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Foot Pain Or Numbness? You May Have Tarsal Tunnel Syndrome

5 March 2015

Edward Payne

If you've recently begun to notice a numbness, tingling, or sharp pain in one or both feet, you may suspect plantar fasciitis (a condition causing pain and inflammation in your heel) or even plantar warts. However, your symptoms could be stemming from an increasingly common disorder called tarsal tunnel syndrome. Read on to learn more about this syndrome, as well as what you can do to permanently alleviate the pain and numbness you're experiencing.

What is tarsal tunnel syndrome?

You've probably heard of carpal tunnel syndrome -- a chronic wrist pain caused by overuse of the carpals (finger joints) combined with poor ergonomic support while typing or performing other activities. Carpal tunnel pain is usually caused by a gradual build-up of scar tissue that begins to restrict the nerves in your hands, causing pain and numbness.

Your feet and ankles undergo even more strain on a daily basis than your hands and wrists. Over time, pressure on your tarsal bones and joints can also cause scar tissue to build up and restrict your nerves. This is termed tarsal tunnel syndrome.

If left untreated, tarsal tunnel syndrome may remain fairly static, or can advance rapidly, causing significant foot pain and a reduced range of motion. Because it hurts to stand or walk, you may find yourself adopting a more sedentary lifestyle, which can lead to weight gain -- making it even more difficult to spend much time on your feet.

What causes tarsal tunnel syndrome?

Although nearly anyone can come down with tarsal tunnel syndrome during his or her life, it is more common in the overweight, those who perform repetitive standing and walking activities while performing their jobs (such as a baggage handler or postal worker), and those who wear restrictive or non-supportive shoes.

What tarsal tunnel treatments are available?

If you seek medical advice on your foot pain shortly after you've begun to experience it, you may be able to successfully treat your tarsal tunnel by using minimally invasive methods.

Generally, the first step is to determine what is causing your symptoms. If you tend to wear shoes that don't have good arch support, or are too tight, you may be able to nearly eliminate your foot pain by transitioning to better-fitting shoes or using a custom orthotic device. 

If your weight is likely a contributing factor, your doctor may recommend some low-impact exercises or a few tweaks to your diet. In many cases, losing a relatively small percentage of your total body weight can send these symptoms back into remission.

There are some new technologies on the market that can allow your doctor to break up and remove the scar tissue restricting your nerves by using ultrasound or laser devices. However, in most cases, if your tarsal tunnel is severe, your doctor will perform a "release" surgery to help restore the large nerves in your feet to their normal function.

How is tarsal tunnel release surgery performed?

During a release surgery, you'll be put under general anesthesia to help you relax and to allow the surgeon to perform his or her best work. Your surgeon will begin by making a small incision up the side of your foot, where the largest nerves travel near the skin's surface.

The surgeon will then use a scalpel to carefully remove any of the scar tissue restricting the nerves in your foot. This procedure is usually over fairly quickly, and you can be stitched up and wheeled to recovery.

After your surgery, your orthopedic doctor will give you instructions on cleaning and bandaging the wound, as well as some foot and ankle exercises to perform during the healing phase. It's important to keep your foot active and mobile after surgery, even if you're experiencing some residual pain -- in many cases, patients who did not move the operated area after the surgery (or were placed in a cast) ended up developing even more scar tissue than they had before. 

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