Sandy Tarsal Tunnel Syndrome

While many people have heard of carpal tunnel syndrome, tarsal tunnel syndrome is not as well known. It is a similar condition that results from the compression of a nerve – in this case, the posterior tibial nerve that runs down the inside of the ankle.

This nerve is located in the tarsal tunnel, which is a narrow area next to the ankle bones. People with damage to this nerve can experience pain anywhere along the tibial nerve, but most commonly in the sole of the foot or inside the ankle.

What Kind of Doctor Treats Tarsal Tunnel Syndrome?

As foot and ankle specialists, podiatrists are trained to treat tarsal tunnel syndrome. They may also work hand in hand with neurologists and orthopedists.

If you have tarsal tunnel syndrome, your Sandy podiatrist will have the knowledge and experience to evaluate your symptoms and recommend a treatment plan for your needs and goals.

What Are the Symptoms of Tarsal Tunnel Syndrome?

Many people experience symptoms similar to other types of nerve compression or issues:

• A tingling or burning feeling, usually in the inner ankle of the bottom of the foot. Some people describe the feeling as an electrical shock or a “zap” in their ankle or foot.
• Pain. You might also have shooting or stabbing pain in the foot or ankle.
• Numbness. With nerve issues, it’s not unusual for the symptoms to vacillate between burning/tingling/pain and a lack of sensation. You might feel that part of your ankle or foot has gone numb. Often the tingling sensation returns as the numbness starts to recede.
• Weakness in the lower leg or foot, which can sometimes cause you to have difficulty walking.
• Feeling like your foot is too hot or cold.

The symptoms listed above usually worsen when you’ve been standing or walking long.

What Causes Tarsal Tunnel Syndrome?

Your podiatrist will examine the ankle and foot, perform manual tests, and may also do nerve conduction studies or imaging to understand better what is happening inside the tarsal tunnel. There are several potential causes of this syndrome:

• Flat feet. If you’ve been told you have flat feet, you may be at increased risk of issues with the tarsal tunnel. Fallen arches can cause the heel to point outward, and in turn, this sometimes leads to compression of the posterior tibial nerve.
• Anything that takes up space in the tarsal tunnel. Some examples include varicose veins, cysts, swollen tendons, or bone spurs.
• Injury. A sprained ankle or any other injury that causes swelling in the area in or around the tarsal tunnel could also compress the nerve.
• Systemic health issues. Some conditions like diabetes or arthritis may also cause nerve damage and/or swelling in the tarsal tunnel.
• New or vigorous exercise or overuse of the foot and ankle. Some people develop symptoms of tarsal tunnel syndrome after starting a new exercise program or spending extensive time standing, walking, or running for any reason.

What Are the Treatment Options for Tarsal Tunnel Syndrome in Sandy?

Treatment options vary depending on the severity of your condition, your overall health and other medical history, and the cause of the tarsal tunnel syndrome. Your foot and ankle specialist may recommend one or more of the following:

Rest and Ice

Sometimes mild cases respond to staying off your feet and applying ice to the ankle and foot.

Over-the-Counter Medication

Non-steroidal anti-inflammatory medications like ibuprofen or aspirin can help reduce the inflammation around the nerve, diminishing pain and bringing down any internal swelling.

Immobilizing the Ankle and Foot

In more advanced cases, your foot and ankle specialist may recommend a cast to immobilize the foot. This prevents movement from aggravating the nerve, allowing it to heal.

You might need to get around with a cane or crutches until the cast is removed, so preparing might be good.

Physical Therapy

Your podiatrist might suggest that you work with a physical therapist to improve blood flow, strength, and mobility in the affected foot and ankle. A physical therapist will walk you through exercises to strengthen the lower leg and foot muscles and to “glide” the affected nerve.

If your tarsal tunnel syndrome has negatively impacted your balance and coordination – which is common – the therapist may also prescribe exercises to help with these difficulties. They might also tape your ankle or brace it.

