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Tarsal tunnel syndrome is a condition in which there is a compression of the posterior tibial nerve. The posterior tibial nerve runs along the inside of the ankle into the foot. Tarsal tunnel syndrome is named for the tarsal tunnel, which is a thin space along the inside of the ankle beside the ankle bones. This space contains various nerves, arteries, and tendons, and includes the posterior tibial nerve. The tibial nerve is the peripheral nerve in the leg responsible for sensation and movement of the foot and calf muscles. In tarsal tunnel syndrome the tibial nerve is compressed, causing tingling or burning, numbness, and pain.
Common causes of tarsal tunnel syndrome involve pressure or an injury. Injuries that produce inflammation and swelling in or around the tunnel may place pressure on the posterior tibial nerve. Direct pressure on the tibial nerve for an extended period of time, sometimes caused by other body structures close by or trauma to the tibial nerve, can result in tarsal tunnel syndrome. Diseases that damage nerves, such as diabetes or arthritis, may cause tarsal tunnel syndrome. Those with flat feet are at risk for developing the condition, as the extra pressure and strain placed on the foot may compress the posterior tibial nerve.
Feeling different sensations in the foot at different times is a common symptom of tarsal tunnel syndrome. An afflicted person may experience pain, tingling, burning or other unusual sensations in the foot of the affected leg. Symptoms are primarily felt on bottom of the foot and/or the inside of the ankle. Symptoms can appear suddenly and may occur due to overuse of the foot.
To diagnose tarsal tunnel syndrome, your podiatrist may examine the foot and tap the posterior tibial nerve to see if symptoms surface. He or she may also order an MRI to determine if a mass is present.
Treating tarsal tunnel syndrome will depend on the decision of your podiatrist. Multiple options are available, however, and can include rest, ice, immobilization, oral medications such as anti-inflammatory drugs (NSAIDS), physical therapy, injection therapy, orthotics, supportive shoes, braces, and surgery.
Morton's Neuroma, also called Intermetatarsal Neuroma or Plantar Neuroma, is a condition that affects the nerves of the feet, usually the area between the third and fourth toe. Neuroma refers to a benign growth that can occur in different parts of the body. Morton's Neuroma strictly affects the feet. This condition causes the tissue around the nerves that lead to the toes becoming thick, causing pain in the ball of the foot.
This condition can be caused by injury, pressure or irritation. Normally no lump will be felt, but instead burning pain in the ball of the foot will be experienced. Numbness and tingling may also occur. With the onset of this condition, a person may feel pain when tight or narrow shoes are worn. As the condition worsens, the pain may persist for days, or even weeks.
Persistent foot pain should always be a concern. The foot should be examined by a podiatrist if pain persists longer than a few days with no relief from changing shoes. The earlier the foot is examined and treated, the less chance there will be for surgical treatment.
There are some factors that can play a role in the development of Morton's Neuroma. These include wearing ill-fitting shoes that cause pressure to the toes, such as high heels. Also, high impact exercise may contribute to the cause of this condition. Morton’s Neuroma may also develop if the foot sustains an injury. Another cause includes walking abnormally due to bunions or flat feet. This causes excessive pressure and irritates the tissue. At times, people are affected for no determinable reason.
Podiatrists can alleviate the effects of this condition using a treatment plan to help decrease the pain and heal the foot tissue. Depending upon the severity of the Morton's Neuroma, the treatment plan can vary. For cases that are mild to moderate, treatments may include applying padding to the arch to relieve pressure from the nerve and reduce compression while walking. Ice packs can also help reduce swelling. The podiatrist may also create a custom orthotic device to support the foot and reduce compression and pressure on the affected nerve. The doctor will probably advise against partaking in activities that cause constant pressure on the affected area. They may provide wider shoes to ease the pressure from the toes. If these treatments do not relieve the symptoms of this condition, the doctor may use injection therapy.
Surgical treatment may be recommended by the podiatrist if all other treatments fail to provide relief. Normally, the podiatric surgeon will decide on either a surgical procedure that involves removal of the affected nerve or will choose surgery to release the nerve. After examination, the surgeon will decide on the best approach to treat the problem.
Recovery varies according to the type of surgical procedure. The patient will also be instructed on the best shoe wear to prevent the return of this condition, along with changes to workout routines, if this was a cause. Preventative measures are important in ensuring the condition does not return.
A congenital foot problem is a problem affecting the feet, toes, and/or ankle that a child is born with. Several issues with a child’s feet can occur congenitally. Such problems include clubfoot, vertical talus, tarsal coalition, polydactyly, macrodactyly, and cleft foot. Some of these problems have a genetic basis, with someone in their family history having a gene causing the condition, and some are simply an anomaly.
The following are specifics about a few of these conditions:
- Clubfoot, also called congenital talipes equinovarus or talipes equinovarus, is When the tendons of the foot shorten, the bones are of an unusual shape, and the Achilles tendon is tight, causing an inward and downward pointing of the foot. The soles of the feet might also face each other. In most cases of clubfoot, both feet are affected. If not treated, the affected child will walk on the sides of their feet or ankles.
- Polydactyly is a condition where the child has more than five fingers or toes on either or both feet. Presentation usually consists of a nubbin or small lump of tissue without a bone, a toe that is partially formed but has no joints, or an extra toe.
- Vertical talus is where the talus bone forms in the wrong position, other bones in the foot do not line up properly, the front of the foot points up, and the bottom of the foot is stiff, has no arch, and usually curves out. This can occur in one or both feet and if left untreated, can lead to serious disability or discomfort as the child grows.
- Tarsal coalition is when there is an abnormal connection of two or more bones in the foot leading to severe, rigid flatfoot. The tarsal bones, located toward the back of the foot and in the heel, are the ones affected. This condition is often present at birth, but signs of the disorder usually come on in early adolescence.
- Cleft foot is a rare condition where the foot has missing toes, a V-shaped cleft, and other anatomical differences. Surgery can often help improve the foot’s function since the heel remains normal and is what is most needed for walking. The main issues with this affliction are whether the affected foot can fit into a shoe and the shape and appearance of the foot.
- Macrodactyly is when the toes are abnormally large due to overgrowth of the underlying bone or soft tissue. Having this condition makes it harder for the child to use the affected foot for certain activities.
Heel spurs are calcium deposits that cause bone protrusions on the heel bone. Heel spurs are usually associated with plantar fasciitis, which occurs when the plantar fasciitis in the foot becomes inflamed. Typically, heel spurs don’t cause any symptoms. However, they can produce chronic or intermittent heel pain. Those who have had the condition often describe the irritation as a stabbing pain.
There are risk factors that may make you more likely to develop heel spurs. People who have abnormal walking gaits, run and jog on hard surfaces, are obese, or wear poorly fitting shoes are more likely to develop heel spurs.
Fortunately, there are precautions you can take to avoid developing heel spurs. One of the best ways to do this is by wearing well-fitting shoes with shock-absorbent soles. Another preventative technique is to choose running shoes if you plan on running, and walking shoes if you plan on walking. Shoes are made for different activities and it is important to research a shoe before you purchase a pair.
The pain associated with heel spurs often decreases the more you walk. However, a recurrence of pain after an extended period of rest or walking is likely to occur with this condition. Those with severe heel spur pain may opt to go the surgical route for treatment. However, more than 90% of those with the condition get better without surgical treatment. If you have a heel spur and want to know if surgery is right for you, you should go to your podiatrist and he or she will be able to conduct a pre-surgical test or exam to determine if you are an optimal candidate for surgery.