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TTS diagnosed - What should I be doing??

Posted by Barbara E on 7/01/02 at 18:49 (088872)

Hi all - I'm so delighted to find this board!! People who understand!! Anyway, here's my situation.

I have been recently diagnosed with TTS. I'm 100% that the diagnosis is correct (since I made it myself after the doctors couldn't figure it out). Two separate doctors didn't help - I ended up spending a sleepless night surfing the web and found out about it. My symptoms are classic (but I'll give you the abbreviated version here ).

It started about six months ago. Burning/tingling/numbness in ball of foot and first three toes (and part of fourth). Worse at night. Saw a doctor that gave me pain pills. Eventually (couple of days) eased off but area remained numb.

Two weeks ago I took a 2 mile walk with a friend who's trying to lose weight. Walked for 4 days straight (yup, on roads). Well, that night the burning/pain started again only now it involved the whole bottom of my foot. Pain was very bad. That's when I spent the night surfing. Went to the doctor the next morning with all my documentation. He agreed with the diagnosis and gave me a cortisone shot. Acute pain eased off after a couple of days. But the bottom of my foot is still numb and tingles maybe 25% of the time with occasional flashes of pain.

So - what should I do now?? I will be going to a neurologist but anything I can do meantime?? I bought some arch supports - they do help some. I have a walking cast - should I use it?? Luckily (?) I have a desk job so I don't need to stay on my feet all day. I'd like to heal this before it gets too bad. I.e. I'd like to avoid surgery if possible because I'm a big chicken.

Any suggestions would be appreciated. Thank you.

Re: TTS diagnosed - What should I be doing??

Barbara E on 7/01/02 at 20:08 (088875)

I have no idea how I did this twice. Sorry!!

Re: TTS diagnosed - What should I be doing??

wendyn on 7/01/02 at 21:00 (088879)

Barbara, any time there is unexplained numbness and tingling - most doctors will do nerve conduction tests, as well as blood work to rule out diabetes, low b12 etc.

Usually TTS causes very distinct pain in the inner ankle area. Do you have this?

Most people with TTS find the pain increases throughout the day - but I haven't heard any (that I recall) say that the pain is worse at night.

Where did your doctor put the cortisone injection? Did your doctor give you the walking cast to use?

Re: TTS diagnosed - What should I be doing??

J. King on 7/01/02 at 21:14 (088881)

Yeah, I would be careful about the TTS surgery. If they do it right it is o.k. but if they mess if up I think the complications are serious.

Re: TTS diagnosed - What should I be doing??

Barbara E on 7/02/02 at 05:55 (088901)

Wendyn - thanks for your response. In trying to keep my original message short , I wasn't as clear as I could have been. Here is the original info I found that made me sit up and say 'AHA!!'

SYMPTOMS
Tarsal Tunnel Syndrome, or TTS, is rare and only one of many causes for FOOT PAIN and NUMBNESS of the SOLE, of one foot. It is worse in the evening and at night after activity and is aggravated by obesity and any underlying more generalized nerve disorder (polyneuropathy).

SIGNS
Patients have relative numbness on the sole of the affected foot and an electric 'zinger' when the affected nerve, the Posterior Tibial is tapped ('Tinel's Sign') at the affected site - the inside of the ankle just below the bony prominence (medial malleolus).

This is at http://www.idiom.com/~drjohn/tarsal.html

I don't think it is so much that it's worse at night, it's that I notice it most at night since I'm trying to sleep. Right now, I just woke up and it doesn't hurt at all.

Yes, I have that particular pain underneath/behind the inner ankle and sometimes radiating down to the arch. And I have that 'Tingels' sign' (sp?)

I probably will have that nerve test when I go to the neurologist but I've also heard that a fair amount of damage has to have already happened to the nerve before it really registers on the test. I'd like to prevent it getting that bad to start with.

I was very athletic when I was younger (*very* athletic) and have had multiple ankle sprains during my life. I lived with taped-up ankles during my teenage years. I recently took up exercising again to try and get back into shape. I'm 42 years old.

The kicker is that this seems to have occurred in two steps. The first time just involved the ball of the foot and several toes. Just recently it's escalated to the entire bottom of my foot. My left foot is fine, I'm in perfect health - in fact, I'm disgustingly healthy.

I know I have a very mild cast of TTS compared to many of this board and I'd like to heal it now. I have an inkling of what it's like and I'm in awe of the people here who manage to keep going with a more severe case.

By the way, the doctor put the cortisone injected right in the sensitive spot just behind the ankle. That's where it hurt most when pressed (nearly sent me off the table ). I've also had an x-ray of the ankle, the bones, etc. are fine. I had the walking cast prior to this problem.

Re: TTS diagnosed - What should I be doing??

wendyn on 7/02/02 at 07:29 (088905)

Barbara, if your doctor didn't give you the cast for this, I would be reluctant to use it without his consent.

I've read the website you're quoting, I think it's the only one that I ever came across referring to worse pain at night. It's not something I've heard complained of much here.

I was in your 'shoes' about 3 years ago when I was first diagnosed.

The nerve conduction test and an MRI will probably be the next logical steps - as well as all the blood work. The blood work should be done to rule out all kinds of systemic things that could be causing the problem. This is an absolute must - we have had people here who have had surgery, and then found out LATER that there was a problem like diabetes at work.

Re: TTS diagnosed - What should I be doing??

wendyn on 7/02/02 at 08:45 (088911)

Barbara, in the mean time - you may want to consider trying something like Birkenstock sandals. They won't put any pressure on your TT area, and they still provide a lot of support.

Re: TTS diagnosed - What should I be doing??

