Foot & Ankle Surgery located in Fort Worth and Weatherford, TX
Compression on the tibial nerve is related to the cause, for example:
At times the cause may be idiopathic (unknown) without any specific pathology compressing the nerve.
Frequently patients will present with heel pain and similar symptoms as plantar fasciitis (i.e. pain on the bottom of the heel, pain in the arch, pain in the morning). This is due to a communicating nerve from the main tibial nerve that runs adjacent to the plantar fascia. At times the tarsal tunnel symptoms can be masked during the treatment of the heel pain (rest, ice, injection, night splint, physical therapy, shoe wear modification, inserts) however, the symptoms do not subside and often times return more abruptly and robust.
Symptoms are felt on the inside of the ankle and/or on the bottom of the foot towards the toes. At times the symptoms may shoot or extend to the calf.
At time the symptoms appear suddenly. Other times they are aggravated by overuse of the foot, such as in prolonged standing, walking, exercising, or even beginning a new exercise program.
In diagnosing Tarsal Tunnel Syndrome your surgeon will examine the foot to determine if there is any loss of feeling and/or sensation. During the exam, your surgeon will position the foot in (inverted) and out (everted) and tap on the nerve to see if the symptoms (i.e. burning, tingling, shooting) can be reproduced. Your surgeon will also press on this area to determine if a small mass is present.
Advanced imaging studies may be ordered if a mass is suspected or if initial treatment does not reduce the symptoms. An electromyography and nerve conduction velocity (EMG/NCV) will be ordered to evaluate the extent of the tarsal tunnel syndrome and also to rule out other neurogenic problems. An MRI may also be ordered to determine the extent of the pathology (i.e. space occupying lesion) as well as determine surgical planning should surgery be warranted.
Non Surgical Treatment
Treatment approaches for Tarsal Tunnel Syndrome are based on the severity of the symptoms and the confirmation of the diagnosis with an EMG/NCV and/or MRI. Conservative treatment options are encouraged prior to surgical intervention and include:
If non-surgical approaches fail to relieve the compressed nerve and symptoms of tarsal tunnel syndrome, surgery may be necessary. Your surgeon will discuss the surgical approach to release the compressed nerve as well as address the heel pain that often accompanies the tarsal tunnel syndrome.
Surgery is typically an outpatient procedure (day surgery) and scheduled at your convenience.
A splint or boot will be placed on your surgical foot/ankle after surgery. No weight to the surgical foot/ankle is advised until your surgeon encourages weight bearing (typically 2-4 weeks post surgery).