According to eOrthopod.com, tarsal tunnel syndrome is a condition that occurs from abnormal pressure on the nerve in the foot. The tarsal tunnel is located on the inside of the ankle and is formed by ankle bones on the bottom and sides. A ligament, called the flexor retinaculum, covers the tarsal tunnel. People with flat feet, arthritis, systemic diseases and enlarged or abnormal structures in the ankle are at risk for developing this condition. Both non-surgical and surgical treatment may be necessary to treat tarsal tunnel syndrome.
Rest
According to the American College of Foot and Ankle Surgeons (ACFAS), a patient should stay off the foot to prevent further injury and encourage healing. Rest may be beneficial because tarsal tunnel syndrome can be caused by inflammation that occurs with heavy physical activity. Thus, resting the ankle should allow inflammation in the tarsal tunnel to subside and reduce compression in the posterior tibial nerve, which is the nerve affected by tarsal tunnel syndrome.
Medications
Medications may be used to treat tarsal tunnel syndrome, states the ACFAS. Specifically, nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen or ibuprofen can reduce pain and inflammation related to tarsal tunnel syndrome. These medications are effective because they reduce chemical signals that cause pain and inflammation in the tarsal tunnel. Thus, taking these medications as recommended may provide relief. Patients with heart, stomach, liver or kidney problems should not take NSAIDs because they can cause serious complications. Furthermore, healthy patients who experience bloody vomit, stomach pain, bloody stools, clay-colored stools or dark urine should seek immediate medical treatment because they may be experiencing significant side effects of taking NSAIDs.
A doctor may recommend an injected corticosteroid to relieve tarsal tunnel syndrome, states the ACFAS. Corticosteroids are strong anti-inflammatory drugs that reduce inflammation. When injected in the tarsal tunnel, corticosteroids can reduce inflammation in the tarsal tunnel. Complications from this procedure are minimal, but include infection, excessive bleeding, nerve damage or cartilage breakdown.
Physical Therapy
Physical therapy sessions may be effective in treating tarsal tunnel syndrome, states the ACFAS. A physical therapist can provide ultrasound therapy, exercises and other physical therapy modalities to reduce tarsal tunnel symptoms. In addition to physical therapy, orthotic shoe inserts or supportive shoes may be included to relieve symptoms. A patient who adheres to the physical therapist's recommendations and consistently wears orthotic devices has the best chance at recovery.
Surgery
In more severe cases, eOrthopod.com states that surgery may be required to treat this condition. In this case, the surgeon will make a small incision behind the inner ankle bone. After making the proper incision, the surgeon will cut the flexor retinaculum, which will release pressure placed on the posterior tibial nerve. This allows more space in the tarsal tunnel and will likely reduce tarsal tunnel syndrome symptoms. Risks of surgery include infection, excessive bleeding and nerve damage. All post-surgical recommendations should be followed to ensure maximum recovery.
