Tuesday, February 2, 2010

Taming Tarsal Tunnel Syndrome

Ever experience a combination of numbness and sharp, burning pain around your ankle? Did it feel similar to that crazy sensation you get when your feet fall asleep, yet more intense? If this sounds familiar, you could have been experiencing compression of either your posterior tibial or deep peroneal nerves which caused tarsal tunnel syndrome.

Tarsal tunnel syndrome is very similar to carpal tunnel syndrome. The only difference is that tarsal tunnel syndrome involves the ankle and sometimes pervades into adjacent parts of the foot. The posterior tibial nerve running along the medial aspect of the ankle is more frequently affected since it rests in a narrow canal, bundled together with an artery and vein. The neurovascular bundle is surrounded by tendons that all run behind the medial malleolus as they traverse from the lower leg down into the foot. Excessive pronation causes more pressure along this canal, and entrapment of the nerve can result. Trauma suffered from an ankle sprain may also cause compression.

Conservative treatment measures are primarily taken to relieve the pressure surrounding the nerve. An orthotic is often prescribed to relieve the pressure that may be caused by excessive pronation. Shoe gear is assessed to ensure it isn’t too tight, and consults with a neurologist may be necessary to rule out other causes of the symptoms. Surgical treatment is explorative in nature, and involves releasing the tissue surrounding the nerve.

Numbness, tingling and burning pain in your feet can also be caused by a variety of other conditions such as diabetic peripheral neuropathy, peripheral arterial disease, charcot-marie-tooth disease, hypothyroidism, chronic kidney disease, HIV, vitamin deficiency anemia, and alcoholism. While your foot-jerk reaction may be to self-diagnose the problem, it’s important to allow your podiatrist to investigate the sensations instead. We’ll go the extra mile to ensure the true underlying cause is treated!