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Tarsal Tunnel Treatment in Pune
Get expert tarsal tunnel syndrome treatment in Pune with specialists providing nerve decompression, pain relief, and long-term mobility care.
Overview
Tarsal Tunnel Syndrome is a painful condition that affects the foot and ankle, causing significant discomfort for those who experience it. This condition occurs when the posterior tibial nerve becomes compressed as it passes through a narrow space called the tarsal tunnel, located on the inner side of your ankle.
Think of it like carpal tunnel syndrome, but in your foot instead of your wrist. The tarsal tunnel is a small passageway behind the bony bump on the inside of your ankle (medial malleolus). This tunnel contains important structures including arteries, veins, tendons, and most importantly, the tibial nerve.
When tissues around this tunnel become swollen or when abnormal growths take up space in the tunnel, pressure builds up on the tibial nerve. This nerve compression leads to the characteristic symptoms of Tarsal Tunnel Syndrome.
Symptoms
Tarsal Tunnel Syndrome causes various types of nerve pain in the affected foot and ankle. These symptoms can range from mild to severe and often get worse with activity. Here’s what you might experience:
Primary Symptoms:
- Pain on the inside of the ankle that can spread to the heel, arch, and toes
- Burning sensation, especially on the bottom of the foot
- Tingling or “pins and needles” feelings in the ankle, foot, and toes
- Numbness or loss of feeling in parts of the foot
- Electric shock-like sensations
- Weakness in the muscles of the foot
These symptoms typically worsen when you stand, walk, or exercise for long periods. Certain shoes can also make the discomfort worse. In severe cases, the pain may continue even when you’re resting.
A key diagnostic sign doctors look for is called Tinel’s sign. This involves tapping the nerve area below the ankle bone, which can trigger tingling or shock-like sensations if you have Tarsal Tunnel Syndrome.
Causes
Tarsal Tunnel Syndrome develops when something puts pressure on or damages the posterior tibial nerve inside the tarsal tunnel. The causes can vary significantly from person to person:
Structural Problems:
- Flat feet (fallen arches) or very high arches
- Poor foot alignment that causes the ankle to roll inward
Injuries:
- Ankle sprains or fractures
- Trauma to the ankle area causing swelling and inflammation
Abnormal Growths:
- Ganglion cysts
- Varicose veins
- Swollen tendons
- Bone spurs
- Tumors or lipomas
Medical Conditions:
- Diabetes or diabetic neuropathy
- Arthritis, including rheumatoid arthritis
- Underactive thyroid (hypothyroidism)
Activity-Related Causes:
- Overuse injuries from repetitive stress
- Sports involving running, jumping, or sprinting
- Jobs requiring prolonged standing
Other Factors:
- Lower back problems that affect nerve function
- Sometimes, no specific cause can be identified (idiopathic cases)
Risk Factors
Several factors can increase your chances of developing Tarsal Tunnel Syndrome:
Physical Factors:
- Having flat feet or unusually high arches
- Previous ankle injuries – more than 40% of people with this condition have a history of ankle trauma
- Being between 40-70 years old
Health Conditions:
- Diabetes and other conditions affecting nerve health
- Arthritis or rheumatoid arthritis
- Thyroid disorders
Lifestyle Factors:
- Jobs requiring long periods of standing or walking
- Participating in high-impact sports
- Being overweight or pregnant (increases pressure on feet)
- Wearing shoes with poor arch support or thin soles
Diagnosis
Getting an accurate diagnosis is crucial for proper treatment and preventing permanent nerve damage. The diagnostic process typically includes:
Physical Examination: Your doctor will discuss your symptoms and medical history, then examine your foot and ankle. They may manipulate your foot and perform Tinel’s test by tapping the nerve area to see if it reproduces your symptoms.
Imaging Tests:
- X-rays to rule out bone fractures or detect bone spurs
- MRI scans to create detailed images of soft tissues and identify any masses or nerve damage
- Ultrasound to check for inflammation or cysts
Electrical Testing:
- Electromyography (EMG) to measure electrical activity in nerves and muscles
- Nerve conduction studies to assess nerve function and locate the exact area of compression
Treatment
Treatment for Tarsal Tunnel Syndrome typically starts with conservative, non-surgical approaches. Surgery is only considered when these methods don’t provide adequate relief.
Non-Surgical Treatment
Most people find significant improvement with these conservative treatments:
Immediate Relief Measures:
- Rest and avoiding activities that worsen symptoms
- Ice application for 10-20 minutes at a time to reduce pain and swelling
- Elevating the foot to decrease swelling
Medications:
- Over-the-counter anti-inflammatory drugs (NSAIDs) like ibuprofen
- Corticosteroid injections directly into the tarsal tunnel area
Support and Immobilization:
- Braces, splints, or casts to limit foot movement
- Orthotic devices such as custom shoe inserts
- Arch supports and heel cushions
- Supportive footwear
Professional Treatment:
- Physical therapy with specific exercises and treatments
- Ultrasound therapy and other modalities
Surgical Treatment
When conservative treatments fail or when there’s severe nerve damage, tarsal tunnel release surgery may be recommended. This outpatient procedure typically takes about an hour and involves:
- Making a small incision along the inner ankle
- Dividing the thick ligament (flexor retinaculum) that forms the tunnel wall
- Creating more space to relieve pressure on the tibial nerve
- Removing any masses or scar tissue if present
Recovery usually involves 1-2 hours of monitoring after surgery, followed by wearing a soft bandage for about a week. Crutches may be recommended for the first two weeks, and full walking activity can typically resume after bandage removal.
Rehabilitation
Rehabilitation is essential for recovery, whether you’ve had surgery or are managing the condition conservatively. Physical therapy usually begins 4-6 weeks after surgery and focuses on restoring strength, flexibility, and proper foot function.
