Tarsal Tunnel Syndrome

Tarsal Tunnel Syndrome Condition

This is a rare syndrome that is hard to diagnose and treat. Finding a
physician that specializes in foot and ankle disorders is absolutely
essential. Tenderness and or tingling are usually found over the
posterior tibial nerve.

The most definitive diagnostic tool is a skilled and experienced
physician using a nerve conduction study across the tarsal tunnel. This
test is not infallible and some false negative results are seen. If the
hind foot is in valgus (pronated) diagnosis should be re-checked. This
being said, the point of whether the rear foot is pronated or supinated
in tarsal tunnel syndrome is somewhat controversial. Many excellent
reviews of tarsal tunnel syndrome suggest that it is due to a pronated
hind foot. According to this theory, the posterior tibial nerve is stretched by a pronated hind foot as is goes around the foot. This makes intuitive sense. However during a study by Dr. Mark A. Riley, M.D. (one of the Orthopedic Specialty Physicians for the University of California, Berkeley, Health Services, and has been the Chief Orthopedic Consultant for the Adult Hemophilia Clinic at Bates Hospital in Berkeley), all the patients with tarsal tunnel syndrome that were treated with a varus post, (medial posting to reduce pronation) all became worse or were no better. It was concluded that in a supinated foot the posterior tibial nerve is impinged upon producing pain. A custom molded biomechanical orthotic with lateral posting to put the foot into a pronated position opens up the space and may provide relief. It is because of these different opinions that we strongly advise patients to seek the advice of a skilled and experienced physician for an accurate diagnosis.
Disclaimer: All information published by P.T.I. Orthotic Laboratory or ptiorthotics.com is provided solely for general information and shall not be construed as an attempt to practice medicine or provide specific medical advice and should not be used to make a diagnosis or to replace or overrule a physician, or qualified health care provider's judgment. We strongly encourage users to consult with a physician or qualified health care professional for answers to personal health questions.