Tarsal tunnel syndrome

Tarsal tunnel syndrome (TTS) is a type of compression neuropathy (nerve disease due to compression of the nerve) in the ankle and foot. TTS is similar to the better-known carpal tunnel syndrome (CTT) caused by compression and irritation of the median nerve within the carpal tunnel, a bony canal in the palm side of the wrist that provides passage for the median nerve to the hand. The irritation of the median nerve is specifically due to pressure from the transverse carpal ligament. Anatomy similar to that of the wrist and hand exists in the ankle and foot. Tarsal is a word from Latin which means ankle. The sensory nerve in the ankle passes through the tarsal tunnel and can be compressed and irritated causing numbness and tingling of the foot and toes. This condition is far less common the carpal tunnel syndrome (CTS). Both CTS and TTS are usually due to trauma from repetitive work involving the wrist and ankle, respectively. Other factors predisposing to TTS include obesity, pregnancy, hypothyroidism, arthritis, and diabetes. The symptoms of TTS include numbness and tingling of the foot and toes, a "pins and needles" feeling at night, and feelings of weakness in the ankle and of incoordination. The diagnosis of TTS is suspected based on symptoms, supported by signs on physical examination, and confirmed by nerve conduction testing. The treatment of TTS depends on the severity of symptoms and the underlying cause. Early TTS is usually treated by modification of activities, a removable ankle brace and anti-inflammatory medicines. Caught early, TTS is reversible. If numbness and pain continue in the foot and toes, a cortisone injection into the tarsal tunnel can help. Surgery is only indicated if other treatments have failed. In advanced TTS, particularly with profound weakness and muscle atrophy (wasting), surgery is done to avoid permanent nerve damage. The surgical procedure is called a tarsal tunnel release. It relieves the pressure exerted on the nerve within the tarsal tunnel. This surgical procedure is performed via a small incision using conventional surgery or a fiberoptic scope (endoscopic tarsal tunnel repair).

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a syndrome of overuse injury with a complex of symptoms resulting from compression of the posterior tibial nerve or of the plantar nerves in the tarsal tunnel, with pain, numbness, and tingling paresthesia of the sole of the foot.