Tarsal tunnel syndrome is a rare clinical condition whose main symptom is foot pain. It is more common in women between the ages of 40 and 45 and affects about 0.58 people per 100,000 worldwide.
Pollock and Davis first described this syndrome as early as 1932. However, the cause of tarsal tunnel syndrome could be expected for several decades, as it was not until 1960 that Kopell and Thompson’s studies revealed the mechanisms that determined the causes of this syndrome.
A few years later, in 1962, Charles Keck gave a detailed description of this syndrome while noting that the disease had often been misdiagnosed due to its similarity to plantar fasciitis, or degeneration of the tendon membrane of the plantar bed. Goodgold, Kopell, and Spieldholz, on the other hand, described the effects of this syndrome on the tibial nerve.
What is Talsal Tunnel Syndrome?
A number of signs and symptoms due to compression of the plantar nerves of the tibial nerve or tarsal tunnel are called tarsal tunnel syndrome. This is located under the lower leg restraint bandage just in the middle of the ankle.
The tarsal tunnel, or the ductus tibial canal, is the osteofibrotic canal. It is located on the inside of the ankle. The roof of this tunnel is formed by a flexor retinaculum, which extends from the internal spinal bone to the heel bone. Its function is to stabilize the tendons responsible for the bending motion.
The tarsal tunnel also passes under the finger extending muscle. The tibial nerve and its branches pass between the ligament, muscle and heel. When these nerves are compressed, the phenomenon is called tarsal tunnel syndrome. This compression occurs in the unexpanded osteofibrotic gut.
This syndrome is the result of inflammation of the tissues surrounding the tarsal tunnel. When tissues become inflamed, nerves can also become inflamed and pinched. It is this compression state that causes the pain characteristic of the syndrome.
Causes of tarsal tunnel syndrome
The tarsal tunnel syndrome is caused by several different causes, which in turn may have been caused by several different processes. These include the following reasons:
- Injury due to trauma. Trauma injury is the most common cause of tarsal tunnel syndrome. Usually, the tarsal tunnel syndrome occurs after either a sprain or a fracture of the internal sphincter, heel, or heel. All of these fractures produce a thickening of the annular ligament and subsequent nerve compression.
- Excessive use of the ankle area. Excessive use of the ankle area is associated with repetitive movements of the ankle area due to either daily activities or sports.
- Foot defects. Foot posture defects, especially the so-called flat foot, i.e. the low arch of the foot, cause biomechanical abnormalities in the foot, which lead to elongation of the internal structures and can therefore cause tarsal tunnel syndrome.
- Inflammatory processes. In particular, tendonitis of the tibias and posterior tibia, or tenosynovitis, can lead to the development of tarsal tunnel syndrome.
- Diseases of the tendon or veins. Varicose veins can put pressure on the nerves. Other factors, such as tendon cyst, can also cause tarsal tunnel syndrome.
- Systemic diseases. Systemic diseases account for about 10 percent of cases. The most common of these systemic diseases are diabetes, arthritis, hypothyroidism, and hyperlipidemia, an abundance of blood lipids.
- No known reason. As we mentioned earlier, in about 25% of cases of tarsal tunnel syndrome, no identifiable cause of the disease is found.
Interesting information about tarsal tunnel syndrome
The main symptom of tarsal tunnel syndrome is pain. This pain is usually located around the ankle, almost always inside the ankle. This discomfort often spreads to the toes as well and worsens when walking. Advanced tarsal tunnel syndrome also causes pain at rest.
The pain is burning and is usually accompanied by tingling, cramps, or painful pain. At first, the pain is felt only when standing, walking, or wearing certain types of footwear. The pain most often occurs at night after normal daily activities. The pain is partially relieved by moving the ankle, foot or soles of the feet.
Very common in Talsal Tunnel Syndrome is numbness in the area affected by the syndrome, as well as weakness in the muscles of the foot, toes or ankles. In the most severe cases, this feeling of weakness becomes very significant and can even lead to deformities in the structure of the foot.
Fortunately, complete recovery from tarsal tunnel syndrome is possible with proper treatment. In only a small proportion of patients does the syndrome lead to other serious sequelae, such as partial or complete numbness or loss of mobility. Even in a small percentage of patients, the syndrome returns.