Key Rehabilitation Exercises:
Flexibility and Mobility:
- Calf stretches using a strap or towel
- Nerve gliding exercises to help the tibial nerve move freely
- Ankle range of motion exercises (pumps, circles, side-to-side movements)
Strengthening:
- Arch strengthening exercises like toe curls with a washcloth
- Heel raises to strengthen calf muscles
- Balance training on one foot
Self-Care Techniques:
- Foam rolling the calf muscles
- Foot massage using a tennis ball under the arch
Cross-friction massage of the tarsal tunnel area
Complications
Without proper treatment, Tarsal Tunnel Syndrome can lead to serious complications:
Long-term Effects:
- Permanent nerve damage
- Chronic pain that doesn’t respond to treatment
- Persistent numbness affecting daily activities
- Significant limitations in walking and exercise
Surgical Complications (though rare):
- Wound healing problems or infection
- Further nerve injury
- Persistent or worsening pain
- Unusual sensations as nerves heal
- Swelling and cramping during recovery
Early diagnosis and treatment significantly reduce the risk of these complications and improve the chances of full recovery.
Prevention
While you can’t prevent all cases of Tarsal Tunnel Syndrome, several strategies can significantly reduce your risk:
Footwear and Support:
- Wear properly fitting shoes with good arch support
- Avoid shoes with thin soles or high heels
- Use custom orthotics if you have flat feet or high arches
Activity Management:
- Warm up properly before exercise
- Stretch your feet and ankles regularly, especially the calves
- Allow adequate rest between intense activities
- Use proper technique in sports
Health Management:
- Maintain a healthy weight to reduce pressure on your feet
- Manage underlying conditions like diabetes and arthritis
- Consider using a brace if you’re prone to foot positions that compress nerves
Work and Lifestyle:
- Take breaks if your job requires prolonged standing
- Be cautious with high-impact activities like sprinting and jumping
Living With Diabetes
Living with Tarsal Tunnel Syndrome can significantly impact your daily life, but with proper management, most people can return to their normal activities.
Management Strategies: Following your treatment plan consistently is crucial. This includes taking medications as prescribed, using orthotic devices, and performing rehabilitation exercises regularly at home.
Lifestyle Adjustments: You may need to modify activities that worsen your symptoms. This might mean switching to lower-impact exercises or taking frequent breaks during work. Regular self-care practices like icing, elevation, and recommended stretches can help manage pain and swelling.
Pain Management: For ongoing discomfort, work with your healthcare team to develop effective pain management strategies. This might include specific medications or other treatments beyond basic anti-inflammatory drugs.
Recovery Expectations: Nerve healing is often a slow process that can take months to over a year, especially after surgery. Patience and consistent effort in rehabilitation will give you the best chance of returning to full function.
Key Takeaways
- Tarsal Tunnel Syndrome results from compression of the posterior tibial nerve in the ankle
- Symptoms include pain, burning sensation, tingling, and numbness that often worsen with activity
- Common causes include flat feet, ankle injuries, abnormal growths, and conditions like diabetes and arthritis
- Diagnosis involves physical examination, imaging tests, and electrical studies
- Treatment typically starts with conservative approaches including rest, medications, orthotics, and physical therapy
- Surgery may be necessary when conservative treatments fail
- Rehabilitation exercises are crucial for recovery and include stretching, strengthening, and nerve gliding activities
- Early treatment prevents permanent nerve damage and improves outcomes
- Prevention focuses on proper footwear, activity modification, and managing underlying health conditions
At Sancheti Hospital, we understand how debilitating Tarsal Tunnel Syndrome can be for our patients. Our comprehensive orthopedic care team specializes in diagnosing and treating complex nerve compression conditions of the foot and ankle.
We offer state-of-the-art diagnostic facilities including advanced MRI imaging and nerve conduction studies, along with a full range of treatment options from conservative physical therapy programs to advanced surgical techniques.
Our experienced orthopedic surgeons work closely with certified physical therapists to develop personalized treatment plans that address each patient’s unique needs. Whether you’re dealing with chronic foot pain, nerve-related symptoms, or require specialized rehabilitation services, Sancheti Hospital provides the expertise and comprehensive care needed to help you return to an active, pain-free lifestyle.
Meet Our Foot and Ankle Specialists
Patient Stories & Experiences
The pain in my left knee left me feeling helpless for years. After my treatment here, I can finally say I'm pain-free.
Vinita Singh
The nerves were swollen, and the body went numb. But thanks to Sancheti Hospital, I got a second life!
Parvati
I finally could walk again, a relief I've only felt after the hip pain surgery. I thank the doctors at Sancheti Hospital for their help.
Balaji Kharat
I'm a police officer, and I'm extremely thankful to Sancheti Hospital for treating my fracture without surgery.
Shantilal
My life has completely changed after the knee replacement surgery at Sancheti Hospital. It's like I can finally live again!
Kalpana Lepcha
The knee pain I've carried for years finally went away with the help of Sancheti Hospital.
Karuna
I can't believe that I get to finally live a normal and happy life, all thanks to the knee surgery I had at Sancheti Hospital.
Kishore Bhosle
Frequently Asked Questions
Can Tarsal Tunnel Syndrome be cured?
Yes, with proper diagnosis and treatment, Tarsal Tunnel Syndrome can often be successfully managed or cured. Early treatment gives the best results and helps prevent permanent nerve damage. However, people with chronic conditions like arthritis may need ongoing symptom management.
How is this different from plantar fasciitis?
While both conditions cause foot pain, they’re completely different. Plantar fasciitis involves inflammation of the plantar fascia ligament in the heel, while Tarsal Tunnel Syndrome results from nerve compression in the ankle. Accurate diagnosis is essential for proper treatment.
