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Tarsal Tunnel Syndrome

Tarsal tunnel syndrome is similar to the more commonly known “carpal tunnel syndrome” that occurs in the hands. Both conditions are created when compression of the nerve that travels through the tunnel places consistent pressure on the nerve, resulting in pain. Tarsal tunnel syndrome caused by a compression of the posterior tibial nerve, which runs through the tarsal tunnel.

The tarsal tunnel is a passageway along the ankle that is surrounded by bone and tissue. The purpose of the tarsal tunnel is to protect the posterior tibial nerve as it travels through the ankle, between the heel and foot bones, separates into three parts and runs through the arch of the foot, to the toes.

When compression occurs in the tarsal tunnel, the posterior tibial nerve is placed under pressure and pain is experienced. Tarsal tunnel syndrome pain is described as shooting or tingling and often involves the entire foot, from the ankle to the toes. The pain begins around the ankles and “shoots” to the toes. Tarsal tunnel syndrome pain is typically worse when walking and better with rest.

Taping or strapping the foot to limit movement is often used to treat the early stages of tarsal tunnel syndrome. Ice to reduce swelling can be helpful, as well. Rest is very important for allowing the cause of the compression to subside and to permit the nerve to heal.

Dr. Jeffery Kleis is a board-certified, award-winning podiatrist, specializing in all conditions of the foot and ankle, including tarsal tunnel syndrome. Dr. Kleis can prescribe the best methods of treatment for tarsal tunnel syndrome, which may include: rest, ice, over-the-counter anti-inflammatory medications, anti-inflammatory injections, orthotic inserts, physical therapy exercises, acoustic-wave or low-level laser therapy, or surgery. Only a doctor can fully evaluate tarsal tunnel syndrome and determine all of the underlying causes. The underlying causes of the tunnel compression must be determined and properly treated to reach full recovery.

If you experience pain in your foot or ankle that lasts more than three days or is not made better by rest and ice, you should be evaluated by a medical professional. Dr. Jeffery Kleis is conveniently located in Costa Mesa and serves all of Southern California. Schedule an appointment online or call (714) 760-4944 today for a complete evaluation of tarsal tunnel syndrome.

What is the Tarsal Tunnel?

The tarsal tunnel is an opening that runs through the ankle and between the heel and the ankle and foot, to form a safe passage for the posterior tibial nerve which supplies sensation to the bottom of the foot. Other important tendons and arteries also use the tarsal tunnel for safe passage through the ankle and heel. Inside the tarsal tunnel, you will find the posterior tibial nerve as well as the posterior tibial artery, the flexor tendon, the posterior tibial vein, tibialis posterior tendon, and the flexor hallacis longus tendon. That’s a lot of crowding in a narrow tunnel!

With so many vital resources running through this tunnel, it’s no wonder that seemingly slight injuries can place extra pressure on the contents of the tarsal tunnel. If a tendon gets pulled or stressed, it may swell, taking up more than its share of the space in the tarsal tunnel. This seemingly unrelated injury then places pressure on the posterior tibial nerve and causes pain that starts at the ankle and runs through the bottom of the foot because of the pressure placed on the nerve inside the tunnel.

If the cause of the compression can be treated, the pressure on the nerve will be relieved, and the foot can return to normal. If the pressure or irritation stays on the nerve for too long, permanent damage can be done and the condition may become chronic or require surgery for treatment.

Only a doctor can determine the full cause of tarsal tunnel syndrome and treat the full array of possible conditions. Dr. Jeffery Kleis, of Costa Mesa, is a board-certified podiatrist, specializing in the treatment of the foot and ankle. With more than 25 years of experience, Dr. Kleis is well-qualified to evaluate the cause of your foot pain and treat tarsal tunnel syndrome and any underlying causes.

What is Tarsal Tunnel Syndrome?

The tarsal tunnel provides safe passage for a variety of foot resources, including the posterior tibial nerve, the posterior tibial artery, the flexor tendon, the posterior tibial vein, tibialis posterior tendon, and the flexor hallacis longus tendon. The tunnel is made up of bone on the inside and a thick band of strong, fibrous tissue called the flexor retinaculum on the outside of the tunnel.

The tarsal tunnel is a passageway for blood and nerve function to the bottom part of the foot. When injury or irritation causes any one of these vital resources to become inflamed, the passageway is restricted. The restriction of the tarsal tunnel then creates a separate condition, as the nerves and blood flow become restricted and cause pain and discomfort that can be felt from the ankle through the bottom of the foot.

