TARSAL TUNNEL SYNDROME

SYMPTOMS

Tarsal Tunnel Syndrome, or TTS, is rare and only one of many causes for FOOT PAIN and NUMBNESS of the SOLE, of one foot. It is worse in the evening and at night after activity and is aggravated by obesity and any underlying more generalized nerve disorder (polyneuropathy).

SIGNS

Patients have relative numbness on the sole of the affected foot and an electric "zinger" when the affected nerve, the Posterior Tibial is tapped ("Tinel's Sign") at the affected site - the inside of the ankle just below the bony prominence (medial malleolus).

TREATMENT

Correct diagnosis is essential to avoid mis-directed treatments. Electrodiagnostic testing can confirm the diagnosis but it must be suspected. The condition may resolve spontaneously and, as with many other medical problems, watchful waiting is often reasonable. "Conservative," i.e. non-surgical, treatments are not as gratifying as with Carpal Tunnel Syndrome.

1. Weight loss.
2. Treatment of underlying polyneuropathy if present, e.g. vitamin supplements, better control of blood sugars in diabetics, discontinuation of alcohol.
3. Properly designed orthotics.
4. Xylocaine/cortisone injection - rarely satisfactory, worth a careful try.
5. Surgery can be curative but must be done by someone with experience and the condition is uncommon. Always ask the surgeon how many he or she has done.

Bill Bailey won't you please come home