The tarsal tunnel is a space that is located inside the ankle, right next to its bones. It is delimited by two bony reliefs, the internal or tibial malleolus and the tubercle of the calcaneal bone. Just as there is carpal tunnel syndrome, located in the wrist, the feet can also suffer from a little-known, but very painful, injury called tarsal tunnel syndrome. This injury is a compression of the tibial nerve. In this post we talk about its symptoms, causes and treatment of this condition.
What is tarsal tunnel syndrome?
Tarsal tunnel syndrome, also known as tarsal tunnel syndrome or posterior tibialis neuralgiaThis is a disease that appears when the tissues surrounding the posterior tibial nerve compress it.
Due to the difficulty of its diagnosis, tarsal tunnel syndrome (TTS) is described as an underdiagnosed syndrome. Therefore, this pathology can be detected following other diagnoses of plantar fasciitis.
Symptoms of tarsal syndrome
Patients with tarsal tunnel syndrome experience symptoms on the inside of the ankle and/or on the bottom of the foot.. In some cases, these symptoms may be completely isolated, appearing only in one of these areas.
Tingling in the ankle area, burning sensation and cramps in the fingers and sole of the foot are the most common symptoms of tarsal tunnel, and these can radiate to the knee area.
With daily activities such as walking, playing sports and even lying down, the patient experiences these symptoms.
These symptoms vary greatly depending on the patient, so that some symptoms progress and worsen over time while others begin suddenly. When there is pain during rest periods, it will help distinguish the symptoms of plantar fasciitis. What does agree is that all patients with this disease aggravate their symptoms with physical exercise.
Causes of tarsal syndrome
It can be said that up to a total of 40% of this syndrome is of unknown cause. As mentioned, The main cause of tarsal syndrome is compression of the tibial nerve, but this compression may be due to other causes.
Biomechanical and morphological alterations in the skin or ankle such as the presence of flat feet, excessive pronation during walking and the presence of ankle instability are some of them.
On the other hand, overload of the tibial nerve caused by ankle sprains, performing impact sports on the ankle and feet and wearing inappropriate footwear are other possible causes of tarsal tunnel syndrome.
Metabolic or systematic diseases such as rheumatoid arthritis, diabetes, obesity and hyporiroidism are causes of tarsal tunnel syndrome.
Diagnosis and treatment of tarsal tunnel syndrome
Through clinical history and a diagnostic study, looking for characteristics that could indicate tarsal tunnel syndrome, the treatment that this condition requires can be determined, always taking into account the symptoms of each patient.
Diagnosis of tarsal syndrome
The foot and ankle specialist will take the patient for a diagnosis in order to determine if there is loss of sensitivity, pressing the area in order to also determine if there are lumps in the tibial area.
The Tinel test is a way to confirm the diagnosis of the tarsal tunnel syndrome, evaluating median nerve entrapment.
In cases where lumps appear and the symptoms do not improve as the days go by, the specialist will require an MRI study. Likewise, ultrasound allows the location of the different nerve branches, thus reproducing the symptoms.
Treatment of tibialis posterior neuralgia
To treat tarsal tunnel syndrome, there are various conservative treatments, generally used in combination. It is recommended to rest the skin, trying not to support it to promote healing and thus avoid further injuries.
For tarsal tunnel swelling, ice can be applied to the affected area with a towel for approximately 15-20 minutes.
In the most severe and prolonged cases, which do not improve with these conservative options, the specialist proceeds to minimally invasive surgical techniques, with which it is possible to reduce the patient's postoperative pain and accelerate his recovery.
Just as the median nerve is trapped in the hand, the same happens in the foot. Do you have any of the symptoms mentioned during the post? If so, it is important to identify any symptoms in the ankle and foot area in time, in order to prevent other injuries that it may cause in the future. At Elgeadi Traumatology we are at your disposal traumatologists experts in minimally invasive surgery internationally recognized. Make an appointment with our team of experts for a tailored diagnosis.
10 thoughts on “Síndrome del túnel tarsiano: qué es, síntomas, causas y tratamiento”
Good afternoon. They say that you can see the nerves in an echo, is that true?
It is not necessary to do an Electromography for this.
If Tarsal Tunnel Syndrome were diagnosed, could it be cured by avoiding surgery?
Thank you so much.
Hello, Marina,
With ultrasound, the nerves can be effectively seen, but to know their degree of injury, ultrasound is not always enough, and an EMG study is necessary to be able to more accurately assess the condition of the nerve, degree of injury, chronicity. etc The issue of operating it or not will depend on the degree of injury and its origin or cause.
All the best.
After open TTS surgery in 2021, I recently had an EMG study that showed severe neuropathy of the distal tibial nerve in my left foot. that affects the sensory and motor fibers of the medial and lateral plantar branches, could the aforementioned severe neuropathy be suppressed or attenuated through minimally invasive surgery?
If that is not the solution, what would be the solution you would propose?
Thank you so much.
Hello Modesto, thank you very much for your question.
The first thing would be to check that, indeed, the opening of the third tunnel was not correct and that during the intervention, there were no complications that would lead to nerve injury. Sometimes the Nerve remains compressed due to insufficient release or because it has scarred again above the tunnel. It is important to do a good clinical examination to be able to assess the condition of the tunnel along with new medical tests, including a good ultrasound to assess where the problem is.
Once the cause is detected, there is surely a solution, unless there is a permanent injury to the nerve.
I feel pain when I get up in the morning and when I am having lunch for 45 minutes and I get up to walk on my left heel and I am lame, then as it goes on it normalizes, it will be poor blood irrigation... I have diabetes, I have been diagnosed with tarsal tunnel syndrome, I am doing rehabilitation it will be that I will improve then it will be necessary to have surgery thanks Olga
Hello Olga,
In the most severe cases where improvement is not seen and lasts over time, it is necessary to perform minimally invasive surgery to free the nerve.
Greetings
I have pain with numbness and stiffness in my right toes that is continuous and all day long. On July 24th I had surgery for a hernia in the L5 and they put irons on me. I am very worried. The stretched pain also continues and manifests itself as stiffness and numbness in the toes. When I walk I feel like a ball under my foot. The specialist told me to wear orthopedic insoles for 2 months and that the cause could come from above (back). I am having back injections on the 25th of this month. I hope that this will relieve my discomfort, which I have had since last August (after surgery). I hope that the injury I have is reversible; it is very uncomfortable. They found that I have bursitis in my foot and also sensory radiculopathy, and a small enchondroma, which according to the doctor is not the cause of my pain. It is not Morton's neuroma either. He told me that it is tunnel syndrome and that the cause also comes from above.
Hello Juanjo,
The symptoms you describe may be related to sensory radiculopathy and tunnel syndrome, especially if the cause is in the spine. Back injections may help relieve discomfort, but the outcome will depend on how your body responds to the treatment. It's advisable to follow your specialist's instructions and consider options such as physical therapy or treatment adjustments if symptoms persist. If you'd like a second opinion, you can schedule an appointment with our team by calling 91 005 39 00.
Greetings.
Hello, good evening, doctor. My dad has been experiencing pain in the sole of his foot for several days, or let's say a few months, that radiates to the sweet potato. He has already been to several doctors and even undergone some therapies, but the pain still persists. His thumb also feels numb. What could be the approximate diagnosis?
Hi Erika,
The pain you describe could be due to different causes, so it's essential to see a doctor so they can order the necessary tests to arrive at an accurate diagnosis. If you'd like, we can schedule an appointment so our team can evaluate your father's case in detail and provide guidance.
Greetings.