Barbara E on 7/08/02 at 19:31 (089322)

Wendyn - I just wanted to say thanks for recommending the Birkenstocks. They're hugely popular among teenagers here - my sons each have a couple of pairs. But I never thought of getting any for myself. So I went to a store called 'The Walking Store' - had some knowledgable (sp?) salesmen - and bought some Birkenstocks and some New Balance sneakers. It really makes a difference in how I feel.

The bottom of my foot is still numb but the actual pain is mainly gone. It 'tingles' a lot. Have to call my doctor and find out if he set up that appointment with a neurologist yet - I'm curious as to what they'll say.

Thanks again for your advice.

Re: TTS diagnosed - What should I be doing??

wendyn on 7/08/02 at 20:21 (089323)

BarbaraE - I'm glad to hear that they helped. You may find that as you wear them more - your foot gets better.

I sure hope so!!!!!!

Re: TTS diagnosed - What should I be doing??

Barbara E on 7/01/02 at 20:08 (088875)

I have no idea how I did this twice. Sorry!!

Re: TTS diagnosed - What should I be doing??

wendyn on 7/01/02 at 21:00 (088879)

Barbara, any time there is unexplained numbness and tingling - most doctors will do nerve conduction tests, as well as blood work to rule out diabetes, low b12 etc.

Usually TTS causes very distinct pain in the inner ankle area. Do you have this?

Most people with TTS find the pain increases throughout the day - but I haven't heard any (that I recall) say that the pain is worse at night.

Where did your doctor put the cortisone injection? Did your doctor give you the walking cast to use?

Re: TTS diagnosed - What should I be doing??

J. King on 7/01/02 at 21:14 (088881)

Yeah, I would be careful about the TTS surgery. If they do it right it is o.k. but if they mess if up I think the complications are serious.

Re: TTS diagnosed - What should I be doing??

Barbara E on 7/02/02 at 05:55 (088901)

Wendyn - thanks for your response. In trying to keep my original message short , I wasn't as clear as I could have been. Here is the original info I found that made me sit up and say 'AHA!!'

SYMPTOMS
Tarsal Tunnel Syndrome, or TTS, is rare and only one of many causes for FOOT PAIN and NUMBNESS of the SOLE, of one foot. It is worse in the evening and at night after activity and is aggravated by obesity and any underlying more generalized nerve disorder (polyneuropathy).

SIGNS
Patients have relative numbness on the sole of the affected foot and an electric 'zinger' when the affected nerve, the Posterior Tibial is tapped ('Tinel's Sign') at the affected site - the inside of the ankle just below the bony prominence (medial malleolus).

This is at http://www.idiom.com/~drjohn/tarsal.html

I don't think it is so much that it's worse at night, it's that I notice it most at night since I'm trying to sleep. Right now, I just woke up and it doesn't hurt at all.

Yes, I have that particular pain underneath/behind the inner ankle and sometimes radiating down to the arch. And I have that 'Tingels' sign' (sp?)

I probably will have that nerve test when I go to the neurologist but I've also heard that a fair amount of damage has to have already happened to the nerve before it really registers on the test. I'd like to prevent it getting that bad to start with.

I was very athletic when I was younger (*very* athletic) and have had multiple ankle sprains during my life. I lived with taped-up ankles during my teenage years. I recently took up exercising again to try and get back into shape. I'm 42 years old.

The kicker is that this seems to have occurred in two steps. The first time just involved the ball of the foot and several toes. Just recently it's escalated to the entire bottom of my foot. My left foot is fine, I'm in perfect health - in fact, I'm disgustingly healthy.

I know I have a very mild cast of TTS compared to many of this board and I'd like to heal it now. I have an inkling of what it's like and I'm in awe of the people here who manage to keep going with a more severe case.

By the way, the doctor put the cortisone injected right in the sensitive spot just behind the ankle. That's where it hurt most when pressed (nearly sent me off the table ). I've also had an x-ray of the ankle, the bones, etc. are fine. I had the walking cast prior to this problem.

Re: TTS diagnosed - What should I be doing??

wendyn on 7/02/02 at 07:29 (088905)

Barbara, if your doctor didn't give you the cast for this, I would be reluctant to use it without his consent.

I've read the website you're quoting, I think it's the only one that I ever came across referring to worse pain at night. It's not something I've heard complained of much here.

I was in your 'shoes' about 3 years ago when I was first diagnosed.

The nerve conduction test and an MRI will probably be the next logical steps - as well as all the blood work. The blood work should be done to rule out all kinds of systemic things that could be causing the problem. This is an absolute must - we have had people here who have had surgery, and then found out LATER that there was a problem like diabetes at work.

Re: TTS diagnosed - What should I be doing??

wendyn on 7/02/02 at 08:45 (088911)

Barbara, in the mean time - you may want to consider trying something like Birkenstock sandals. They won't put any pressure on your TT area, and they still provide a lot of support.

Re: TTS diagnosed - What should I be doing??

Barbara E on 7/08/02 at 19:31 (089322)

Wendyn - I just wanted to say thanks for recommending the Birkenstocks. They're hugely popular among teenagers here - my sons each have a couple of pairs. But I never thought of getting any for myself. So I went to a store called 'The Walking Store' - had some knowledgable (sp?) salesmen - and bought some Birkenstocks and some New Balance sneakers. It really makes a difference in how I feel.

The bottom of my foot is still numb but the actual pain is mainly gone. It 'tingles' a lot. Have to call my doctor and find out if he set up that appointment with a neurologist yet - I'm curious as to what they'll say.

Thanks again for your advice.

Re: TTS diagnosed - What should I be doing??

wendyn on 7/08/02 at 20:21 (089323)

BarbaraE - I'm glad to hear that they helped. You may find that as you wear them more - your foot gets better.

I sure hope so!!!!!!