as a result abnormal proliferation of cells
-Nerve tumors
-Varicose Veins

Work up:

Tinel sign- Percussion of a nerve with radiation of pain along the course of the nerve.

The doctor may order any of the following tests to help with the diagnosis:
-Electromyography (EMG) – A technique for evaluating and recording the electrical activity produced by skeletal muscles
-Nerve conduction velocity (NCV)
-Magnetic resonance imaging (MRI)- In cases of suspected soft-tissue masses and other space-occupying lesions

Conservative Treatment:
-Non steroidal anti-inflammatory drugs-to help reduce pain and inflammation
-Immobilization- Restricting movement of the foot by wearing a cast or cam boot
-Physical therapy
-Injection therapy
-Orthotic devices: To control any abnormal bio mechanics of the foot

-Surgical Therapy
Tarsal tunnel release surgical intervention may be needed if conservative therapy fails to alleviate pain and symptoms. This procedure is used to decrease pressure on the posterior tibial nerve. Any space occupying lesions may also be excised.