Tarsal Tunnel Syndrome (TTS) is a medical condition that involves compression or irritation of the tibial nerve as it passes through the tarsal tunnel, a narrow space on the inside of the ankle that is similar to carpal tunnel syndrome in the wrist. The tibial nerve provides sensation and motor function to the bottom of the foot. When it becomes compressed or irritated, it can lead to various symptoms.
What are the symptoms of tarsal tunnel syndrome?
Common symptoms of tarsal tunnel syndrome include:
- Pain: This can be sharp, shooting, burning, or tingling pain in the inside of the ankle, heel, and sole of the foot.
- Numbness and Tingling: Patients may experience numbness or tingling sensations in the sole of the foot or toes.
- Weakness: Weakness in the muscles supplied by the tibial nerve may be experienced, leading to difficulties with walking or standing.
- Radiating Pain: The pain may radiate along the path of the tibial nerve, traveling up the leg.
Often, symptoms worsen during or after physical activity, but if TTS is severe or long-lasting, you may experience symptoms all the time.
What are the most likely causes of tarsal tunnel syndrome?
TTS may be caused by any condition that strains or compresses the tibial nerve, including:
- Severely flat feet that can stretch the tibial nerve
- Fallen arches or high arches
- Injuries or trauma that cause swelling such as an injury to the ankle, sprain or fracture
- Body-wide systemic conditions such as hypothyroidism, arthritis or diabetes, which can cause swelling and nerve compression
- Irregular growths such as a ganglion cyst, a swollen tendon or bone spur
- Varicose veins in the membrane surrounding the tibial nerve, which cause compression on the nerve
- Lesions and masses such as lipomas or tumors near the tibial nerve
- An overuse injury
How is tarsal tunnel syndrome diagnosed?
Diagnosing TTS requires the expert attention of experienced neurologists and nerve specialists. It is important that the doctor determine the severity of the condition in order to recommend the most appropriate treatment plan, including surgery if necessary.
A diagnostic workup for TTS may involve a combination of: a complete medical history, a comprehensive physical examination to assess the patients symptoms, check for specific points of tenderness, evaluate the foot’s sensation and muscle strength, as well as electrical testing (EMG or a nerve conduction study) and/or imaging studies such as X-rays, a CT scan or MRI, to visualize the structures in the tarsal tunnel and rule out other possible causes of the symptoms.
What treatments are available for tarsal tunnel syndrome?
Treatment options for tarsal tunnel syndrome depend on the severity of the condition. Mild cases can often be managed with conservative measures:
- Rest and reducing activities that worsen symptoms
- Ice to reduce inflammation
- Nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain and inflammation
- Custom-made shoe inserts to help your foot maintain a proper arch. This position reduces the movements that cause nerve compression. A stability or motion-controlled shoe also keeps your foot from rolling inward (pronation) and reduces tension on your nerve.
- Orthotic devices, such as braces, casts, or splints to help reduce pressure on the foot and limit movement that could cause compression on the nerve.
- Shoe modifications to alleviate pressure on the nerve
- Physical therapy to improve flexibility and strengthen surrounding muscles, including prescribed exercises and stretches
- Corticosteroid Injections: Injections of corticosteroids around the tarsal tunnel can help reduce inflammation and relieve symptoms
When is tarsal tunnel surgery necessary?
If conservative treatments don't provide relief, ultimately, surgery might be considered to release the pressure on the tibial nerve called tarsal tunnel release. This involves cutting the ligament that forms the roof of the tarsal tunnel and creating more space for the nerve. In tarsal tunnel release, the surgeon creates an opening behind the ankle that extends down to the arch of the foot. The surgeon carefully divides the ligament, so it is not pressing against the tibial nerve. Or the surgeon may need to widen the tarsal tunnel. If a mass is putting pressure on your nerve, your surgeon will remove it.
How long is recovery for tarsal tunnel surgery
Tarsal tunnel release is an outpatient surgery, so the patient can leave the same day. Recovery first starts with minimizing pain and caring for the incision. The minimally invasive surgery reduces the recovery time significantly, allowing for light walking after one week. After that, the patient will need physical therapy to return to normal activities like running.
The patient should perform prescribed exercises both at home and with a physical therapist. Doctors usually recommend patients move only short distances while closely monitoring pain. Full, pain-free recovery takes about 6-12 months.
Can tarsal tunnel syndrome be prevented?
There’s no sure way to prevent tarsal tunnel syndrome, but you can lower your risk of developing TTS if you adhere to the following:
- Rest between workouts to avoid overuse injuries.
- Stretch your feet and ankles regularly.
- Warm up before exercise.
- Wear proper-fitting, supportive footwear.
Symptoms of TTS may go away after you treat the underlying cause of TTS. For example, if you have a bone spur or lipoma, symptoms may disappear after treatment. However, TTS is less likely to go away entirely if you have a chronic condition such as arthritis. Without treatment, TTS can lead to nerve damage, which can be permanent and irreversible, causing difficulty walking, exercising or performing your daily activities.
