Although tarsal tunnel syndrome, which is one of the causes of pain in the ankle and sole of the foot, is known as a rare entrapment neuropathy, it is one of the entrapment neuropathies we encounter frequently in our neurology outpatient clinic. It is an entrapment neuropathy characterized by pain, numbness and loss of strength that can start from the inner part of the ankle and spread to the entire sole of the foot. It occurs as a result of compression of the posterior tibial nerve, which comes from the leg and goes to the toes, as it passes through the canal called the tarsal tunnel in the inner part of the ankle.
Causes of tarsal tunnel syndrome
Traumas of the ankle, cysts in the wrist, vascular anomalies, tumors, infections can cause tarsal tunnel syndrome. However, in our outpatient clinic, we encounter more often overweight women who stand a lot and do not wear suitable and comfortable shoes. The nerve is easily compressed in the tarsal tunnel, which is also narrowed by continuous and excessive load on the ankle and weight gain. The pain hits the soles of the feet as well as the upper legs. In most patients, because the pain spreads over a wide area, the person cannot recognize the focal point where the pain starts. For this reason, heel spurs are confused with other causes of pain such as rheumatic diseases, sciatica, and it becomes difficult to make an accurate diagnosis. The definitive diagnosis of the disease is made by MRI examination of the ankle and EMG examination.
Treatment in Tarsal Tunnel Syndrome
If there is an underlying cause such as infection, edema, cyst, tumor, these causes should be eliminated. First of all, the condition causing tarsal tunnel syndrome should be eliminated. Such as losing weight, not standing too long, using suitable and comfortable shoes. Analgesic and anti-inflammatory drugs can be used in neuropathic pain in consultation with a neurologist. In patients who do not respond adequately with these measures, local cortisone injection can be applied to this area under the control of a neurologist. If there is no response despite all these treatments, the treatment is surgery.