Tarsal Tunnel Syndrome
Tarsal tunnel syndrome is a painful condition in which the large nerve leaving your leg is injured in the area behind your ankle as it enters the foot.
Lower extremity nerves
Your spine has multiple levels and each level gives off a nerve branch with go to various parts of your body. The lower extremity is basically controlled by the lumbar and sacral nerve roots exiting the spine, traveling through the pelvis and down the leg to the foot.
Neves are obviously sensitive tissue and respond swiftly with injury. The nerve can be injured in several places with resultant pain. In the back the nerve can be injured by disc disease or spinal arthritis causing pinching of the neve in the back.
As the nerve leaves the pelvis tight muscles or muscles in spasm can also pinch the nerve as it begins to travel down the leg. A common area of nerve injury is just behind the ankle bone where the nerve begins to transform into the smaller tighter bundle of nerves commonly found in the foot. As the nerve turns and changes position it can become crimped and damaged. Also, the position of the foot can have influence as excessive pronation will cause the foot to flatten and as a result the nerve will become stretched and pinched as its canal becomes tight.
The diagnosis of nerve injury can be made through both history and clinical exam. Historically, patients often report a burning pain that shoots or moves around. Pain is also more at the end of the day or even in bed when tissue should be resting and not painful. Weakness or loss of feeling often is also a tell-tale sign of nerve injury. On examination, there is pain on palpation of the nerve along its course. There may be increased sensitivity or there may be numbness as nerve conditions have a remarkable inconsistency to them making their diagnosis often difficult.
Attempts are made to decrease the inflammation of the nerve in treatment. Cortisone injections to reduce inflammation that is resent and in-shoe orthotics to prevent pulling and pinching o the nerve can help prevent irritation that may develop later. Topical compounded medicine has been shown to provide relief in 60% of patients. Failure to respond requires electrodiagnostic testing which will confirm the presence of a more involved injury or problems and providing guidance for further treatment.
Should you have a suspected nerve injury or an injury that is not responding to mechanical treatment, let the Doctors of the Weil Foot & Ankle Institute help find the cause and provide relief.