What is tarsal tunnel syndrome?
Tarsal tunnel syndrome is damage to the tibial nerve (tibial nerve) in the area of the ankle. The tunnel is formed by the inner ankle of the foot with a tight band. The tibial nerve controls the foot soles muscles and the muscles of the lower leg, which is responsible for flexion of the leg.
Furthermore, all perceptions in the area of the lower leg, the heel and the sole of the foot are guided through the nerve to the central nervous system. When the nerve in the tarsal tunnel is irritated by permanent pressure, the tarsal tunnel syndrome occurs. Foot and lower leg are mainly affected.
Tarsal tunnel syndrome symptoms
Tarsal tunnel syndrome is characterized mainly by nocturnal symptoms in the area of anterior foot sole and the toes.Burning in the foot, numbness and tingling often occur in affected people at night. The symptoms can also radiate into the calf. In addition, the area around the inner ankle is permanently sensitive to pain. Long standing and walking intensify the symptoms, but rest can relieve the symptoms.
Since the nerve initially always regenerates itself, the symptoms occur at first irregularly. In the course of the disease, however, the nerve suffers permanent damage, which prevents emotions and pain. Later, the nerves that are supplied by the nerve can also be damaged. Those affected feel a muscle weakness and can not move the foot properly.
Most common symptoms of tarsal tunnel syndrome are:
- Pain on the foot or lower leg
- Muscle weakness
- Sensivity in inner ankle
- Limited mobility
What are the causes of tarsal tunnel syndrome?
Due to its special position on the foot, the tarsal tunnel is particularly exposed to the movement of a large load.Therefore,additional irritations quickly lead to compressions. This is also the reason why the tarsal nerve compression syndrome is defined as a typical lesion.
There are some causes of tarsal tunnel syndrome:
Unsuitable leg wear
By the regular or protracted wearing of too narrow, too small or too high shoes (for example highheels, too tight ski boots or sports shoes) the tissue around the tarsal tunnel can swell strongly and thus exert pressure on the tibial nerve. The development of the tarsal tunnel syndrome is caused by the running pressure which in case of inappropriate footwear quickly causes a tissue irritation.
Misalignment of the foot
It is always important to carry out movements correctly in high-speed sports.With a view to the tarsal nerve compression syndrome, there are some risky sports as sprinting, skiing, hurdles jumping, tennis and many more.Similarly,team sports such as football or basketball can lead to a tarsal tunnel syndrome. In addition, the overweight and the lack of feet are a permanent source of false foot strain.
Inflammation of the foot
Inflammation or inflammatory diseases such as rheumatism and arthritis also lead to swelling of the feet. These can constrict the tarsal tunnel .
Abnormal bone growth, varicose veins significantly increase the risk of tarsal tunnel syndrome.
Narrowing of the tarsal tunnel can also be caused by external forces.Whether injuries, sprains or bone fractures in the area of the foot – they all involve the risk of swelling or edema in the foot.
Tarsal tunnel syndrome diagnosis and therapy
A tarsal tunnel syndrome is best diagnosed by an orthopedic examination. The orthopaedist first performs a physical examination according to the initial medical history.
This includes the scanning and tapping of the affected foot section to pinpoint the pain of the compression. The doctor taps the skin along the nerve course, causing the patient to have an electrifying pain in the area of the tarsan tunnel.
In order to prevent severe damage to the nerve pathways, a nerve performance test by means of electro-electrography or electromyogram is important after scanning. Now X-ray and MRI follow to detect swelling and injury.
The treatment of a tarsal tunnel syndrome depends on the symptoms, the duration and the severity of the nerve damage that has already occurred. As far as possible, conservative therapies are first used to cure the tarsal tunnel syndrome without complications. It is only necessary in rare cases (for example, in cases of foot deficiencies) to correct the syndrome by surgery.
Depending on the findings, patients with the following treatments are expected:
Relaxation of the tissue: In order to prevent pain, swelling and inflammation, injections into the affected tissue are made. In most cases it is cortisone. By applying cooling compresses, swollen tissue parts can also be supported during decongestion and pain can be alleviated.
Insoles and physiotherapy: To relieve the compression of the nerves, orthopedics use rails or tape bandages that contribute to the relief of the swollen tissue. The wearing of orthopedic shoe inserts are recommended against misalignments such as flat or the bend arches.
Medications: In cases of inflammation due to a tarsal tunnel syndrome, the use of analgesic and anti-inflammatory drugs may be necessary.
Operation: If conservative methods of treatment remain without success, tarsal tunnel syndrome can also require surgery. In doing so, either existing defects are corrected, growths are removed or bone fragments are pushed right. Also, by separating the tendon band running over the tarsal, it may be necessary to relieve damaged nerves.
Tarsal tunnel syndrome – progression, complications and prevention
Tarsal tunnel syndrom can be easily and completely remedied in good time and adequately treated. If it is untreated, the disease can lead to irreversible nerve damage.
In order to prevent the onset of a nerve compression syndrome in the tarsal, you should seek medical advice at an early stage in existing malformations of the foot bones. Operative corrections, deposits and rails have achieved very good results today, so that a tarsal compression of the nerves can often be avoided.
Athletes should always wear appropriate footwear to prevent tarsal tunnel syndromes and do not exaggerate with the training. Tired feet tend to be much faster than tissue irritation and associated compressions.
When it comes to women’s shoes, it is generally not advisable to run highheels frequently. These can not only lead to compression in the nerves. In addition, they are also sensitive to the footbed, which in turn favors a tarsal syndrome due to foot deficiencies.
The tarsal tunnel syndrome is a special form of the nerve compression syndrome and describes the painful constriction of the tibial nerve in the tarsal tunnel. The pressure exerted on the nerves also cause severe nervous disturbances, such as tingling, burning or numbness.
Frequently the tarsal tunnel syndrome is caused by overexertion or misuse of the foot. Luckily, however, an early compression of the nerves can be treated well and the tarsal tunnel can be nurtured quickly by careful care.