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Tarsal Tunnel Syndrome

Posted by James H on 10/23/02 at 01:55 (098124)

After going to the foot doc for 10 months and induring injections of cortisone
he was a his wits end sent me to doctor for a nerve conduction velocity test.
Guess what? He said I have TTS. Why did'nt the MRI show that I had this condition? I have been induring this problem now for 10 months. First It started with the right foot then a month latter went to the left foot.
I ask is surgery the answer to my problem? I hope it gets better before it gets worse. I'm waiting for it all to go away....

Re: Tarsal Tunnel Syndrome

Sharon W on 10/23/02 at 08:20 (098129)

James,

Surgery should not be your first choice of treatment for tarsal tunnel syndrome; the tarsal tunnel release is very risky (success rate is probably only about 70%, although research studies reveal results as low as 42% and as high as 94%). And if the surgery is NOT successful, you can end up in more pain than you started out with!

Available 'conservative treatments' (that is, ones that don't involve surgery) include rest, anti-inflammatory medications, taping, orthotics, ice, contrast baths, night splints, physical therapy, physical therapy treatments such as iontophoresis and ultrasound, compression socks to reduce swelling, ibuprofen cream or other topical drugs to rub on the inner ankle for pain reduction, using a cast for a few weeks to immobilize your foot and ankle, a pharmaceutical drug called Neurontin, a painkiller called Ultram for episodes of severe pain, Elavil or some other pain reducing antidepressant to take at night, Ambien to help you sleep if the pain is making that impossible, foot block and/or steroid injections into the tarsal tunnel area, ART (a massage technique), other massage techniques, accupuncture, 'nutritional supplements,' etc.

But RIGHT NOW, if you are not already doing this, I suggest the following method to help control swelling and pain. Wear a thick sock, and put a bag of frozen peas over the INSIDE of your ankle, being sure that it covers the inside of your heel and touches your arch. Leave the frozen peas there for 20 minutes, then take it off and put it back in the freezer. You can do it again after another 40 minutes, if you want to. (You can use them for up to 20 minutes out of every hour, if needed.) Frozen peas are ROUND; they don't have sharp edges to poke the tender spots like crushed ice does. They don't leak like bags of ice can, either, and because they're round, peas will actually mold themselves to fit the shape of your foot -- so the ice touches all the places where you need it. (This really WILL help your tarsal tunnel syndrome to feel better.)

You might want to take a look at Steve's web site. A link for it is listed at the top of the main tarsal tunnel syndrome message board page.

Sharon

Re: Why didn't the MRI show that you had TTS?

Sharon W on 10/23/02 at 11:46 (098145)

James,

Just one more comment: an MRI really isn't very good at diagnosing tarsal tunnel syndrome (TTS) most of the time. In fact, about the only time an MRI will show TTS is when you actually have a THING (a cyst, a large deposit of scar tissue, a lipoma, a large varicose vein, etc.) inside your tarsal tunnel that needs to be taken out.

However, the fact that you have already HAD an MRI and that nothing like that was found, will be interesting information for whatever doctor ends up treating your TTS, especially if he/she is considering surgery as an eventual possibility.

Sharon

Re: Why didn't the MRI show that you had TTS?

James H on 10/24/02 at 02:49 (098199)

Thanks Sharon for the info: I think I must be in the first stages of TTC because all I have is numbness in the soles of both feet. If I twitch my toes together I get a tingling feeling. I have trouble standing for long periods of time. Why would I want to put ice or frozen pea's around by ankle and arch if I have no pain there?

Sharon I am one of the luckly ones and do not have severe pain with my TTC. I am hoping that my condition improves over time. I can tell that you have done your researched TTC. And I hope to do the same in the near future.
Thanks for your help Jim H..........

Re: Why didn't the MRI show that you had TTS?

Sharon W on 10/24/02 at 08:08 (098212)

Steve,

As part of that research, I suggest looking at Steve's website, as I mentioned before (link at the top of the page) and at Wendy's FAQ.

I'm glad you have no ankle swelling or major pain. Good luck to you!

Sharon

Re: Tarsal Tunnel Syndrome

Ginger L on 10/26/02 at 21:20 (098413)

THe pain in my ankle is on the OUTSIDE of the ankle and the calf all the way up my leg at times. COuld this still be TTS?

Re: Tarsal Tunnel Syndrome

Ginger L on 10/26/02 at 21:20 (098414)

The pain in my ankle is on the OUTSIDE of the ankle and the calf all the way up my leg at times. Could this still be TTS?

Re: Why didn't the MRI show that you had TTS?

Des L. on 10/27/02 at 13:10 (098433)

James H. & Sharon W. -- Does TTS have different degrees and places of pain and numbness/tingling or electric shocks? Mine began with pain in heel and arches (sometimes shooting pains also) and then progressed to the ball of my foot and toes. My feet always 'feel' swollen with numbness and pain at the same time. There is no pain in my ankles as James mentioned.

