Tarsal Tunnel Syndrome Treatment in Los Angeles

What is Tarsal Tunnel Syndrome?

Tarsal tunnel syndrome occurs when the posterior tibial nerve, which runs along the inside of the ankle, becomes compressed within the tarsal tunnel, a passageway formed by ligaments and bone. This nerve provides sensation to the heel and the bottom of the foot. When it is compressed, it cannot function properly, leading to pain, numbness, or tingling on the bottom of your feet and toes. Tarsal tunnel syndrome is similar to carpal tunnel syndrome in the hand, as both conditions result from nerve compression.

If you're concerned you have tarsal tunnel syndrome, early diagnosis and prompt treatment from Dr. Soomekh, the best tarsal tunnel doctor in Los Angeles, can help prevent further nerve damage and worsening symptoms.

Signs and Symptoms of Tarsal Tunnel Syndrome

Tarsal tunnel syndrome can cause a range of symptoms, from mild discomfort to severe nerve pain. The symptoms often start in the heel and spread to the bottom of the foot and big toe, but can also affect the inner side of the ankle. Pain and numbness may be present at rest and worsen with activity. Common symptoms of tarsal tunnel syndrome include:

• Burning, tingling, or electric shock-like sensations in the foot
• Numbness or pain in the heel, sole, or toes
• Symptoms that worsen with walking, standing, or exercise
• Pain that may be present even at rest
• Increased discomfort after physical activity

Causes of Tarsal Tunnel Syndrome

Tarsal tunnel syndrome most often affects active adults, as nerve compression is usually caused by changes in the foot’s anatomy or repetitive stress. Anything that compresses or irritates the posterior tibial nerve can lead to symptoms. Common causes include:

• Flat feet: A fallen arch can stretch and compress the nerve
• Muscle enlargement or scar tissue: Can create excess pressure on the nerve
• Cysts or masses: Growths near the nerve can cause direct compression
• Systemic conditions: Diabetes, rheumatoid arthritis, and other inflammatory diseases can increase nerve susceptibility
• Ankle trauma: Fractures or sprains can lead to excessive scar tissue that entraps the nerve
• Overgrown or damaged veins: Enlarged veins can constrict the nerve, especially after exercise

Diagnosing Tarsal Tunnel Syndrome

Diagnosing tarsal tunnel syndrome begins with a clinical examination and imaging tests. Dr. Soomekh uses the following methods:

• Patient consultation: Listening to your symptoms, concerns, and treatment goals
• Hands-on evaluation: Examining the foot and assessing your gait to identify signs of nerve compression
• MRI scan (if needed): Used to examine the tarsal tunnel in detail
• Nerve conduction study (NCV): Helps determine the extent of nerve damage
• Lower back assessment (if necessary): To rule out other nerve issues that could mimic tarsal tunnel syndrome

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Tarsal Tunnel Syndrome Treatment Options

Dr. Soomekh recommends that early diagnosis and timely treatment of tarsal tunnel syndrome are the keys to successful treatment, faster recovery, and a painless lifestyle.

Conservative Treatment for Tarsal Tunnel Syndrome

The goal of conservative treatment is to reduce the abnormal forces on the nerve and promote healing. This includes supportive footwear, anti-inflammatory measures, and targeted therapies to relieve pressure and prevent progression.

• Supportive shoes to minimize strain on the nerve
• Anti-inflammatory medications and ice therapy to reduce swelling
• Physical therapy to improve mobility and decrease irritation
• Custom orthotics to slow progression and prevent recurrence
• Cortisone injections to reduce swelling and scar tissue around the nerve

Surgical Treatment For Tarsal Tunnel Syndrome

Dr. Soomekh, widely regarded as the best ankle surgeon in Los Angeles, always recommends and attempts conservative treatment options when appropriate. However, when a tarsal tunnel syndrome deformity becomes chronically painful and activity becomes difficult, surgical repair may be indicated.

Tarsal Tunnel Release

Tarsal tunnel release surgery in Los Angeles relieves nerve compression, allowing the posterior tibial nerve to move freely without pressure from surrounding tissues. Once released, the nerve can function properly, and symptoms gradually subside.

Surgical Process:

• Incision placement: To access the tarsal tunnel, a precise incision is made along the inner ankle down to the heel.
• Identifying and releasing structures: The ligamentous structures compressing the nerve are carefully identified, cut, and released.
• Nerve decompression: The posterior tibial nerve and its branches are examined, and any abnormal ligaments, masses, or engorged veins are removed to relieve pressure.
• Tissue and muscle release: Additional tunnels, ligaments, and muscles restricting the nerve’s branches are carefully freed to restore normal nerve function.
• Closure and recovery: The incision is closed using plastic surgery techniques for optimal healing. The patient is placed in a cast with crutches for three weeks, followed by three weeks in a walking boot. Physical therapy is recommended to ensure a full recovery.