The cause of the inflammation must be addressed for the tarsal tunnel syndrome to be fully treated and resolved. Treatment for tarsal tunnel syndrome may include rest, ice, over-the-counter anti-inflammatory medications, anti-inflammatory injections, orthotic inserts, physical therapy exercises, acoustic-wave or low-level laser therapy, or surgery. Only a doctor can fully evaluate tarsal tunnel syndrome and determine all of the underlying causes. The underlying causes of the tunnel compression must be determined and properly treated to reach full recovery.

If you experience pain in your foot or ankle that lasts more than three days or is not made better by rest and ice, you should be evaluated by a medical professional. Dr. Jeffery Kleis is conveniently located in Costa Mesa and serves all of Southern California. Schedule an appointment online or call (714) 760-4944 today for a complete evaluation of tarsal tunnel syndrome.

Tarsal Tunnel Syndrome Symptoms

Tarsal tunnel syndrome is caused by a restriction or increased pressure on the tibial nerve as it passes through the tarsal tunnel, on its way to the bottom of the foot. The nerve splits immediately after leaving the tarsal tunnel and forms a branch of nerves, which provide sensation in the bottom and side of the foot and out to the toes. Damage to this nerve causes pain that can be felt from the ankle to the toes.

The most common symptom of tarsal tunnel syndrome is a pain in the ankle and shooting pain or tingling sensations that extend from the ankle to the toes. The pain is made worse when walking or standing and generally better when resting. Some people with tarsal tunnel syndrome also report that their feet have a burning sensation at night. Occasionally, a weakness in the muscles that bend the toes can be felt, as well.

Tarsal tunnel syndrome is more common in athletes. This is thought to be because athletes are more often subject to other, seemingly unrelated, injuries that cause inflammation on one of the resources using the tarsal tunnel and causing the tibial nerve to become restricted. This can cause tarsal tunnel syndrome as a secondary condition that may be overlooked.

Only a podiatrist or other physician can fully determine the cause of your tarsal tunnel syndrome symptoms and prescribe treatment that will address all of the issues involved. For a complete evaluation of your tarsal tunnel syndrome symptoms, visit Dr. Kleis at his centrally located Costa Mesa practice. Schedule an appointment online or call (714) 760-4944 today for a complete evaluation of tarsal tunnel syndrome symptoms.

Tarsal Tunnel Syndrome Treatment

Treatment for tarsal tunnel syndrome may include rest, ice, over-the-counter anti-inflammatory medications, anti-inflammatory injections, orthotic inserts, physical therapy exercises, acoustic-wave or low-level laser therapy, or surgery.

  • Rest – This is the first line of defense and should be employed at home when experiencing any symptoms of tarsal tunnel syndrome. Rest can provide the injured and inflamed foot to heal and recover on its own.
  • Ice – Ice will help reduce the inflammation in the tarsal tunnel and relieve the pressure on the nerve, providing relief for the pain and shooting sensations experienced by tarsal tunnel syndrome sufferers.
  • Over-the-counter Medications – Over-the-counter anti-inflammatory medications, such as ibuprofen, acetaminophen, and Naproxin Sodium can help relieve inflammation, reduce pressure on the nerve, and provide pain relief for tarsal tunnel syndrome symptoms.
  • Anti-inflammatory Injections – Your doctor may determine that cortisol injections are appropriate to relieve the pain and pressure in the tarsal tunnel. Only a doctor can determine if cortisol injections are right for you.
  • Orthotic Inserts – Inserts or other orthotic devices can assist in relieving pressure on the foot and provide the proper support, allowing the inflammation to subside and the injured or irritated nerve to heal.
  • Physical Therapy – Specific exercises can strengthen supporting muscles and ligaments, reducing the pressure on the tarsal tunnel.
  • Acoustic-wave or Low-level Laser Therapy – Dr. Kleis is a leader in the field of laser therapy for treating disorders of the foot. Top athletic teams utilize acoustic-wave and laser therapy to treat injuries and provide faster healing. Dr. Kleis ensures that he and his team remain on the cutting edge of treatment technology.
  • Surgery – As a last resort, Dr. Kleis may recommend surgery to treat chronic and un-responsive tarsal tunnel syndrome. With all of the other resources at his disposal, surgery is very rare.

Tarsal Tunnel Syndrome Surgery

Dr. Kleis employs a variety of non-invasive treatment measures that help ensure that surgery for tarsal tunnel syndrome is not often required. If all other treatments have failed, however, and the symptoms of tarsal tunnel syndrome simply cannot be eliminated, surgery may be required.

For a complete evaluation of tarsal tunnel syndrome schedule an appointment online or call (714) 760-4944 today.

 

 

 

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