Home The Book Dr Articles Products Message Boards Journal Articles Search Our Surveys Surgery ESWT Dr Messages Find Good Drs video

TTS with ankle pain, top-of-foot hyper-sensitivity, tingling up calf?

Posted by kenf on 4/12/02 at 17:17 (079467)

I was diagnosed with TTS after a bone-scan, xray, MRI, PT, NCV (which was positive) but my symptoms seem to differ from most I've seen. I present with ankle pain around the joint and down across the top of my left foot and tingling a few inches up my leg. The top of my foot seems hyper-sensitive at times (the bed sheets touching it can be bothersome). The pain is usually worse at night, particularly when I kick back. Stretching my foot out to the point where the joint pops seems to provide brief relief. I've never had pain in the sole or bottom of my foot.

Is this presentation consistent with anyone's experiences here?

Thanks, Ken

Re: TTS with ankle pain, top-of-foot hyper-sensitivity, tingling up calf?

LaVona J. on 4/12/02 at 17:42 (079469)

Thats pretty much the way mine started, the pain of the sheet's touching and leg pain is horrible but can be helped by icing you feet, either ice packs or a tub of ice water and plunge in, its a shock at first but stick in there, there is much relief. Quite often I use soft a ice pack to put my feet on when I go to bed. I have lot's of pain in the bottom of my feet now and in the begining it burned alot,I have the numbness on bottom of right foot and some tingling on top but both of my feet are affected. I also occasionally get the popping but usually when I take a step. Nothing showed on MRI. So what is your Dr. suggesting for treatment?
LaVona J.

Re: TTS with ankle pain, top-of-foot hyper-sensitivity, tingling up calf?

Laurie R on 4/12/02 at 19:20 (079489)

Hi Ken , Has your doctor mentioned RSD to you at all ? Just wondering . Laurie R

Re: TTS with ankle pain, top-of-foot hyper-sensitivity, tingling up calf?

Cheri A on 4/12/02 at 19:54 (079495)

Hi Ken! The tops of my feet have been hypersensitive since day 1. I can't stand to sleep without socks on. The socks are bad enough but it does seem to 'protect' them from the sheets! I also have ankle pain, and pains in the calf of my leg, and worse pain at night. There does seem to be a pretty wide variety of symptons, doesn't there?
I don't have any tingling, but I have a lot of numbness in the bottoms of
my feet. Cold floor? No problem!

Re: TTS with ankle pain, top-of-foot hyper-sensitivity, tingling up calf?

Michael T. on 4/13/02 at 04:17 (079508)

Hello,
you write:
> I present with ankle pain around the joint and down across the top
> of my left foot and tingling a few inches up my leg.
> The top of my foot seems hyper-sensitive at times

That's exact the way it started in my first foot, the TTS in the other one started 3 month later with a strong pain like a cutting knife - so the start-sympthoms of TTS can be VERY different.
Many greetings
Michael Trenkel from 53844 Troisdorf (Germany)
(email removed)

Re: TTS with ankle pain, top-of-foot hyper-sensitivity, tingling up calf?

Ann E on 4/13/02 at 09:09 (079513)

Hi Ken. I don'y have alot of pain on the tops of my feet. Mostly pain and numbness on the bottom front meta tarcel areas. I have problems with my knee joints and ankle joints. The muscles tighten up alot in those areas. The physical theropy along with theraputic massage does help.

Re: TTS with ankle pain, top-of-foot hyper-sensitivity, tingling up calf?

Sharon W on 4/13/02 at 09:57 (079516)

Ken,

If you look down to the very bottom of this page you will see some posts by Lara, who is interested in collecting information from us TTS sufferers into a research project. I think it would be FASCINATING to have information from many of us compiled into numbers -- you know, 8 people reported pain on top of the foot, 12 reported arch pain, 9 said they often got pain that shoots toward the middle toes past the ball of the foot, etc... She is on a trip right now, but said she would be posting about this research thing again after she gets back, so you might be interested in checking into it when she does!

