The posterior tibial nerve, which is one of the two branches of the sciatic nerve, provides motor and sensory innervations to the lower leg and foot muscles. It passes through the tarsal tunnel—the osteofibrous space (composed of bone and soft connective tissue) situated in the middle back part of the ankle.
Anything that causes the tarsal tunnel to narrow can consequently compress the posterior tibial nerve, hence the condition referred to as tarsal tunnel syndrome (TTS). Inflammation in a nearby tendon or blood vessel, ankle swelling due to injury, certain diseases (e.g., arthritis and diabetes), and flatfeet are some of the common culprits in tarsal tunnel syndrome.
As with any other type of nerve compression syndrome, TTS can result in irreversible nerve damage if left untreated. Thus, it pays to learn how to prevent, treat, and cure it. Read on to learn about the preventive and treatment strategies for tarsal tunnel syndrome.
Preventing Tarsal Tunnel Syndrome
It isn’t always possible to prevent the onset of TTS, especially if it is related to an underlying condition. However, there are things you can do to reduce your risk of developing the condition. These include:
- Getting frequent breaks, to rest the feet in between extended periods of standing or walking. This helps reduce the stress on the tarsal tunnel.
- Warming up properly before strenuous exercise, to reduce the chance of injuries to the structures in the foot.
- Ensuring your feet have adequate support. If you have a foot problem, such as high arches, custom orthotics can help to support the foot correctly and reduce strain placed on the area.
- Using wraps or bracing while engaging in athletic activity, especially when on uneven surfaces or during activities involving sudden changes in direction, to reduce the chances of injury.
- Exercising, to improve strength and flexibility in the lower leg muscles and also reduce the chance of injury and stress on tendons and muscles.
Diagnosis, Treatment, and Cure
TTS is diagnosed through a comprehensive clinical exam, which includes a review of your medical history, and a number of tests, such as nerve conduction velocity (NCV) tests, electromyograms (EMGs), and/or imaging tests (X-rays, CT scan or MRI).
Treatment can vary and will depend on the severity and cause of the nerve compression.
Nonsurgical treatments for TTS may include:
- Anti-inflammatory medications
- Steroid injections into the tarsal tunnel to relieve pressure and swelling on the nerve
- Bracing or a splint
- Custom orthotics
- Physical therapy
Custom orthotics are shoe or heel inserts that are specifically made to address your unique requirements. Custom orthotics are used for correcting gait or irregular walking patterns, which may cause or contribute to foot, ankle, leg or back pain.
For TTS, custom orthotics may help to reduce pressure on the foot and limit movement that could cause compression on the tibial nerve.
For severe cases of TTS or if conservative treatments fail to relieve symptoms successfully, surgery may be recommended to completely resolve the condition.
Tarsal tunnel release surgery is the most common type of procedure for TTS. Tarsal tunnel release works to reduce compression on the nerve. The procedure involves the surgeon creating an opening behind the ankle that extends down to the arch of the foot. They will then divide the ligament to prevent it from pressing against the tibial nerve.
Treatment for Tarsal Tunnel Syndrome in South Texas
At The Podiatry Group of South Texas, we use a broad range of nonsurgical and surgical treatment options to effectively treat the full spectrum of foot and ankle conditions.
To learn more about our services or to schedule an appointment with one of our board-certified podiatrists for tarsal tunnel syndrome treatment, call us at the location nearest you. You can also request an appointment online.