Tarsal Tunnel Syndrome

                 Dr. Vincent Giacalone               

Dr. Vincent Giacalone

Podiatric Medicine & Surgery

466 Hook Rd., Suite 24D, Emerson, NJ 07630

Phone: 201-261-0500

Tarsal Tunnel Syndrome

What  is Tarsal Tunnel Syndrome?

Tarsal tunnel syndrome is an entrapment neuropathy (pressure on the nerve) of the tibial nerve as it courses through the inside aspect of the foot and ankle. This problem is similar to carpal tunnel syndrome in the hand and wrist. It’s not unlike having a rubber band wrapped around tour finger.

What are the Symptoms?
Pain, numbness, burning and electrical sensations may occur along the course of the nerve, which includes the inside of the ankle, heel, arch and bottom of foot. Symptoms are usually worsened with increased activity such as walking or exercise. Prolonged standing in one place may also be an aggravating factor.

What are the Cause?
There are a variety of factors that may cause tarsal tunnel syndrome. These may include repetitive stress with activities, flat feet, and excess weight. Additionally, any lesion, mass or cyst taking up room within the tarsal tunnel region may cause pressure on the nerve and subsequent symptoms. Examples include tendinitis, hematoma, tumor, varicose veins and lower extremity swelling.

How is it Diagnosed?
The diagnosis of tarsal tunnel is made primarily by the clinic experience of Dr. Giacalon. A Tinel’s sign (radiating pain upon tapping the nerve) may be noted. Temporary relief may be obtained with a diagnostic local anesthetic injection. Electrodiagnostic studies such as nerve conduction velocity (EMG/NCV) testing may also prove useful. Magnetic resonance imaging (MRI) may also help to evaluate this problem and look for the cause.

What are the Treatment?
Conservative treatment for tarsal tunnel syndrome includes the use of non-steroidal anti-inflammatory medication, ice, physical therapy, orthotic devices, steroid injections and cast immobilization.

When conservative treatment is unsuccessful, surgical intervention may be offered by Dr. Giacalone. The surgery involves releasing the fibrous tunnel over the tibial nerve and its branches from the surrounding tight structures along with incision of the laciniate ligament, a structure that forms a roof over the nerve bundle, similar to removing the rubber band wrapped around your finger.  The surgery is performed on an outpatient basis under local anesthesia with intravenous sedation.

Postoperatively, a period of immobilization followed by protected weight-bearing and physical therapy may be prescribed. Complications of surgery may include continued tingling, numbness and the possibility of infection.

Dr. Giacalone has been trained specifically and extensively in the diagnosis and medical and surgical treatment of foot disorders.  Dr. Giacalone has been board certified by The American Board of Podiatric Orthopedics and The American Board of Podiatric Surgery since 1993 and 1995 respectively and is a Fellow of the American College of Foot and Ankle Surgeons. Dr. Giacalone performs surgery at Hackensack University Medical Center in Hackensack, Hackensack University Medical Center @ Pascack Valley in Westwood and Surgicare Surgical Center in Oradell.