My TTS is combined with PF so it can be hard to distinguish the symptoms. But I have certainly felt the ankle pain around the joint; I guess that's inflammation -- it ACHES. And sometimes I get shooting pains from my ankle to my toes, but usually it feels as though the problem runs along the BOTTOM or through the middle of my foot. And I often get either tingling or sharp pain going a little way up my ankle... but sometimes on a 'bad day' it does shoot FURTHER up may ankle and into the calf.

I can't think of a time when the TOP of my foot has been hypersensitive, but there have certainly been many times when the tarsal tunnel and arch areas were very sensitive to the touch. And also my toes -- just the pressure on them of those covers at night, sometimes drives me MAD!

I also get LOTS of numbness and tingling all over the soles of my feet and my toes, mostly at night.

It is VERY typical of TTS to have much pain at night than by day, and I am certainly an example of that. It often wakes me up at night, in spite of the sleeping pills I have to take most nights just to be able to get to sleep with all the numbness and little shots of pain. But besides being different at different hours of the day, my TTS is also VERY sensitive to whether I've been on my feet. (And of course, that really irritates the PF, too...) Worse than walking around, though, is driving my little stick shift car. And the WORST thing of all, the thing that's pretty much GUARANTEED to make me miserable after just 20 minutes or so, is walking around on UNEVEN GROUND.

So how about you -- are you bothered more by standing, walking, or driving, or by uneven ground, or don't any of those things have a particular effect on your foot pain?

Re: TTS with ankle pain, top-of-foot hyper-sensitivity, tingling up calf?

Sharon W on 4/13/02 at 10:09 (079518)

Cheri,

Have you checked out Lara's posts (at the bottom of this board) about doing a research project to help us compare symptoms, how long it took to get a 'good' diagnosis, what treatments have been tried and which were more effective, etc? I think it's a really good idea, might help us all to make more sense of what's going on with this foot thing! She isn't around right now but says she'll be back at the end of the month...

-- Sharon

Re: TTS with ankle pain, top-of-foot hyper-sensitivity, tingling up calf?

kenf on 4/15/02 at 07:55 (079683)

Thanks for all the responses.

My Pod. suggests surgery. He claims to have performed 150-200 TTS release
procedures. Its concerns me that he hasn't offered any more conservative treatments so I'm seeing an Ortho. tomorrow morning for a second opinion. I'd love to hear from people about what non-surgical treatments worked for them. This has been going on for almost 2 years now any my right ankle is starting to show similar symptoms.

I can't say that activity helps or hurts. At first the pain was only at night. Now, its most of the time, but still flares up at nights. Aspirin helps me get to sleep. One thing I noticed is that when on a week ski trip, it didn't bother me at all -- Maybe wearing ski boots all day helped.

- Ken

Re: TTS with ankle pain, top-of-foot hyper-sensitivity, tingling up calf?

Sharon W on 4/15/02 at 10:19 (079691)

Ken,

That's very interesting about the ski boots. Were the boots the firm kind that basically hold your foot & ankle immobile? Were they well padded?

-- Sharon

Re: TTS with ankle pain, top-of-foot hyper-sensitivity, tingling up calf?

kenf on 4/15/02 at 10:43 (079697)

The boots hold your ankle and foot pretty much immobile. They are relatively well padded. The improvement of my symptoms could also be a result of the way in which the boots make you stand. They force you to stand with your knees bent, i.e. on the balls of your feet.

- ken

Re: Weight on balls of feet?

Sharon W on 4/15/02 at 12:37 (079709)

Ken,

I am obviously not a Dr. but I've read that one of the techniques that is sometimes tried with plantar facaetis is elevating the heel slightly (usually with padding) so that less pressure is put on the heel, and slightly more of the weight is on the ball of the foot. Perhaps that is similar to what your ski boots do for you -- move more of your weight forward and less weight to the back of your foot. That might make you feel better if your stress point is at or near the heel.

