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Scared of Tarsal Tunnel Syndrome

Posted by AnnaG on 7/16/01 at 13:42 (053363)

I am scared out of my wits when I realized this morning that I might have tarsal tunnel syndrome. I had a ganglion cyst aspirated from my right foot a few weeks ago. I've had two cortisone shots since. At the end of this week I am scheduled for an EMG/NCV exam. I am the classic case to be diagnosed with tts. I have high arches. I've had plantar fascia operations on each foot and up until this year enjoyed running. My running has been curtailed quite a bit due to a back, neck and shoulder injury sustained on the job (19 weeks of pure misery -- my upper back has shooting pains running up and down as I write this-my right foot is just numb). I usually swim 1/2 mile once a week. I stopped swimming a few weeks ago when I realized that turning my head is causing neck pains. I went back to the breast stroke only last week. I know that if I experience any pain while swimming, trouble is brewing somewhere. Yes, I experienced pain in my entire right foot while swimming on Saturday and Sunday. I am scared out of my wits knowing that I might have tts. This is coupled with the worst pain (back, neck and shoulders) I have ever experienced. I used to be healthy. Now I am a wreck. Any helpful encouragement would be most appreciated. It's very difficult for me to concentrate on work. I am the only working member in my family. My son starts college in August. My husband retired (reading USA Today til noon everyday was more pressure than he could take as a civil servant) 3 years before he gets any benefits. I don't make that much money but feel stuck because I am not young and I do not have the drive to search for new opportunities. I need help.

Re: Scared of Tarsal Tunnel Syndrome

GinaC on 7/16/01 at 18:29 (053399)

I'm sorry that you are having so many physical and emotional problems. It's easy to be overwhelmed when everything seems to be going wrong.

You may or may not have tarsal tunnel. I was terribly surprised that I did, as I have not had any 'nervy' pain in my feet. And I sure know what those nerve symptoms are, as I have carpal and ulnar tunnel in my hands. I've had pf and tt release on one foot and am fairly satisfied with the results to this point.

If you do have tts, you can take your time and decide how you want to treat it. You'll manage it as best you can, I'm sure.

Sometimes the uncertainty of waiting, worrying, and wondering is worse than the reality of whatever comes next. Good luck with your test. Gina

Re: Scared of Tarsal Tunnel Syndrome

wendyn on 7/16/01 at 22:32 (053425)

Hi Anna...please take a deep breath. Now take one more.

Try not to become preoccupied with whether or not you have TTS - maybe you do - maybe you don't. I know the horror stories that are here, but many of us represent 'worst case scenarios'.

You may have TTS - or you could have something systemic going on that is affecting your whole body. Or maybe none of the above. If you are having unexplained pain and what's happening in your feet -most doctors will want to do tests for:
Diabetes
Thyroid
Lupus
Rhematoid Arthritis
to ensure that the problem isn't just in your feet.

Have you had these done yet?

The nerve conduction tests may give a clearer idea of what's happening - so please try to relax (I know it's easier said than done) and wait and see what the results are.

Above all, please come back and let us know how things turn out - and then maybe others will have some support/advice related to whatever the diagnosis turns out to be.

Re: Scared of Tarsal Tunnel Syndrome

AnnaG on 7/17/01 at 08:40 (053463)

Thank you Wendy and Gina for your welcoming remarks. I feel so glad that
there is a support group out there.
I will let you know how the tests come out. Is the doctor able to make a diagnosis on the spot or do results have to come back 'in a few weeks'?

Re: test results

GinaC on 7/17/01 at 08:56 (053464)

I've had NCT/EMG done several times. I've gotten results a couple of ways. One is by asking the doctor doing the test to let me know how things are going during the test. Usually, if the nerve conduction speed is 'slow' that's not desirable and may be indicative of a problem; the neurolgist can tell you whethere the nerve impulses are slow as you go along. I've also asked to fill out a release before taking the test, so that I am mailed a copy of the results about the same time they are sent to the doctor ordering the test. That way I also have a record in case I need to take those results somewhere else. Again, good luck with it. gina

Re: Scared of Tarsal Tunnel Syndrome

wendyn on 7/17/01 at 13:49 (053493)

Probably depends on who does the test - but likely they will tell you right there. Ask lots of questions, it's your body...don't feel like you don't have the right to know what they're doing and why.

