Tunnels can make convenient highways. It’s often much quicker to drive through a tunnel than to have to travel around or over the mountain, river, or other structure blocking a direct path. Tunnels do come with risks, of course—if they aren’t properly supported, they can collapse. Your body is filled with mini “tunnels” to allow nerves, blood vessels, and more to pass easily through your body. Although they don’t typically collapse, they can pinch the tissues running through them, leading to conditions like tarsal tunnel syndrome.
The Tunnel in Your Ankle
The tarsal tunnel is a narrow structure on the inside of your ankle, where several bones come together. Blood vessels, important nerves, and thin tendons fit nicely into this narrow space, which protects them as they travel past your ankle and into your foot. A thick ligament sheath called the flexor retinaculum covers this space, turning it into a “tunnel.” Tarsal tunnel syndrome is a painful problem that develops when the posterior tibial nerve, which runs through the tunnel to enter your foot, ends up pinched, compressed, or otherwise irritated in this narrow space.
Compressing the Tunnel-Travelers
Anything that causes swelling, inflammation, or otherwise takes up extra space in the narrow tarsal tunnel can compress the posterior tibial nerve and lead to pain. The flexor retinaculum, which is meant to protect the structures in the tunnel, can’t stretch very much. This means that anything trapped between the ligament sheath and the hard ankle bones can get pinched there.
An injury to the ankle joint that causes swelling is a common culprit. Irritation and thickening of the tendons in the tunnel, swollen varicose veins, a ganglion cyst, and a tumorous growth can all pinch the nervous tissue. Some systemic diseases like diabetes and arthritis cause swelling in the ankle as well. Even flat feet can cause a problem—“fallen” arches allow the ankle to tilt in such a way that might compress the nerve against the ligament sheath.
The nerve damage leads to intense pain in the foot. You might notice a shooting, tingling, or burning sensation that reaches into the arch and possibly the heel. Sometimes you’ll experience numbness as well. Often you feel this discomfort most strongly in the sole of your foot.
Relieving the Pain
You need a correct diagnosis to get the best treatment, so Dr. Darren Silvester and our staff here at Next Step Foot & Ankle Clinic will carefully evaluate your lower limbs. We might use diagnostic images to rule out other causes of your discomfort. Then we can work with you to determine the best course of treatment.
To alleviate the nerve pain, the pressure on the nerve must be released. Take a break from hard impact activities to rest your foot and avoid more irritation in the tissues. Ice the inside of the ankle to help discourage swelling and inflammation in the tarsal tunnel area. Stretch the calf, heel, and ankle to try to loosen tight or stiff tissues that could be contributing to the problem. Orthotics can help correct biomechanical issues connected to the condition. We may recommend anti-inflammatory medications or direct injections as well. In severe cases, you may need to have your foot immobilized for a period of time. Only very rarely does someone need surgery to care for this problem.
Tarsal tunnel syndrome is painful, but it’s also treatable. Don’t just accept nerve pain in your feet. Let Dr. Darren Silvester and our team of experts at Next Step Foot & Ankle Clinic in Universal City and Pleasanton, TX, help correct the problem for you. Just use our website to make an appointment. You can also call us directly at 210.375.3318.