Tarsal Tunnel Syndrome: A Detailed Guide
Overview
Tarsal Tunnel Syndrome (TTS) is a peripheral compression neuropathy that affects the tibial nerve as it passes through the tarsal tunnel near the ankle. Despite its significance, it remains under-diagnosed, contributing to various foot pains such as heel and arch pain.
Symptoms
Patients with TTS often experience sensory disturbances including tingling, numbness, and a burning sensation in the plantar aspect of the foot. These symptoms are sometimes accompanied by a sensation of a tight band around the foot.
Anatomy of the Tarsal Tunnel
The tarsal tunnel is bordered by bone on one side and a tough band of fibrous tissue called the flexor retinaculum on the other. The tibial nerve, along with tendons and blood vessels, passes through this narrow space.
Etiology
Causes of TTS can range from systemic diseases like diabetes to local factors such as trauma or the presence of space-occupying lesions. Foot deformities and improper footwear can also contribute to the development of this syndrome.
Diagnosis
Diagnosis is based on clinical examination, patient history, and may be supported by imaging studies like MRI or diagnostic ultrasound. Electrodiagnostic testing remains a crucial tool despite its limitations.
Treatment Options
Treatment can be conservative or surgical. Conservative methods include orthotics and physical therapy, while surgery may involve decompression or correction of structural abnormalities.
Conclusion
Early diagnosis and tailored treatment of Tarsal Tunnel Syndrome are essential for successful management and to prevent long-term damage to the tibial nerve.