Focus very hard on just relaxing and breathing - it make the test much easier.

Re: Scared of Tarsal Tunnel Syndrome

AnnaG on 7/17/01 at 14:06 (053499)

Thanks, Wendy. I will ask questions and demand that the doctor not treat me like part of an assembly line. My uncle, who is not one to be brushed off lightly, is coming with me. I need the support and I'm so glad he is taking a vacation day for me.
Wendy, I also want to thank you for posting such a nice site with FAQs.
Can anyone out there offer any success stories? Are there any weekend athletes, marathoners or long distance bikers, out there who have tts, either surgery or not, who can say s/he was back to the sport within 3 months? How much conditioning is lost? (I know. I shouldn't be concerned about being in shape but I am competitive and I know what being in the peak of health is all about. I don't want to regress until I'm too old to drive.)

Re: Scared of Tarsal Tunnel Syndrome

wendyn on 7/17/01 at 22:05 (053546)

Anna - I cannot jog or do aerobics - but I can bike on a recumbent bike. I was very worried about decreasing fitness level too. The best think I can recommend is to really start working on non weightbearing excerise. For now add some serious weight training (no squats or standing with weights or leg weights at all). You might also want to try pilates and yoga for something extra.

I went about a year with very little work on my legs - when I went back to biking 5 minutes gave me jelly legs. But, before I knew it - the improvements were coming back fast.

Do you do any type of weight training right now?

Oh - wait - I get my people mixed up....are you the one having trouble with your shoulders and neck etc? If so - forget what I said...wait till you have your nerve conduction and other tests - give it a few weeks anyway...your fitness level will change very little in that period.

Re: Scared of Tarsal Tunnel Syndrome

Ed Davis, DPM on 7/30/01 at hrmin (054878)

Good response from Wendyn---you need a thorough workup, perhaps by a rheumatologist to see if there is anything going on to cause the TTS.
Carpal tunnel is very common and this carpal tunnel surgery is common. TTS is less common--I believe there is about one case of TTS to thirty cases of carpal tunnel syndrome.

If the TTS is independent of the entities listed by Wendyn then treatment can bring a lot of relief. About 30% to TTS is due to something pressing on the nerve--occasionally varicosities in the tarsal tunnel--treatment is farily simple and has a high success rate. If the problem is scarring in the tarsal tunnel, cortisone shots help about 30% of the time but are definitely worth a try. I try to obtain high resolution MRI pictures of the tarsal tunnel when possible to try to see if anything is encroaching on the nerve before surgery. Surgical treatment is effective between 60 to 90% of the time. This variability is due to certain aspects of technique. It definitely helps to find a surgeon who has done a fair number of the procedures. Neurosurgeon, A. Lee Dellon, MD of Baltimore has some of the highest success rates I have seen. He produces an excellent CD ROM of his technique which I show to the podiatric surgical residents I train in Tacoma, WA at least twice a year.
Ed

Re: Scared of Tarsal Tunnel Syndrome

GinaC on 7/16/01 at 18:29 (053399)

I'm sorry that you are having so many physical and emotional problems. It's easy to be overwhelmed when everything seems to be going wrong.

You may or may not have tarsal tunnel. I was terribly surprised that I did, as I have not had any 'nervy' pain in my feet. And I sure know what those nerve symptoms are, as I have carpal and ulnar tunnel in my hands. I've had pf and tt release on one foot and am fairly satisfied with the results to this point.

If you do have tts, you can take your time and decide how you want to treat it. You'll manage it as best you can, I'm sure.

Sometimes the uncertainty of waiting, worrying, and wondering is worse than the reality of whatever comes next. Good luck with your test. Gina

Re: Scared of Tarsal Tunnel Syndrome

wendyn on 7/16/01 at 22:32 (053425)

Hi Anna...please take a deep breath. Now take one more.

Try not to become preoccupied with whether or not you have TTS - maybe you do - maybe you don't. I know the horror stories that are here, but many of us represent 'worst case scenarios'.

You may have TTS - or you could have something systemic going on that is affecting your whole body. Or maybe none of the above. If you are having unexplained pain and what's happening in your feet -most doctors will want to do tests for:
Diabetes
Thyroid
Lupus
Rhematoid Arthritis
to ensure that the problem isn't just in your feet.

Have you had these done yet?

