Tarsal Tunnel Syndrome (TTS)
This condition is caused by the compression or irritation of the posterior tibial nerve as it passes through the tarsal tunnel (a narrow space on the inside of the ankle). TTS can lead to pain, numbness, tingling, or weakness in the ankle, foot, and toes.
Tarsal tunnel syndrome is often associated with repetitive stress, injury, or structural issues in the foot and ankle. Although it can impact daily activities and ambulation, our advanced, nonsurgical techniques offer innovative solutions for relief and recovery.
What causes Tarsal Tunnel Syndrome (TTS)?
Identifying the root cause(s) of any condition is essential for effective treatment and relief. The factors below can contribute to the development of TTS.
- Repetitive stress or overuse from activities such as running or prolonged standing
- Inflammation and swelling from conditions like arthritis or injury
- Biomechanical issues such as flat feet or hyperpronation, which put excess pressure or torque on the nerve
- Scar tissue or cysts that may encroach on the tarsal tunnel space
Symptoms of Tarsal Tunnel Syndrome (TTS)
TTS can present with a variety of symptoms that often worsen over time. Common signs include:
- Burning or shooting pain along the inner ankle and bottom of the foot
- Numbness or tingling in the affected area
- Increased discomfort and reduced endurance with prolonged standing, walking, or activity
- Pain that becomes more noticeable at night and interferes with restful sleep
To treat the symptoms above and prevent further complications, affected individuals should seek early medical intervention.
Diagnosing Tarsal Tunnel Syndrome (TTS)
A thorough medical evaluation is required to accurately diagnosis TTS. Generally, this process includes the following steps:
- Taking a complete patient history to understand symptoms, lifestyle, and any previous injuries
- Conducting a thorough physical examination to assess possible lumbar spine or hip involvement, ankle movement, gait patterns, arch integrity, leg length discrepancy, and hyperpronation
- Conducting a thorough neurological exam
- Nerve conduction studies (NCS), if necessary, to evaluate nerve function and pinpoint the severity of the condition
- however—due to the technical difficulty of diagnosing TTS with NCS—nerve tests may not show any abnormality, even when the condition being present
- The potential use of advanced imaging techniques such as MRI to identify nerve compression or structural issues contributing to the condition and rule out upstream nerve entrapment in the hip or lumbar spine
- Musculoskeletal ultrasound to assess for fluid or scar tissue in the tarsal tunnel and / or crowding of the structures that pass through the tarsal tunnel (including the nerve)
- Ultrasound-guided nerve block in the tarsal tunnel to confirm diagnosis of the condition
Determining the cause of a patient’s tarsal tunnel syndrome is a necessary part of the diagnostic processes, allowing us to tailor preventive and therapeutic strategies to meet each individual’s needs.
Nonsurgical Treatment for Tarsal Tunnel Syndrome (TTS)
The Orthohealing Center offers advanced, nonsurgical techniques to address the underlying causes of tarsal tunnel syndrome, alleviate pain, restore function, and promote natural healing; please reference the list below.
- Platelet lysate or alpha 2 macroglobulin (A2M): these processes uses the patient’s own growth factors and proteins to reduce inflammation and stimulate tissue repair
- MFAT: the stroma fibers and mesenchymal stem cells present in fat are used to support the health and reduce symptoms associated with damaged tissue and nerve
- Class V laser therapy: this noninvasive technology promotes an anti-inflammatory environment, improves blood flow, and reduces pain mediators
- Nerve hydrodissection therapy: a minimally invasive technique that uses fluid to separate and relieve compressed nerves
Customized, cutting-edge treatment plans are designed to meet our patient’s unique needs and to restore function, alleviate pain, and enhance quality of life without the risks of surgery.
