Tarsal tunnel syndrome is often confused with Plantar Fasciitis or Morton’s neuroma. Tarsal Tunnel Syndrome is characterized by the entrapment of tibial nerve during its passage from the tarsal tunnel affecting both sensory and motor functions of the lower limb. It can mimic Plantar Fasciitis or Morton’s neuroma in clinical presentation.
Any condition that aggravates the pressure on the tibial nerve or compress the contents of tarsal tunnel can lead to tarsal tunnel syndrome (such as flat arches). The specific factors that aggravate the risk of tarsal tunnel syndrome are history of moderate to severe trauma on the foot, unstable ankle or foot due to congenital or acquired deformities, ganglionic cysts, varicose veins and bony spur formation.
Tarsal tunnel syndrome can be diagnosed by conducting a detailed history and extensive clinical examination. A positive Tinel’s sign for tarsal tunnel syndrome is characterized by onset of pins and needles sensation along the inner aspect of the foot when the examiner taps behind the inner prominence of the ankle (the medial malleolus).
An EMG (electromyography) study can also help make the diagnosis. An EMG test is a procedure that measures the electrical conductivity of the nerves. A decline in electrical conductivity suggests an entrapped nerve. However, keep in mind that an electromyography (EMG) study is not always reliable, as decreased conductivity is also observed in arthritis.
Most clinicians adopt non-surgical options to address the symptoms of pain and discomfort.
Surgical management options include releasing the lacinate ligament and decompression of the posterior tibial nerve by surgical manipulation. Generally, the recovery time varies from 4 to 18 months and the outcome depends on the degree of entrapment.
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