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Tarsal Tunnel Decompression and Surgery

Tarsal tunnel painYou’ve probably heard about carpal tunnel syndrome, a common condition that causes pain, tingling, and numbness hands. This happens when the nerve traveling through the carpal tunnel of the wrist is damaged by pressure. Did you know that the same thing can happen in your leg, too?

Tarsal Tunnel Syndrome—Pressure on the Nerve

The carpal tunnel of the wrist has a “partner” in the lower limb—the tarsal tunnel, which runs along the inside of the ankle near the medial malleolus (or, in other words, the bony knob on the side of the ankle). The posterior tibial nerve, which reaches from the knee all the way into the arch and toes, must pass through this relatively tight space.

Unfortunately, a number of factors can collapse the tunnel and physically damage the nerve:

  • Pressure from an external object, such as a cyst or varicose vein
  • A direct injury, such as an ankle sprain
  • Systemic diseases, especially diabetes, which tighten the tunnel due to swelling and inflammation
  • Biomechanical flaws, such as flat feet or overpronation

When the tibial nerve is impaired at the tarsal tunnel, symptoms usually appear along the inside of the ankle and bottom of the foot, potentially all the way to the toes. They can range from shooting pain, to tingling, burning, or shocking sensations, to outright numbness. Without quick treatment, the damage to the nerves may become permanent.

Fixing the Tunnel with Decompression Surgery

The Procedure

In some cases, we may be able to relieve the pressure on the tibial nerve through conservative remedies such as physical therapy, orthotics, or immobilization. You can read about some of these options in our article on tarsal tunnel syndrome. However, sometimes decompression surgery is the best way to relieve the pressure.  

Surgery is usually fairly quick (30-60 minutes in most cases), and can take many forms depending on the source of pressure. For example:

  • Cutting or “releasing” one or more of the muscles and ligaments surrounding the tarsal tunnel in order to relieve the constriction and compression on the tibial nerve.
  • If the tibial nerve is being pressed upon by an external mass, such as a cyst, tumor, or bone spur, we’ll excise it.
  • If the damage is caused by a bony deformity that resulted from an injury, we’ll repair the necessary structures.

The surgery can often be performed under local or regional anesthesia. We’ll make an incision, usually along the back of the ankle, so we can access and decompress the tunnel. Afterward, we’ll close up the incision, provide the appropriate bandage, and send you on your way.

The Recovery and Outlook

The outlook for most patients is very good, with most people experiencing rapid relief from the numbness, pain, or uncomfortable sensations associated with tarsal tunnel syndrome. Some permanent nerve damage may persist; however, if you sought treatment for your condition early enough, there’s a good chance you’ll make a full recovery and restore all lost nerve function.

The recovery period is generally around two months, though it can be longer or shorter depending on various factors. Our team will ensure you’re supplied with a detailed schedule and list of guidelines for your post-operative care at home. Over the next several weeks, you will be able to gradually resume and increase your regular daily activities.

If you’re experiencing pain, numbness, or “phantom” symptoms in your ankles and feet, please don’t wait until the symptoms are unbearable to do something about it! Contact the Absolute Foot Care Specialists in Las Vegas for a consultation and a review of your treatment options. The longer you wait to address a nerve injury, the more likely you’ll need surgery—and the more likely problems will persist. Give us a call today at (702) 839-2010 to set your appointment.