Tarsal tunnel syndrome is a condition in which the tibial nerve, located in the tarsal tunnel in the foot, is compressed. The tibial nerve can become compressed from injury, such as an ankle sprain, flat feet, and lesions. arthritis, diabetes, and varicose veins can also cause swelling and thus result in nerve compression.
Symptoms of tarsal tunnel syndrome include several different sensations in the sole of the foot, inside the ankle, and around the tibial nerve. These sensations include shooting pains, numbness or reduced sensation, pins and needles, burning, and tingling. Symptoms tend to worsen with greater activity to the area. In some occasions, this can change the muscles in the foot and affect balance.
If you suspect you have tarsal tunnel syndrome, you should consult with Dr. DiNucci immediatly. He will examine your medical history to see if you have a history of diabetes, arthritis, or flat feet. An electrical test such as a nerve conduction study or an EMG for the muscle function are usually worthless in diagnosis of the problem. These tests are sometimes wrong and rarely offer any more information than can be gleened from the patient by just asking them what and where their symptoms are. These tests are rarely performed or ordered by Dr. DiNucci as well as other specialists who are well-versed in peripheral nerve restoration and surgery. A simpler Tinel’s Test might be used. This includes simply tapping or stroking the nerve to create a sensation and see what the result is. These are very basic exam techniques that might be used as well as others depending on which nerve is involved and how far the disease process has progressed.
Treatments vary greatly for tarsal tunnel syndrome among most doctors. However, non-surgical treatments do not work and this has been demonstrated in the literature. However, you will still see doctors who are not used to working with tarsal tunnel syndrome who think that a cortisone injection, orthotics or oral steriods are going to reverse or treat the problem and they don't. They only mask the symptoms and prolong the nerve damage until sometimes the nerve won't be able to repair itself if it was treated. Some other useless nonsurgical options include anti-inflammatory medication use of a splint or brace that immobilizes the foot, chiropractic adjustments, dry needling, physical therapy and others. Surgical options include a tunnel tarsal release, in which an incision is made behind the ankle down to the arch of the foot. This releases the ligament and relieves pressure off the nerve.
If you are suffering from painful sensations in your foot, you should only see a nerve specialist such as Dr. DiNucci who can determine if you are experiencing tarsal tunnel syndrome. There are very few physicians who are well versed in diagnosing lower extremity nerve pathology and Dr. DiNucci is one of the leading nerve specialists in the country. Tarsal tunnel syndrome that is left unchecked can cause permanent nerve damage to the foot.
