Tarsal tunnel syndrome occurs due to compression of posterior tibial nerve or its branches in tarsal tunnel.
What causes the tarsal tunnel syndrome?
Any mass taking place in tarsal tunnel puts pressure on the nerve. Ganglion, neurofibroma, lipoma, varicous veins, tenosynovitis, displaced fracture fragments can be discovered in tarsal tunnel as an etiologic factor causing the clinical symptoms. Pronation deformty of the ankle and foot may also lead tarsal tunnel disease by stretching the nerve.
Symptoms of tarsal tunnel disease
Paresthesia tingling, and burning pain are common in tarsal tunnel syndrome. Some patients experience worsening with activity while other may have night pain and burning sensation. Tinnel sign is positive in most patients. Tinnel sign could be produced by tapping on tarsal tunnel area by a reflex hummer or finger tip. Patient usually experience tingling spreading towards to plantar foot surface. Also, dorsiflexion and evertion of foot and ankle may produce tingling sensation. Some patients complain also about pain spreading proximally.
How to diagnose Tarsal Tunnel Syndrome?
Physical exam and EMG test are helpful in Tarsal tunnel diagnosis. Further analysis like MR and ultrasonography is strongly recommended.
Treatment of Tarsal Tunnel Disease
In the early stages, antiinflammatory drugs, orthopedic insoles are recommended. If the symptoms persist despite the nonsurgical modalities, then surgery may be planned. We perform both open release or arthroscopic release. Arthroscopic release has a good standing with its quick healing time.
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