Description

Tarsal Tunnel syndrome is a condition that occurs when nerves are trapped as they pass through a fibrous tunnel under the medial ankle bone. The tunnel is divided into four canals and carries many nerves and tendons, but in most cases it is the Posterior Tibial Nerve that becomes trapped. This condition can affect people from 14-80 years old but begins on average at age 47.

Symptoms

This syndrome can cause burning pain in that area around the medial ankle bone, as well as referring pain down to the toes, or back up the leg. Symptoms of Tarsal Tunnel Syndrome are not reduced by rest and may result in lost sleep by keeping the affected individual up at night. In some cases there may also be numbness and tingling in the foot.

Pedorthic Management

• Custom made orthotics – If there are any forefoot or rearfoot deformitites, custom made orthotics may correct these deformities or gait abnormalities and reduce the pressure on entrapped nerve.
• Orthopedic footwear with an appropriate heel counter to provide support without putting pressure on the Tarsal Tunnel  (top line of the shoe should not touch the bottom of the ankle bone)

Other Treatment/ Modalities

• Massage therapy and Physiotherapy may be prescribed to manually relax the fibrous bands that are causing the entrapment and to separate scar tissue which may provide some relief.
• In severe cases the fibrous band may be surgically cut to reduce pressure on nerves and tendons
• Cortisone Injections
• Bracing
• Elevating the leg
• Self-massage