The outcome of tarsal tunnel syndrome treatment varies depending on factors such as the severity of the condition, the effectiveness of the chosen treatment approach, and the individual patient's response. Many individuals experience improvement in their symptoms with conservative measures or surgical intervention if necessary. However, it's important to note that nerve-related conditions can be complex; and complete resolution of symptoms is not guaranteed for everyone. Early diagnosis and appropriate treatment can significantly improve the chances of a positive outcome or may even cure the condition.
Early action is important!
Don’t ignore your feet. If you suspect you have tarsal tunnel syndrome or are experiencing symptoms, you should consult a medical professional for proper evaluation and guidance tailored to your specific situation. It’s important to get treatment as soon as you start experiencing symptoms.
Tarsal Tunnel Syndrome (TTS) ni hali ya matibabu ambayo inahusisha compression au irritation ya tibial nerve wakati inapita kupitia Tarsal Tunnel, nafasi nyembamba ndani ya mguu ambayo ni sawa na Carpal Tunnel Syndrome katika mkono. Mishipa ya tibia hutoa hisia na utendaji wa mwendo kwenye sehemu ya chini ya mguu. Inaposhinikizwa au kusumbuliwa, inaweza kusababisha dalili mbalimbali. Dalili za ugonjwa wa tarsaal tunnel ni zipi? Dalili za kawaida za ugonjwa wa tarso tunal syndrome ni pamoja na: - Maumivu: Hii inaweza kuwa kali, risasi, kuchoma, au maumivu ya kuchochea ndani ya mguu, kisigino, na mguu wa mguu. - Ugonjwa wa kutojua na kutikisa: Wagonjwa wanaweza kupata hisia za kutojua au kutikisa katika kiatu cha mguu au vidole vya miguu. - Udhaifu: Udhaifu katika misuli inayotolewa na neva ya tibial inaweza kupatikana, na kusababisha matatizo ya kutembea au kusimama. - Maumivu ya kuangaza: Maumivu yanaweza kuenea kando ya njia ya neva ya tibial, kusafiri juu ya mguu. Mara nyingi dalili huongezeka wakati wa mazoezi au baada ya mazoezi, lakini ikiwa TTS ni kali au ya muda mrefu, unaweza kuwa na dalili wakati wote. Ni nini kisababishi kinachoweza kusababisha ugonjwa wa tarsaal tunnel? TTS inaweza kusababishwa na hali yoyote ambayo inasisitiza au kufinya neva ya tibial, ikiwa ni pamoja na: miguu ya gorofa sana ambayo inaweza kunyoosha neva ya tibial, misuli iliyoanguka au misuli ya juu, majeraha au majeraha ambayo husababisha uvimbe kama vile uharibifu wa mguu, kupasuka au kuvunjika, hali za mfumo wa mwili kama vile hypothyroidism, ugonjwa wa ugonjwa wa viungo au ugonjwa wa kisukari, ambayo inaweza kusababisha uvimbe na kuvunjika kwa neva ya tibial, misuli ya varicose katika utando unaozunguka neva. Ugonjwa wa TTS unahitaji uangalifu wa wataalamu wa neva na wataalamu wa neva wenye uzoefu. Ni muhimu kwamba daktari aamue uzito wa hali hiyo ili kupendekeza mpango unaofaa zaidi wa matibabu, ikiwa ni pamoja na upasuaji ikiwa ni lazima. Uchunguzi wa TTS unaweza kuhusisha mchanganyiko wa: historia kamili ya matibabu, uchunguzi wa mwili wa kina ili kutathmini dalili za mgonjwa, kuangalia kwa pointi maalum za uchungu, kutathmini hisia ya mguu na nguvu ya misuli, na vile vile upimaji wa umeme (EMG au utafiti wa conductivity ya neva) na (au) uchunguzi wa picha kama vile X-ray, CT scan au MRI, ili kuona miundo katika handaki ya tarsal. Ni matibabu gani yanayopatikana kwa ugonjwa wa handaki la tarsal? Njia za kutibu ugonjwa wa tarsal tunnel zinategemea jinsi ugonjwa huo ulivyo mbaya. Kwa kawaida, kesi kali zinaweza kusimamiwa kwa hatua za kihafidhina: kupumzika na kupunguza shughuli ambazo zinafanya dalili ziongeze - barafu ili kupunguza uvimbe - dawa zisizo za steroid za kuzuia uvimbe (NSAIDs) ili kupunguza maumivu na uvimbe - vifuniko vya viatu vya kawaida kusaidia mguu wako kudumisha upinde