But if I recall correctly, you didn't mention having problems with your heels...(?) so that doesn't make much sense! My other thought was, maybe you got relief from wearing the boots because it immobilized your feet and kept them from pronating. Are you a pronator? If you are, and you haven't already tried them, maybe you should think about trying orthotics?

Re: Weight on balls of feet?

kenf on 4/15/02 at 13:01 (079715)

Please define pronate in this context.

- Ken

Re: Weight on balls of feet?

Sharon W on 4/15/02 at 15:28 (079726)

Ken:

I meant pronation as described in the Heel Pain Book: 'when the inside ankle bone 'rolls' down and inward the foot passes under the torso during normal walking or running'. My pod says the fact that the toes of my right foot turn outward, causing it to pronate, was probably a factor in creating my TTS. In my case,it is probably caused by over-flexibility of my right knee and/or ankle. My daughter, oddly enough, has this problem with her LEFT foot; I arranged for my pod to examine her, and then an ortho (who sent her back to the pod for orthotics)and she now uses orthotics in the hope that correcting her pronation NOW will mean that she will NEVER develop PF or TTS.

-- Sharon

Re: Weight on balls of feet?

kenf on 4/15/02 at 15:39 (079730)

My pod. has examined my walk several times and has never mentioned this.

Re: Weight on balls of feet?

Sharon W on 4/15/02 at 15:48 (079733)

Ken,

If he has examined your walk repeatedly and never discussed pronation, it's probably not a factor for you.

By the way, I am NOT dead-set against surgery... I just figure, considering all the misery that failed foot/ankle surgery can lead to, it makes sense first to try anything else that has any chance of working for you...

-- Sharon

Re: Weight on balls of feet?

kenf on 4/15/02 at 16:00 (079738)

I agree completely. That's why I'm seeing an ortho tomorrow since my pod isn't offering much but surgery. We did try PT and an arch support, but that was before the TTS diagnosis. I'm not all that optimistic about tomorrow since the last ortho I saw knew squat about TTS.

- Ken

Re: Weight on balls of feet?

Sharon W on 4/15/02 at 16:48 (079749)

Ken,

I had the same impression of the ortho that my daughter was referred to. He really seemed to have the idea that feet are unimportant and anyone who acts as if they are, must be a wimp and/or a hypochondriac. He did the necessary X-rays and provided the official opinion that we needed, but we will NOT be back to that same ortho...

Hopefully you will have better luck with this one. Good luck -- it can be a real search, to try to find someone who can really help!

-- Sharon

Re: TTS with ankle pain, top-of-foot hyper-sensitivity, tingling up calf?

LaVona J. on 4/12/02 at 17:42 (079469)

Thats pretty much the way mine started, the pain of the sheet's touching and leg pain is horrible but can be helped by icing you feet, either ice packs or a tub of ice water and plunge in, its a shock at first but stick in there, there is much relief. Quite often I use soft a ice pack to put my feet on when I go to bed. I have lot's of pain in the bottom of my feet now and in the begining it burned alot,I have the numbness on bottom of right foot and some tingling on top but both of my feet are affected. I also occasionally get the popping but usually when I take a step. Nothing showed on MRI. So what is your Dr. suggesting for treatment?
LaVona J.

Re: TTS with ankle pain, top-of-foot hyper-sensitivity, tingling up calf?

Laurie R on 4/12/02 at 19:20 (079489)

Hi Ken , Has your doctor mentioned RSD to you at all ? Just wondering . Laurie R

Re: TTS with ankle pain, top-of-foot hyper-sensitivity, tingling up calf?

Cheri A on 4/12/02 at 19:54 (079495)

Hi Ken! The tops of my feet have been hypersensitive since day 1. I can't stand to sleep without socks on. The socks are bad enough but it does seem to 'protect' them from the sheets! I also have ankle pain, and pains in the calf of my leg, and worse pain at night. There does seem to be a pretty wide variety of symptons, doesn't there?
I don't have any tingling, but I have a lot of numbness in the bottoms of
my feet. Cold floor? No problem!