The nerve conduction tests may give a clearer idea of what's happening - so please try to relax (I know it's easier said than done) and wait and see what the results are.

Above all, please come back and let us know how things turn out - and then maybe others will have some support/advice related to whatever the diagnosis turns out to be.

Re: Scared of Tarsal Tunnel Syndrome

AnnaG on 7/17/01 at 08:40 (053463)

Thank you Wendy and Gina for your welcoming remarks. I feel so glad that
there is a support group out there.
I will let you know how the tests come out. Is the doctor able to make a diagnosis on the spot or do results have to come back 'in a few weeks'?

Re: test results

GinaC on 7/17/01 at 08:56 (053464)

I've had NCT/EMG done several times. I've gotten results a couple of ways. One is by asking the doctor doing the test to let me know how things are going during the test. Usually, if the nerve conduction speed is 'slow' that's not desirable and may be indicative of a problem; the neurolgist can tell you whethere the nerve impulses are slow as you go along. I've also asked to fill out a release before taking the test, so that I am mailed a copy of the results about the same time they are sent to the doctor ordering the test. That way I also have a record in case I need to take those results somewhere else. Again, good luck with it. gina

Re: Scared of Tarsal Tunnel Syndrome

wendyn on 7/17/01 at 13:49 (053493)

Probably depends on who does the test - but likely they will tell you right there. Ask lots of questions, it's your body...don't feel like you don't have the right to know what they're doing and why.

Focus very hard on just relaxing and breathing - it make the test much easier.

Re: Scared of Tarsal Tunnel Syndrome

AnnaG on 7/17/01 at 14:06 (053499)

Thanks, Wendy. I will ask questions and demand that the doctor not treat me like part of an assembly line. My uncle, who is not one to be brushed off lightly, is coming with me. I need the support and I'm so glad he is taking a vacation day for me.
Wendy, I also want to thank you for posting such a nice site with FAQs.
Can anyone out there offer any success stories? Are there any weekend athletes, marathoners or long distance bikers, out there who have tts, either surgery or not, who can say s/he was back to the sport within 3 months? How much conditioning is lost? (I know. I shouldn't be concerned about being in shape but I am competitive and I know what being in the peak of health is all about. I don't want to regress until I'm too old to drive.)

Re: Scared of Tarsal Tunnel Syndrome

wendyn on 7/17/01 at 22:05 (053546)

Anna - I cannot jog or do aerobics - but I can bike on a recumbent bike. I was very worried about decreasing fitness level too. The best think I can recommend is to really start working on non weightbearing excerise. For now add some serious weight training (no squats or standing with weights or leg weights at all). You might also want to try pilates and yoga for something extra.

I went about a year with very little work on my legs - when I went back to biking 5 minutes gave me jelly legs. But, before I knew it - the improvements were coming back fast.

Do you do any type of weight training right now?

Oh - wait - I get my people mixed up....are you the one having trouble with your shoulders and neck etc? If so - forget what I said...wait till you have your nerve conduction and other tests - give it a few weeks anyway...your fitness level will change very little in that period.

Re: Scared of Tarsal Tunnel Syndrome

Ed Davis, DPM on 7/30/01 at hrmin (054878)

Good response from Wendyn---you need a thorough workup, perhaps by a rheumatologist to see if there is anything going on to cause the TTS.
Carpal tunnel is very common and this carpal tunnel surgery is common. TTS is less common--I believe there is about one case of TTS to thirty cases of carpal tunnel syndrome.

If the TTS is independent of the entities listed by Wendyn then treatment can bring a lot of relief. About 30% to TTS is due to something pressing on the nerve--occasionally varicosities in the tarsal tunnel--treatment is farily simple and has a high success rate. If the problem is scarring in the tarsal tunnel, cortisone shots help about 30% of the time but are definitely worth a try. I try to obtain high resolution MRI pictures of the tarsal tunnel when possible to try to see if anything is encroaching on the nerve before surgery. Surgical treatment is effective between 60 to 90% of the time. This variability is due to certain aspects of technique. It definitely helps to find a surgeon who has done a fair number of the procedures. Neurosurgeon, A. Lee Dellon, MD of Baltimore has some of the highest success rates I have seen. He produces an excellent CD ROM of his technique which I show to the podiatric surgical residents I train in Tacoma, WA at least twice a year.
Ed