sahihi. Msimamo huo hupunguza miendo inayosababisha mfadhaiko wa neva. Viatu vinavyoweza kudhibiti mwendo vinaweza pia kuzuia mguu wako usigeuke kuelekea ndani (pronation) na kupunguza mkazo kwenye neva yako. - Vifaa vya kuunganisha, kama vile braces, casts, au splints kusaidia kupunguza shinikizo juu ya mguu na kupunguza harakati ambayo inaweza kusababisha compression juu ya neva. - Mabadiliko ya viatu ili kupunguza shinikizo kwenye neva - Tiba ya kimwili ili kuboresha kubadilika na kuimarisha misuli inayozunguka, ikiwa ni pamoja na mazoezi na kunyoosha yaliyoagizwa - sindano za corticosteroid: sindano za corticosteroids karibu na handaki la tarsal zinaweza kusaidia kupunguza uvimbe na kupunguza dalili Wakati upasuaji wa handaki la tarsal ni muhimu? Kwa sababu ya upungufu wa matibabu ya kawaida, upasuaji wa kuondoa shinikizo kwenye neva ya tibial unaweza kuonekana. Hilo huhusisha kukata kiungo kinachofanyiza paa la handaki la kiwiko na kutokeza nafasi zaidi kwa ajili ya neva. Katika upasuaji wa kufungua mfereji wa tarsal, daktari-mpasuaji hufanyiza ufunguo nyuma ya mguu ambao huenea hadi chini ya kiunzi cha mguu. Daktari-mpasuaji hugawanya kifungo hicho kwa uangalifu, ili kisisumbue neva ya tibial. Kwa mfano, daktari wa upasuaji anaweza kupanua njia ya tarsal. Ikiwa uvimbe unaweka shinikizo kwenye neva yako, daktari wako wa upasuaji atauondoa. Upasuaji wa Tarsal Tunnel ni upasuaji wa nje, kwa hivyo mgonjwa anaweza kuondoka siku hiyo hiyo. Kupona huanza kwanza kwa kupunguza maumivu na kutunza upasuaji. Upasuaji huo usio na madhara makubwa hupunguza sana muda wa kupona, na kufanya iwezekane kutembea kwa urahisi baada ya juma moja. Baada ya hapo, mgonjwa atahitaji matibabu ya kimwili ili arudi kwenye shughuli za kawaida kama vile kukimbia. Mgonjwa anapaswa kufanya mazoezi yaliyoagizwa nyumbani na pamoja na mtaalamu wa matibabu ya kimwili. Kwa kawaida madaktari hupendekeza wagonjwa wafanye mazoezi ya umbali mfupi tu huku wakichunguza maumivu kwa makini. Kupata nafuu kamili bila maumivu huchukua miezi sita hadi sita. Je, ugonjwa wa tarsal tunnel unaweza kuzuiwa? Hakuna njia ya uhakika ya kuzuia ugonjwa wa Tarsal Tunnel, lakini unaweza kupunguza hatari ya kuendeleza TTS ikiwa utafuata yafuatayo: - Pumzika kati ya mazoezi ili kuepuka majeraha ya overuse. - Nyoosha miguu na vifundo vya miguu mara kwa mara. - Jitayarishe kabla ya kufanya mazoezi. - Vaa viatu vinavyolingana na mtu. Dalili za TTS zinaweza kutoweka baada ya matibabu ya sababu ya msingi ya TTS. Kwa mfano, ikiwa una msukumo wa mfupa au lipoma, dalili zinaweza kutoweka baada ya matibabu. Hata hivyo, TTS ni chini ya uwezekano wa kwenda mbali kabisa kama una hali ya muda mrefu kama vile ugonjwa wa viungo. Bila matibabu, TTS inaweza kusababisha uharibifu wa neva, ambayo inaweza kuwa ya kudumu na isiyoweza kubadilika, na kusababisha ugumu wa kutembea, kufanya mazoezi au kufanya shughuli zako za kila siku. Matokeo ya matibabu ya ugonjwa wa tarsaal tunnel hutofautiana kulingana na mambo kama vile ukali wa hali, ufanisi wa mbinu ya matibabu iliyochaguliwa, na majibu ya mgonjwa binafsi. Watu wengi hupata uboreshaji wa dalili zao kwa kutumia hatua za kihafidhina au upasuaji ikiwa ni lazima. Hata hivyo, ni muhimu kutambua kwamba hali zinazohusiana na neva zinaweza kuwa ngumu; na ufumbuzi kamili wa dalili hauhakikishiwi kwa kila mtu. Uchunguzi wa mapema na matibabu yanayofaa yanaweza kuboresha sana uwezekano wa kupata matokeo mazuri au hata yanaweza kutibu ugonjwa huo. Ni muhimu kuchukua hatua mapema! Usipuuze miguu yako. Ikiwa una shaka ya kuwa na ugonjwa wa tarsaal tunnel au una dalili, unapaswa kushauriana na mtaalamu wa matibabu kwa tathmini sahihi na mwongozo ulioundwa kwa hali yako maalum. Ni muhimu kupata matibabu mara tu unapoanza kupata dalili.