Treatment of Tarsal Tunnel Syndrome
Tarsal tunnel syndrome is a fairly rare condition caused by abnormal pressure on the posterior tibial nerve. The posterior tibial nerve is located behind the medial malleolus, the bump on the inside of the ankle, and runs under the flexor retinaculum, a band of fibrous tissue that is like a canal, or tunnel. This tunnel, the tarsal tunnel, contains the nerve, artery, tendons and veins that go to the bottom of the foot. Tarsal tunnel syndrome has been compared to carpal tunnel syndrome, and both are often misdiagnosed. The pain experienced in the ankle or the wrist is often referred pain and may be due to an injured or weakened annular ligament in the case of carpal tunnel syndrome, and injured or weakened ligaments at the ball of the foot in the case of tarsal tunnel syndrome.
How does tarsal tunnel syndrome develop?
Tarsal tunnel syndrome symptoms develop when the tibial nerve in the tarsal tunnel becomes dysfunctional due to excess pressure. Pressure causes the nerve in the tunnel to be squeezed against the flexor retinaculum, which is quite inflexible. This results in numbness in the nearby skin area, as well as muscle weakness and pain in the area of the pinched nerve.
Unfortunately, however, many people with ankle and foot pain have been misdiagnosed with tarsal tunnel syndrome! Chronic pain in these areas is most often due to a sprain or weakening of the metatarsal, lateral collateral and medial collateral ligaments, ligaments rarely examined by a family physician or an orthopedic surgeon.
What are the symptoms of tarsal tunnel syndrome?
Symptoms include pain in the ankle, arch, toes or heel. Some individuals experience a slight pain, burning or tingling in the sole of the foot. The course of the nerve may also be sensitive to touch. As the condition worsens, weakness and numbness can occur in the foot. If pressure is kept off the foot and ankle, the symptoms may decrease; likewise, they will get worse if the foot and ankle are strained excessively.
Conventional approaches to Tarsal Tunnel miss the mark
A standard practice of modern medicine is to use steroids or to prescribe anti-inflammatory medications. However, in the long run, these treatments do more damage than good. Cortisone shots and anti-inflammatory drugs have been shown to produce short-term pain benefit, but both result in long-term loss of function and even more chronic pain by actually inhibiting the healing process of soft tissues and accelerating cartilage degeneration.
Surgery, too, can make the condition worse, especially when the condition has been misdiagnosed (which is often the case!). Metatarsal, lateral collateral and medial collateral ligament laxity should always be evaluated prior to making the diagnosis of tarsal tunnel syndrome. And surgery for this condition should not be done until a physician who understands the referral patterns of ligaments and is experienced in Prolotherapy performs an evaluation..
A better approach to treating Tarsal Tunnel Syndrome
Since the same patterns exhibited in tarsal tunnel syndrome can be found in metatarsal, lateral collateral and medial collateral ligament weakness, it is very important that a correct diagnosis is made before any treatment begins. More often than not, what has been diagnosed as tarsal tunnel syndrome is actually ligament damage. Since these ligaments bear the bulk of the body weight when a person stands, walks or runs, it is no wonder that they are often the first to weaken.
A better approach is to strengthen the weakened ligaments in the foot with Prolotherapy. Ligament weakness around the knee, hip, sacroiliac joint or pelvis can also cause radiating pain and numbness in the foot area. These areas might need to be treated with Prolotherapy as well. Chronic pain is most commonly due to tendon and ligament weakness, or cartilage deterioration. The safest and most effective natural medicine treatment for repairing tendon, ligament and cartilage damage is Prolotherapy. Prolotherapy stimulates the body to repair painful areas by inducing a mild inflammatory/healing reaction at the fibro-osseous junction, an area rich in sensory nerves. Typically, three to six treatments are needed in total. The tissue strengthening and pain relief stimulated by Prolotherapy is permanent, and allows people continue sports, work, and other activities between treatments.