Re: TTS with ankle pain, top-of-foot hyper-sensitivity, tingling up calf?

Michael T. on 4/13/02 at 04:17 (079508)

Hello,
you write:
> I present with ankle pain around the joint and down across the top
> of my left foot and tingling a few inches up my leg.
> The top of my foot seems hyper-sensitive at times

That's exact the way it started in my first foot, the TTS in the other one started 3 month later with a strong pain like a cutting knife - so the start-sympthoms of TTS can be VERY different.
Many greetings
Michael Trenkel from 53844 Troisdorf (Germany)
(email removed)

Re: TTS with ankle pain, top-of-foot hyper-sensitivity, tingling up calf?

Ann E on 4/13/02 at 09:09 (079513)

Hi Ken. I don'y have alot of pain on the tops of my feet. Mostly pain and numbness on the bottom front meta tarcel areas. I have problems with my knee joints and ankle joints. The muscles tighten up alot in those areas. The physical theropy along with theraputic massage does help.

Re: TTS with ankle pain, top-of-foot hyper-sensitivity, tingling up calf?

Sharon W on 4/13/02 at 09:57 (079516)

Ken,

If you look down to the very bottom of this page you will see some posts by Lara, who is interested in collecting information from us TTS sufferers into a research project. I think it would be FASCINATING to have information from many of us compiled into numbers -- you know, 8 people reported pain on top of the foot, 12 reported arch pain, 9 said they often got pain that shoots toward the middle toes past the ball of the foot, etc... She is on a trip right now, but said she would be posting about this research thing again after she gets back, so you might be interested in checking into it when she does!

My TTS is combined with PF so it can be hard to distinguish the symptoms. But I have certainly felt the ankle pain around the joint; I guess that's inflammation -- it ACHES. And sometimes I get shooting pains from my ankle to my toes, but usually it feels as though the problem runs along the BOTTOM or through the middle of my foot. And I often get either tingling or sharp pain going a little way up my ankle... but sometimes on a 'bad day' it does shoot FURTHER up may ankle and into the calf.

I can't think of a time when the TOP of my foot has been hypersensitive, but there have certainly been many times when the tarsal tunnel and arch areas were very sensitive to the touch. And also my toes -- just the pressure on them of those covers at night, sometimes drives me MAD!

I also get LOTS of numbness and tingling all over the soles of my feet and my toes, mostly at night.

It is VERY typical of TTS to have much pain at night than by day, and I am certainly an example of that. It often wakes me up at night, in spite of the sleeping pills I have to take most nights just to be able to get to sleep with all the numbness and little shots of pain. But besides being different at different hours of the day, my TTS is also VERY sensitive to whether I've been on my feet. (And of course, that really irritates the PF, too...) Worse than walking around, though, is driving my little stick shift car. And the WORST thing of all, the thing that's pretty much GUARANTEED to make me miserable after just 20 minutes or so, is walking around on UNEVEN GROUND.

So how about you -- are you bothered more by standing, walking, or driving, or by uneven ground, or don't any of those things have a particular effect on your foot pain?

Re: TTS with ankle pain, top-of-foot hyper-sensitivity, tingling up calf?

Sharon W on 4/13/02 at 10:09 (079518)

Cheri,

Have you checked out Lara's posts (at the bottom of this board) about doing a research project to help us compare symptoms, how long it took to get a 'good' diagnosis, what treatments have been tried and which were more effective, etc? I think it's a really good idea, might help us all to make more sense of what's going on with this foot thing! She isn't around right now but says she'll be back at the end of the month...

-- Sharon

Re: TTS with ankle pain, top-of-foot hyper-sensitivity, tingling up calf?

kenf on 4/15/02 at 07:55 (079683)

Thanks for all the responses.

My Pod. suggests surgery. He claims to have performed 150-200 TTS release
procedures. Its concerns me that he hasn't offered any more conservative treatments so I'm seeing an Ortho. tomorrow morning for a second opinion. I'd love to hear from people about what non-surgical treatments worked for them. This has been going on for almost 2 years now any my right ankle is starting to show similar symptoms.

