You’ve Heard of Carpal Tunnel, But …

what about carpal tunnel of the foot?

Known as tarsal tunnel syndrome, this condition refers to neuropathy (nerve disorder) of the tibial nerve as it runs under the flexor retinaculum at the medial ankle.

Symptoms sound similar to that of its cousin, carpal tunnel syndrome, and include:

 

• sharp pain
• paresthesia (tingling, burning, pricking, or numbness) radiating up into the lower leg and/or to the hallux and first three digits
• weakness in plantar flexion of the toes
• swelling
• hot and cold sensations
• gait abnormality (over-pronation or limp)

Tarsal tunnel syndrome is caused by any of the following:

• physical trauma to the tibial nerve
• compression on the nerve from a lipoma, bone or cyst
• systemic diseases (diabetes, HIV, hypothyroidism)
• medications
• impingement along the S1 nerve root

Pain worsens and spreads with standing for long periods of time.

As with many other situations of chronic foot pain, misdiagnosis is easy if one is relying only on a verbal description of symptoms. Fortunately, there is an easy and simple assessment that can rule out other disorders.

Tinel Test

In a seated position, with the foot of the leg in question placed across the thigh of the other in the classic tailor’s position, firmly tap repeatedly under the medial malleolus (where reflexology points are for the lower back muscles). A positive Tinel test will produce sharp pain, pointing towards a likely case of tarsal tunnel syndrome.

Allopathy

The common medical approach to this condition is either steroid injections to reduce pain and swelling or surgery.

Tibial nerve decompression surgery involves making an incision at the ankle and then cutting the ligaments surrounding the tibial nerve, so as to relieve the pressure on the nerve.

Recovery depends on the severity of the case and the condition. Some people recover, after two or three weeks of immobilization, with no loss of motion in their feet or ankles; some never recover full sensation.

I like it when I can offer a non-invasive approach to try out before resorting to surgery. In the case of tarsal tunnel syndrome there is a manual procedure (accompanied by homework) that is very successful at relieving the symptoms of tarsal tunnel syndrome.

Manual therapy

It involves a session combining reflexology to the reflexes of the low back muscles, lumbar spine, sciatic nerve, hip, thigh and knee reflexes, followed by specific manual techniques applied to the feet and lower legs to release impingement along the S1nerve root.

In the How to Relieve Chronic Foot Pain workshops, participants learn the above protocol (also effective for plantar fasciosis and peripheral neuropathy) and how to help people dealing with an additional 18 other foot ailments.

I hope to see you at one of these events! So far, I’m scheduled to be in Gainesville, Florida, Vancouver, British Columbia, Fargo, North Dakota, Seattle, Washington and Lindsay, Ontario to give this workshop.