Tarsal tunnel syndrome refers to compression neuropathy which most commonly affects the posterior segment of the tibial nerve. The compression occurs when the nerve passes through the back of the inner ankle bone. The anatomical structure is called the tarsal tunnel and hence the name.
Less frequently tarsal tunnel syndrome is associated with the compression of the deep peroneal nerve, which is located on the front portion of the ankle bone.
What Causes Tarsal Tunnel Syndrome?
The condition is more commonly seen in adults who are relatively active. However it can occur in children. Some of the common causes include,
- Osteoarthritis, ankle deformity following a trauma or tenosynovitis (i.e. inflammation of the tendoachilles ligament) are common causes. In some cases, the condition may be associated with diabetes or rheumatoid arthritis.
- A ganglion, exotosis, cyst, lipoma or neoplasm can also cause compression of the nerve.
- Individuals with flat feet are at higher risk of developing the condition compared to others.
Symptoms Of Tarsal Tunnel Syndrome
Some of the common symptoms associated with tarsal tunnel are similar to those experienced as a result of nerve entrapment,
- A sensation of burning, numbness and tingling which may be associated with pain in the heal.The symptoms are usually unilateral, which rule out systemic causes.
- The symptoms get worse at night and are aggravated by walking or standing for long duration. The symptoms tend to worse as the day progresses. In most cases, the symptoms are better by rest, massage and elevation.
- Pain can be restricted to heal or may radiate upwards to the calf muscles. Pain is also aggravated on extreme dorsiflexion i.e. downward movement of the feet.
Natural Ways To Treat Tarsal Tunnel Syndrome
Here are some effective treatments that can help naturally alleviate the symptoms associated with the condition,
- In individuals with flat feet or ankle injuries it is recommended to use shoes with wider arch support, so as to relieve some of the symptoms. Specific shoes can be customized or individuals with flat feet can use orthotics.
- Add three table spoons of turmeric to a glass of warm milk and consume thrice a day. Turmeric has strong and potent anti-inflammatory properties which help alleviate symptoms associated with pain and burning. Use of honey, often increases the overall absorption of the active ingredients of turmeric by the body.
- Vitamin B12 supplements can help improve overall nerve health and alleviate symptoms associated with burning and tingling numbness. Alternatively increase the intake of chicken, lean meat and dairy products, though these would have limited effectiveness in an acute state.
- Simple exercises of the leg, within acceptable pain parameters, can help in improving muscle strength and relieve muscular weakness.
- Homeopathy can be useful to alleviate symptoms associated with burning, swelling and inflammation. Homeopathic drugs effective to deal with nerve entrapment include Bryonia Alba and Rhus Tox. Arnica Montana is effective when entrapment of the nerve is associated with injury or damage.
In severe cases, surgical decompression by cutting the flexor retinaculum muscle can be effective to alleviate pain. This option is exercised only if conservative treatment doesn’t relieve the symptoms.