I can't say that activity helps or hurts. At first the pain was only at night. Now, its most of the time, but still flares up at nights. Aspirin helps me get to sleep. One thing I noticed is that when on a week ski trip, it didn't bother me at all -- Maybe wearing ski boots all day helped.

- Ken

Re: TTS with ankle pain, top-of-foot hyper-sensitivity, tingling up calf?

Sharon W on 4/15/02 at 10:19 (079691)

Ken,

That's very interesting about the ski boots. Were the boots the firm kind that basically hold your foot & ankle immobile? Were they well padded?

-- Sharon

Re: TTS with ankle pain, top-of-foot hyper-sensitivity, tingling up calf?

kenf on 4/15/02 at 10:43 (079697)

The boots hold your ankle and foot pretty much immobile. They are relatively well padded. The improvement of my symptoms could also be a result of the way in which the boots make you stand. They force you to stand with your knees bent, i.e. on the balls of your feet.

- ken

Re: Weight on balls of feet?

Sharon W on 4/15/02 at 12:37 (079709)

Ken,

I am obviously not a Dr. but I've read that one of the techniques that is sometimes tried with plantar facaetis is elevating the heel slightly (usually with padding) so that less pressure is put on the heel, and slightly more of the weight is on the ball of the foot. Perhaps that is similar to what your ski boots do for you -- move more of your weight forward and less weight to the back of your foot. That might make you feel better if your stress point is at or near the heel.

But if I recall correctly, you didn't mention having problems with your heels...(?) so that doesn't make much sense! My other thought was, maybe you got relief from wearing the boots because it immobilized your feet and kept them from pronating. Are you a pronator? If you are, and you haven't already tried them, maybe you should think about trying orthotics?

Re: Weight on balls of feet?

kenf on 4/15/02 at 13:01 (079715)

Please define pronate in this context.

- Ken

Re: Weight on balls of feet?

Sharon W on 4/15/02 at 15:28 (079726)

Ken:

I meant pronation as described in the Heel Pain Book: 'when the inside ankle bone 'rolls' down and inward the foot passes under the torso during normal walking or running'. My pod says the fact that the toes of my right foot turn outward, causing it to pronate, was probably a factor in creating my TTS. In my case,it is probably caused by over-flexibility of my right knee and/or ankle. My daughter, oddly enough, has this problem with her LEFT foot; I arranged for my pod to examine her, and then an ortho (who sent her back to the pod for orthotics)and she now uses orthotics in the hope that correcting her pronation NOW will mean that she will NEVER develop PF or TTS.

-- Sharon

Re: Weight on balls of feet?

kenf on 4/15/02 at 15:39 (079730)

My pod. has examined my walk several times and has never mentioned this.

Re: Weight on balls of feet?

Sharon W on 4/15/02 at 15:48 (079733)

Ken,

If he has examined your walk repeatedly and never discussed pronation, it's probably not a factor for you.

By the way, I am NOT dead-set against surgery... I just figure, considering all the misery that failed foot/ankle surgery can lead to, it makes sense first to try anything else that has any chance of working for you...

-- Sharon

Re: Weight on balls of feet?

kenf on 4/15/02 at 16:00 (079738)

I agree completely. That's why I'm seeing an ortho tomorrow since my pod isn't offering much but surgery. We did try PT and an arch support, but that was before the TTS diagnosis. I'm not all that optimistic about tomorrow since the last ortho I saw knew squat about TTS.

- Ken

Re: Weight on balls of feet?

Sharon W on 4/15/02 at 16:48 (079749)

Ken,

I had the same impression of the ortho that my daughter was referred to. He really seemed to have the idea that feet are unimportant and anyone who acts as if they are, must be a wimp and/or a hypochondriac. He did the necessary X-rays and provided the official opinion that we needed, but we will NOT be back to that same ortho...

Hopefully you will have better luck with this one. Good luck -- it can be a real search, to try to find someone who can really help!

-- Sharon