Foot Numbness – Tarsal Tunnel Syndrome

Have you ever heard the expression that “love makes your toes curl?” That is all well and good but what if you can’t feel your toes? What if your foot is numb?
That raises the question as to why your foot would be numb. It seems that there are several reasons why you might have a foot or portion of a foot that would be numb.
One of the reasons for your foot to be numb would be that the nerves going to your foot or part of your foot have been compressed. That compression could come from sitting on your foot so long that the nerves signals get shut down. Or it could be that your shoes are compressing the nerves. In either of these two cases, moving your foot or removing your shoes will allow the nerve signals to start firing again. That “pins and needles” feeling? That is the sign of the nerve function starting back up again.
Also, there are several different conditions that can cause the nerves in your foot to not work correctly.  This week we will talk about one of them.
Tarsal Tunnel Syndrome
Have you ever heard of carpal tunnel syndrome? That is when the nerves in your wrists are affected generally due to overuse and compression of the nerves. Well, it can happen in your foot also. There is a nerve called the posterior tibial nerve that runs along the back of your leg and into your foot. The nerve inserts into the tarsal tunnel which is a space on the inside of the ankle right next to the ankle bone.  The tarsal tunnel is covered with a thick ligament that protects the veins, arteries, and nerves that are contained in the tarsal tunnel. Tarsal tunnel syndrome occurs when the posterior tibial nerve is compressed in the tarsal tunnel.
How does the nerve get compressed?
There can be several ways for this to happen. If you have flat feet, the way that you walk (using the outside of your foot more than an even distribution of weight) can cause stress and compression of the nerve. If you have a ganglion cyst, a swollen tendon, a bone spur or varicose vein, those can also compress the nerve. It could be that you sprained your ankle and the inflammation has put pressure on the nerve. Last but not least, diabetes or arthritis can cause swelling which can put pressure on the nerve.
How can you tell if you have tarsal tunnel syndrome? The symptoms of tarsal tunnel syndrome are much like the symptoms of other foot problems that can cause numbness. With tarsal tunnel, you can feel numbness or a tingling sensation or shooting pain. Any or a combination of these can be an indication. Also, some people will feel (or not feel) the problem on the inside of the ankle or perhaps the bottom of the foot. The pain could be isolated or it could spread to the entire foot and even the calf.
The symptoms can suddenly appear especially if you have just started a new exercise program or you have had to stand or walk more than usual.
Due to the symptoms for tarsal tunnel syndrome being so similar to other foot issues, you will need to see your friendly local podiatrist to have the doctor determine the root of your pain or numbness. During the exam, the doctor will press on the posterior tibial nerve. An exam of the area will also check to see if a lump can be felt. It may be that you will have to have some imaging tests to see if there is a mass located by the tarsal tunnel.
The treatment will depend upon the source of your tarsal tunnel issue. In most cases, non-surgical treatments will be tried first to see if you can feel relief. The non-surgical treatments can include
1.       Rest
2.       Ice
3.       Anti-inflammatory medications (like Ibuprofen)
4.        Immobilization (a cast to hold the foot in place and allow healing)
5.       Physical therapy
6.       Injection therapy ( a local anesthetic to provide relief)
7.       Orthotic devices ( in shoes to help limit movement)
8.       Supportive shoes
9.       Brace (to reduce the amount of pressure on the foot)
Next week, we will talk about another issue that can cause foot numbness. To make sure you don’t miss it, you can sign up to receive notices about these posts at the top right of the page.
See you next week!
Your Pal,
The Foot Blogger Chick


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