Tarsal Tunnel Syndrome

Tarsal tunnel syndrome occurs when there is compression of the posterior tibial nerve in the ankle, causing foot or heel pain. This condition is very similar to carpal tunnel syndrome in the hand, where the median nerve is compressed.

With tarsal tunnel syndrome, compression of the tibial nerve occurs within a tunnel created by a floor consisting of the calcaneus and bounded by the medial malleolus- the bump on the inside part of the ankle- and the far corner of the heel bone. The roof of the tarsal tunnel is formed by a retinaculum- a tough piece of fibrous tissue.

Within the tarsal tunnel run a number of tendons as well as the tibial nerve, and the posterior tibial artery.

In other patient, tarsal tunnel syndrome can occur even if the nerve compression is found elsewhere. An example would be a patient who has a pinched nerve in the low back along with tarsal tunnel syndrome. This condition is termed "double-crush" syndrome, where there is compression at least two locations.

Another problem is that those who suffer from tarsal tunnel syndrome may have peripheral neuropathy. This condition occurs when there is damage to the small nerves in the feet. A tingling sensation and numbness are typical symptoms. Diabetes and thyroid disorders are among the diseases associated with peripheral neuropathy are d.

Medications can also cause a peripheral neuropathy and various chemotherapy agents given for cancer.

Excessive alcohol and tobacco use as well can cause peripheral neuropathy as can exposure to heavy metals. The most common symptom of tarsal tunnel syndrome is foot pain, which can also be accompanied by numbness and tingling.

Tapping on the tibial nerve at the tarsal tunnel may cause pain and tingling to occur. The clinical impression can be confirmed with electrical testing (electromyography and nerve conduction). Electrical testing is important to evaluate the patient for other nerve entrapment problems such as a pinched nerve in the back. Peripheral neuropathy can also be diagnosed. Magnetic resonance imaging (MRI) and ultrasonography may be useful in evaluating a patient for underlying reasons for tarsal tunnel syndrome.

Medical therapy for tarsal tunnel syndrome may start with local injection of steroids into the tarsal tunnel. Physical therapy may be of some value in reducing soft-tissue edema which can ease pressure on the compartment.

Splints and braces may be helpful for patients who have anatomic abnormalities in the hindfoot and ankle.

When conservative therapy fails to help the patient's symptoms, surgical intervention may be warranted.
When a patient doesn't improve and has persistent pain, associated plantar fasciitis may be a cause of persistent pain in the medial heel region after surgery.

There is a plethora of advanced therapies, particularly MicroVas and TENS therapy. Both are instrumental in relieving symptoms, either as a preoperative modality or post operative, and therapeutic medicines such as as gabapentin are also helpful.

The Basics of Ankle Arthritis

The conditions of ankle arthritis can be really painful since the entire body weight is on your lower extremiteis while walking.

Conservative treatment can involve NSAIDS, physical therapy, injection therapy and ankle braces. Surgeries involve ankle arthroscopy (scope), implants, ankle stabilization procedures and fusions. The treatments of ankle surgery are not always successful like knee and hip implants.

The configuration of the ankle joint is difficult to formulate. Also the surface area to weight ratio is a challenge to duplicate. The problem can be tackled by seeking advice from a foot surgeon. Presently the United States and for many years Europe has been using a remarkable technique for this problem. It is known as ankle arthrodiastasis.. The process simply distracts the ankle joints and regenerates the cartilage which decreases the pain.

Currently, various institutions are combining the above procedure with joint replacement therapy. The procedure of joint fluid replacement therapy is not yet currently FDA approved for use in the ankle joint, so the patient must be fully informed of such.

Family Foot and Leg Center in Naples has been doing this procedure with good success in patients between 80%-90% improvement in pain. This is a good substitute to ankle fusion, which is a permanent procedure in which the surgeon puts two bones together to act as one, taking away the painful joint.

In fact, rheumatoid arthritis is the most common form of feet disorder. It is a degenerative disease of joints which involves the breakdown of cartilage. The symptoms are aching of feet and severe immobility in certain cases. It usually attacks the joints which render them to become weak and eventually prone to such dysfunctionality.

Common Causes of Heel Pain

Heel pain is probably one of the most common pathologic problem of the foot. We sometimes experience foot pain after long periods walking especially after spending a day at the mall. We can also develop heel pain after long periods of standing, just like when we stand on line or if our jobs involve hours of standing.

The heel pain that is produced is due to the enormous strain the feet have to endure during this time, trying to balance your whole body and also carry your weight at the same time. This is the reason why you have to often rest your feet. Most often, you could feel your feet straining and trying to tell you to give it a break.

Pain is one indicator for injury. Of course, pain has different intensities and people have their thresholds against pain. At first, the pain of the foot is bearable so we commonly ignore this condition. We only take notice of foot pain when the pain becomes so severe that it is no longer bearable. In this case you may need a foot doctor to check if there are pathologic conditions contributing to the pain.

Most often the cause of foot pain involves a structure found just below the foot called the plantar fascia. This plantar fascia is a strong fibrous tissue connecting the heel to the toes and is also responsible for the arch of the foot. Due to overuse, this fascia can get injured and cause inflammation, this is called plantar fasciitis. Though this condition could be easily treated by resting the foot, the pain can persist and can be debilitating so then it is advisable to seek a podiatrist.