Tarsal Tunnel Syndrome

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Tarsal Tunnel Syndrome is a painful foot condition that occurs following entrapment of the ‘Posterior Tibial Nerve’ leading to neuropathy symptoms ranging from mild to severe. Anterior tarsal tunnel syndrome is rare and involves entrapment of the deep peroneal nerve at the front of the ankle. Symptoms with the latter syndrome normally appear on the top of the foot and may radiate towards the first and second toes. Due to the less frequent cases of anterior tarsal tunnel syndrome, the below information is based around the posterior tibial nerve irritation.

Causes: The tarsal tunnel is an area beneath the prominent bone on the inside of the ankle joint (medial malleolus) and comprises of various soft tissues travelling through the tunnel including the posterior tibial nerve. Impingement and compression of the posterior tibial nerve may occur with direct trauma, degenerative/arthritic changes, diabetes, tendonitis or swelling & inflammation in the area. Biomechanical implications may also contribute to the onset of symptoms particularly with various foot types such as excessive over-pronation. Repetitive actions or overuse with sports and other leisure activities may be a causative factor to the underlying problem.

Symptoms & Diagnosis: The nerve related injury is associated with pain around the heel, arch of the foot and other areas of either feet.  The problem may exhibit pain, burning sensation, weakness, tingling or numbness in one or both feet. The correct diagnosis must be given by a skilled physiotherapist. Symptoms of plantar fasciitis can often be mistaken for the problem.

Management: Various physiotherapy techniques can aid the recovery and ease the symptoms of the problem. A biomechanical assessment and subsequent intervention may be indicated to help with the management of the problem. In severe cases, a referral to a consultant for further investigations may be required.

Please feel free to contact the Manchester G4 Clinic to speak to a member of the team for any questions that you may have.

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