Tarsal Tunnel Syndrome (TTS) is also known as posterior tibial neuralgia. It is caused by compression of the tibial nerve as it travels through the tarsal tunnel. The tarsal tunnel is found in the inner leg, behind the bump on the inside surface of the ankle. The tibial nerve is a branch of the sciatic nerve, the longest nerve of the human body, which runs from the buttocks down to the feet. The tibial nerve passes below the arch of the foot. It innervates various muscles of the legs, including gastrocnemius. It also innervates the knee joint.
As the nerves of the foot experience compression, blood-flow to key areas of the foot are reduced. Nerves therefore respond to this with tingling and numbness. Fluid collects in the foot when waking and standing, thereby contributing more to the symptoms of TTS. A cramping of the muscles of the foot may also occur as the smaller muscles lose their nervous innervation.
General symptoms of TTS are:
Pain and tingling at the ankles and toes
Foot swelling, or edema
Burning sensations, and numbness of the lower legs
Pain that radiates up the legs and into the foot and toes
Hot and cold sensations in the foot
A pins and needles sensation
Diagnosis of TTS occurs during physical examination. Typically, a chiropractor administers a number of tests, including nerve conduction tests. During these nerve conduction tests, electrodes are placed at various points along the legs and feet, coinciding with the positions of different nerves. Sensory and motor nerves are tested at different locations along the leg and foot. Electrical impulses are sent into the nerves via the electrodes, and the speed and frequency at which the nerve signal occurs is measured. Any compression can then be determined.
TTS is closely related in nature to carpal tunnel syndrome. TTS is commonly comorbid with rheumatoid arthritis, in which symptoms include pain of the lower legs.
The exact cause of TTS may be difficult to establish. However, it is important to try to determine the cause(s) of the issue so that treatment plans may be determined. Since the tibial nerve passes through the tarsal tunnel, any pressure at the tunnel may cause TTS. Benign tumors or cysts may cause that pressure, leading to tibial nerve compression, and then to TTS. Other causes of tunnel pressure include bone spurs, inflammation, or swelling from broken or sprained ankles. Varicose veins may also cause nerve compression.
For those suffering from TTS, treatment options include rest, strengthening of various muscles, corticosteroid treatments, wrapped, various anti-inflammatory medications, chiropractic treatments, as well as acupuncture treatments. For athletes, resting is important so as to reduce the strain causing the nerve compression and TTS. Come see us today!