Most people are familiar with carpel tunnel syndrome in the hand. There is a similar condition in the feet known as Tarsal tunnel syndrome (TTS). TTS involves a compression or entrapment of the major nerves entering the arch from the ankle.
Symptoms range from mild tingling to severe burning to numbness. This may affect part or the entire bottom of the foot to the toes. These symptoms may intensify while standing but are also common while lying in bed at night.
The nerves course through very tight tunnels along the inside of the ankle then under a muscle into the arch. Anything that results in pressure in or adjacent to these tunnels may initiate TTS. Common causes include swelling of the adjacent tendon or masses within the tunnels such as tumors or ganglion cysts. Also, certain systemic diseases, such as diabetes may cause the nerves themselves to swell.
Early treatment is critical as eventually the nerve will die if not properly managed.
Diagnosis includes a thorough physical examination including nerve testing.
Treatment will depend on the cause of the nerve compression. It may range from oral medications to physical therapy. Molded arch supports may be fabricated if the condition is related to a tendon strain.
In some cases surgery is necessary to release the pressure along the nerves. Dr. Zimmerman has undergone specialty microsurgical training for these procedures at the Institute for Peripheral Nerve Surgery, Johns Hopkins University.