Tarsal tunnel syndrome is a condition in the foot which is very similar to carpal tunnel syndrome in the wrist, and it involves the tibial nerve becoming compressed in the place where it enters the tarsal tunnel. This condition can cause numbness in the bottom of the foot in some cases, or severe pain in other cases. Because the floor of the tunnel is bone and its roof is thick, any space-occupying lesion in that tunnel can cause pressure on the nerve (posterior tibial nerve).
Fortunately, there is a procedure which effectively treats tarsal tunnel syndrome. At the Foot and Ankle Surgery Center of Excellence, our doctors are board-certified and are experts at treating conditions of the foot. While surgery is always the last resort for treating tarsal tunnel syndrome, it may be necessary when conservative methods prove ineffective. If you believe you may have tarsal tunnel syndrome and are interested in learning about treatment options, please contact our outpatient surgery center in Los Angeles.
Types, Symptoms and Causes
Tarsal tunnel syndrome is a compression neuropathy (pressure on a nerve) that can cause severe pain or numbness in the bottom of the feet. The tarsal tunnel is located along the inner ankle and hind foot, and contains a nerve which supplies sensation to the bottom of the foot. When the posterior tibial nerve becomes compressed as it enters the tarsal tunnel, it causes tarsal tunnel syndrome, similar to carpal tunnel syndrome in the wrist.
One form of tarsal tunnel syndrome is anterior tarsal tunnel syndrome, which involves the compression that occurs within the deep peroneal nerve, causing severe ankle and foot pain. Likewise, distal tarsal tunnel syndrome involves the compression of the first branch lateral plantar nerve or the medial calcaneal nerve, and its primary symptom is heel pain. Both of these conditions are rare types of tarsal tunnel syndrome.
There are multiple causes of tarsal tunnel syndrome, including pronation of the foot (flat foot), osteoarthritis, swelling from sprained or broken ankles, and any space-occupying lesion (such as benign tumors, ganglion cysts, inflammation of the tendon sheath, and bone spurs). Any pressure and repeated strain on the tibial nerve plays a major role in the development of the condition.
Tarsal Tunnel Syndrome Symptoms
While some patients may experience numbness or loss of sensation in the bottom of their feet as a result of tarsal tunnel syndrome, others may feel pain in the bottom of their feet and toes. Some of the most common symptoms of this condition include:
- Pain or tingling in the bottom of the feet and toes that subsides with rest
- Sensations of electric shock in the bottom of the foot
- Hot/cold sensations in the bottom of the foot
- “Pins and needs” feeling in the bottom of the foot
- Loss of sensation in the bottom of the foot
While these symptoms may indicate tarsal tunnel syndrome, it is important to see a foot specialist, who can determine more accurately if this condition is actually the cause of your pain, or if another condition is present.
Tarsal Tunnel Release Surgery
Surgery is always the last resort. When you are diagnosed with tarsal tunnel syndrome, your foot specialist will typically prescribe orthotic devices, shoe modifications, and even injections to treat the condition. If conservative methods fail to correct the problem, then surgical decompression may be needed.
Tarsal tunnel release – This procedure involves a small incision to the medial malleolus and posterior margin of the tibia, in which the surgeon “releases” the flexor retinaculum and fascial arcade. The surgeon typically decompresses the nerve by releasing the flexor retinaculum and decompressing the nerve, removing any lesion occupying the space. An MRI beforehand will determine if this procedure is needed.
Frequently Asked Questions
Q: How long is recovery from tarsal tunnel surgery?
A: The surgery can be done on an outpatient basis at our outpatient surgery center. This means patients can go home the same day as their procedure, Most patients are back on their feet and back to regular activities within a few weeks. Anywhere from a couple days to a couple weeks – they are up and about immediately but the wound takes longer to heal – up and walking/mobile (with crutches typically). But depending on the severity and the details of your surgery normally it can take up to 10 days (plus or minus 10 days) – involves only soft tissue and no bone work and therefore the healing is short term
Q: Does tarsal tunnel syndrome always require surgical treatment?
A: No. Many cases of tarsal tunnel syndrome can be treated with orthotics. Foot specialists typically use orthoti.cs as treatment, and only perform surgery in severe cases that do not improve from orthotics. Additionally, some cases of tarsal tunnel syndrome may be alleviated and treated by other conservative methods such as rest, icing the area, or injecting steroids. However, cases that do not improve from these methods may require surgical treatment.
Contact a Los Angeles Orthopedic Surgeon or Podiatrist
At the Foot and Ankle Surgery Center of Excellence, our team of podiatrists and orthopedic surgeons work together to treat foot conditions, utilizing the most advanced techniques. If you are suffering from pain on the bottom of your foot and are concerned it may be tarsal tunnel syndrome, it is important to see a board-certified foot doctor to determine the cause of the pain.
To learn more about foot pain and tarsal tunnel syndrome treatment, please contact the Foot and Ankle Surgery Center of Excellence in Los Angeles. You can schedule a consultation with one of our expert orthopedic surgeons or podiatrists by filling out our online appointment form or by calling (888) 225-0763.
Next, read about midfoot pain.