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Tarsal Tunnel Syndrome - Causes and Cures

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November 13, 2010
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Are you experiencing pain, tingling or numbness and lack of feeling in and around your ankle? Have you developed an unexplainable limp, or are you having problems moving your ankle as freely as usual? If the answer to one or more of these questions is 'yes,' you could be suffering from a condition called "tarsal tunnel syndrome". 

There is some dispute about the number of Americans affected by tarsal tunnel, with some reports estimating that millions of Americans are affected.  According to the Office of Rare Diseases (ORD) of the National Institutes of Health (NIH), tarsal tunnel affects approximately 200,000 Americans.

Tarsal tunnel syndrome is the technical name for the entrapment or compression of the tibial nerve, which runs down the back of the leg to the ankle, where trapping typically occurs. The syndrome was first identified by the 1962 studies of Keck and Lam in the medical journals Bone Joint Surgery and Lancet, respectively.

Tarsal tunnel syndrome is relatively common, as it can be caused by a wide variety of factors, and is the sort of complaint that typically results from a person's life-style. If you spend a lot of time on your feet, or engage in strenuous walking or running, you're more likely to be susceptible. As a result, there's a greater chance of it effecting active adults, though children can also be affected.  

You may have tarsal tunnel syndrome if you're suffering from unusual sensations in the ankle region and the arch at the bottom of the foot, ranging from a sharp, burning pain at one end of the scale, to complete loss of feeling at the other.

In between these extremes, you might experience tingling or numbness in your feet, or a gentle pain that increases towards the end of the day, as you put more pressure on the ankle. Both burning and the tingling and numbness result from the interruption of nerve signals between the tibial nerve and the brain.

Exactly what you feel depends on the individual, as the nature of the sensation varies from patient to patient. You might also suffer from a limp, and from difficulties moving the affected ankle. It's important to seek medical attention quickly if you experience any of these symptoms.  If left untreated, tarsal tunnel syndrome can result in more serious and lasting nerve-damage.

Causes of Tarsal Tunnel Syndrome   

Trapping or compression of the tibial nerve has a wide variety of causes, and naturally it's important to be aware of them: tarsal tunnel syndrome is often the result of causes you can combat easily and quickly with simple modifications to your life-style. Knowing something about the main causes is invaluable for preventing tarsal tunnel syndrome or, if you think you are beginning to display some of the symptoms, to catch it early.

In all cases the essential cause is the tibial nerve's lack of space within the tightly packed ankle region: muscle, ligament, veins, nerves and arteries fit very closely together here, and there is little room for expansion. Tarsal tunnel syndrome results from the disturbance of this equilibrium.

Imagine the nerve is a water pipe. If it becomes kinked or bent,  the water can't flow properly, and communication between the foot and the brain is impeded. This is what happens with tarsal tunnel syndrome.

Types of causes are divided into two broad groups; those that come from outside the body, or "extrinsic causes", and those that stem from some problem within the tarsal tunnel area itself, or "intrinsic causes".

Extrinsic Causes of Tarsal Tunnel Syndrome















Occupation. You're more likely to suffer from tarsal tunnel syndrome if your job requires you to spend a lot of time standing up, Keck's breakthrough 1962 study (above) determined. Changes in the way your feet are accustomed to being used can also bring on tarsal tunnel syndrome: starting a new exercise programme, for example.

Repetitive stress. Similar to occupation, in that if you consistently ask unusual or unnatural movements of your ankle, it may not be able to acclimatise without pressurising the tibial nerve's delicate arrangement with the rest of the tarsal tunnel. 

Flat feet. An extremely flattened arch in the foot puts strain on the nerves and muscles of the tarsal tunnel, slightly altering the route of the tibial nerve. Because everything's so tightly packed together, even this slight change can cause tarsal tunnel syndrome.     

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