Physical therapy is most successful when you follow the therapist’s instructions and perform the at-home exercises they give you. Patients who neglect their “homework” typically progress less than those who keep up with the exercises.

If pain or another issue prevents you from doing the work, discuss it with your therapist at your next session. A modified exercise or a prescription for medication may allow you to do the necessary workout.

Corticosteroid Injections

Steroid injections in the affected area can quickly reduce swelling, inflammation, and pain.

Such injections are one solution if you can’t move your foot or ankle enough for physical therapy. However, this is only a temporary fix to be used with other therapies – steroids can have serious side effects, including bone loss and an increased risk of infection.

By the time the effects of the injection wear off, the hope is that other treatments will have addressed the root cause or causes of your tarsal tunnel syndrome.

Custom Orthotics

Specially-made shoe inserts are often effective if fallen arches trigger your tarsal tunnel syndrome.

To create orthotics, the podiatrist will scan your feet and create a mold in the office, then send these to a lab with instructions. In the meantime, you’ll receive temporary orthotics to put in your shoes until the permanent ones arrive (usually in two to three weeks).

Your foot and ankle specialist may also recommend a more supportive pair of shoes, and they can point you to a local store that sells orthotic shoes.

Bracing

In some situations, the foot doctor might treat a severe case of tarsal tunnel syndrome by fitting you with a brace to take pressure off your foot. This is also sometimes helpful for patients with flat feet.

Surgery

If other treatments have not provided enough relief and you still have significant symptoms, your podiatrist may recommend a tarsal tunnel release surgery.

In this procedure, typically done in the podiatrist’s office, your doctor will give you either general anesthesia or a local anesthetic. Once you are comfortable, the doctor will make an incision into a ligament in the ankle, relieving pressure on the tibial nerve.

If your scans show a bony growth, cyst, or another blockage in the tarsal tunnel, the foot and ankle specialist will remove it during the surgery.

As with any surgery, some risks accompany a tarsal tunnel release, including excessive bleeding, blood clots, infection, or further nerve damage. Sometimes, the surgery may not fully relieve all the patient’s symptoms.

Still, most people are pleased with the outcome of their tarsal tunnel surgery. Your foot and ankle specialist will review the surgery’s risks and benefits and answer your questions so you can make an informed decision.

Following the surgery, you will probably be fitted with a splint to immobilize the ankle. Your doctor will advise you not to put any weight on the foot for several weeks, and a physical therapist may give you exercises to work on while sitting or lying in bed.

After a few weeks, you may be fitted with a walking boot so you can put weight on your foot with protection in place. More sessions with the physical therapist will follow, allowing you to transition to different exercises as you begin walking and doing other activities again.

 

Where Should You Go to Get Tarsal Tunnel Treatment in Sandy?

Dr. Elizabeth Auger, DPM, is an accomplished foot and ankle surgeon who has practiced in the Sandy and Salt Lake City areas for over 24 years. A graduate of Temple University in Philadelphia, she moved to Salt Lake City and completed her medical residency here with intensive foot surgery and wound care training.

She is Board Certified in Podiatric Medicine by The American Board of Lower Extremity Surgery and is also a College of Foot and Ankle Surgeons member. Dr. Auger offers a holistic, patient-centered approach to solving various foot and ankle issues, including tarsal tunnel syndrome.

If you’ve suffered foot or ankle pain, please contact our office for an appointment. Most days, we have openings for same-day appointments.

Our helpful administrative staff can assist you with questions about insurance coverage and schedule an appointment as soon as you’re ready. When you arrive, Dr. Auger will take a detailed medical history, examine your foot or ankle, and order tests as needed, then create a customized treatment plan after reaching a diagnosis.

Tarsal tunnel syndrome sometimes causes permanent and irreversible nerve damage if it goes untreated for too long. If you have any of the symptoms listed above, please call our office at 801-758-7052 right away to schedule an appointment so we can get to work relieving your symptoms.