Posterior Tibial Nerve Neuralgia
Tarsal tunnel syndrome is pain in the ankle, foot, and sometimes toes caused by compression of or damage to the nerve supplying the heel and sole (posterior tibial nerve).
Symptoms include burning or tingling pain that occurs when people walk or wear certain shoes.
The diagnosis is based on an examination of the foot and nerve conduction studies.
Corticosteroid injections, orthoses, and sometimes surgery are needed to relieve the pain.
The posterior tibial nerve runs down the back of the calf, through a fibrous canal (tarsal tunnel) near the heel, and into the sole of the foot. When tissues around the tarsal tunnel become inflamed, they can swell and press on the nerve (nerve compression), causing pain.
Disorders that can cause or contribute to tarsal tunnel syndrome include fracture, ankle swelling caused by heart failure or kidney failure, and an underactive thyroid gland ( hypothyroidism). Also, disorders such as gout or rheumatoid arthritis cause inflammation in the joints. Poor foot posture may also contribute if the ankle rolls too far inward and stresses the nerve within the tarsal tunnel.
Pain, the most common symptom of tarsal tunnel syndrome, usually has a burning or tingling quality that may occur when a person stands, walks, or wears a particular type of shoe. Pain located around the ankle (usually on the inner side) and extending to the toes usually worsens during walking and is relieved by rest. As the disorder progresses, pain also may occur during rest.
A doctor's examination of the foot
Sometimes nerve conduction studies
To diagnose tarsal tunnel syndrome, a doctor manipulates the affected foot during a physical examination. For example, tapping the injured or compressed area just below the ankle bone often causes tingling (referred to as the Tinel sign), which may extend to the heel, arch, or toes.
Nerve conduction studies may be useful to determine the cause or extent of the injury, especially if foot surgery is being considered.
- Corticosteroid injections
- Sometimes surgery
Injections of a corticosteroid/anesthetic mixture into the area may relieve pain.
Other treatments include wrapping the foot and placing specially constructed devices in the shoe (orthoses).
When other treatments do not relieve the pain, surgery to relieve pressure on the nerve may be necessary.
RIVERA FOOT & ANKLE: At Orlando H.Rivera DPM, our priority is to deliver quality care to informed patients in a comfortable and convenient setting. When you have problems with your feet, you need to turn to a podiatrist who listens and responds… an experienced doctor who knows the field and can effectively diagnose and treat your needs… a friendly physician who counsels you on the best ways to maintain and improve your health. Our physician(s) meet all these criteria. Plus, you benefit from a dedicated team of trained professionals who give you the individualized attention you deserve.
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