I have had TTS confirmed with NCV/EMG tests by a neurologist. The Podiatrist also thinks I have plantar fasciitis. Any comments to help would be appreciated.

Re: Why didn't the MRI show that you had TTS?

Sharon W on 10/27/02 at 23:19 (098466)

Des,

Yes, the symptoms you described can be related to TTS and plantar faceitis (PF). Pain (and sometimes swelling) at the inside of the ankle is also common with TTS but not everyone with TTS has it. Numbness is very typical of TTS. Pain, numbness, etc. with these conditions often seems to move around, and most people have 'bad days' and 'good days,' as well.

Please read 'The Heel Pain Book' on this website for PF. And as I mentioned before, both Wendy's FAQ and Steve's website are good sources of information about TTS. There are links for both of them conveniently located at the top of the Tarsal Tunnel Syndrome board.

Sharon

Re: Why didn't the MRI show that you had TTS?

James H on 10/29/02 at 23:09 (098637)

Des: For me the degree of numbness/tingling increases if I am on my feet for a long time. But my numbness has alway's stayed around by sole and or toe area. I have no real pain but do take an occasional ibuprofen. The food doc had given me a cast of my feet for orthotics and I just threw them away. I just had a custom set of orthotics made for me. And boy is there a big inprovement. My problem is move complex because I have a bulging disc on L5 in my back from a fall in Jan 2001. The MRI show compression of both L5 nerve roots. I do not know if this is having an effect on my feet. My neurologist
nerve test show no relation but indicated that it might be a low level possibility, that is low enough that is insturments could not sense a reading.
Thanks Jim

Re: Why didn't the MRI show that you had TTS?

Des L. on 11/05/02 at 22:32 (099473)

James: Thanks for replying. That was interesting information. Helps to hear another's story. Hope you will improve each day.

Sharon: I'll be working on your good suggestions. Thanks.

Re: Tarsal Tunnel Syndrome

Sharon W on 10/23/02 at 08:20 (098129)

James,

Surgery should not be your first choice of treatment for tarsal tunnel syndrome; the tarsal tunnel release is very risky (success rate is probably only about 70%, although research studies reveal results as low as 42% and as high as 94%). And if the surgery is NOT successful, you can end up in more pain than you started out with!

Available 'conservative treatments' (that is, ones that don't involve surgery) include rest, anti-inflammatory medications, taping, orthotics, ice, contrast baths, night splints, physical therapy, physical therapy treatments such as iontophoresis and ultrasound, compression socks to reduce swelling, ibuprofen cream or other topical drugs to rub on the inner ankle for pain reduction, using a cast for a few weeks to immobilize your foot and ankle, a pharmaceutical drug called Neurontin, a painkiller called Ultram for episodes of severe pain, Elavil or some other pain reducing antidepressant to take at night, Ambien to help you sleep if the pain is making that impossible, foot block and/or steroid injections into the tarsal tunnel area, ART (a massage technique), other massage techniques, accupuncture, 'nutritional supplements,' etc.

But RIGHT NOW, if you are not already doing this, I suggest the following method to help control swelling and pain. Wear a thick sock, and put a bag of frozen peas over the INSIDE of your ankle, being sure that it covers the inside of your heel and touches your arch. Leave the frozen peas there for 20 minutes, then take it off and put it back in the freezer. You can do it again after another 40 minutes, if you want to. (You can use them for up to 20 minutes out of every hour, if needed.) Frozen peas are ROUND; they don't have sharp edges to poke the tender spots like crushed ice does. They don't leak like bags of ice can, either, and because they're round, peas will actually mold themselves to fit the shape of your foot -- so the ice touches all the places where you need it. (This really WILL help your tarsal tunnel syndrome to feel better.)

You might want to take a look at Steve's web site. A link for it is listed at the top of the main tarsal tunnel syndrome message board page.

Sharon

Re: Why didn't the MRI show that you had TTS?

Sharon W on 10/23/02 at 11:46 (098145)

James,

Just one more comment: an MRI really isn't very good at diagnosing tarsal tunnel syndrome (TTS) most of the time. In fact, about the only time an MRI will show TTS is when you actually have a THING (a cyst, a large deposit of scar tissue, a lipoma, a large varicose vein, etc.) inside your tarsal tunnel that needs to be taken out.

However, the fact that you have already HAD an MRI and that nothing like that was found, will be interesting information for whatever doctor ends up treating your TTS, especially if he/she is considering surgery as an eventual possibility.

Sharon

Re: Why didn't the MRI show that you had TTS?

James H on 10/24/02 at 02:49 (098199)

Thanks Sharon for the info: I think I must be in the first stages of TTC because all I have is numbness in the soles of both feet. If I twitch my toes together I get a tingling feeling. I have trouble standing for long periods of time. Why would I want to put ice or frozen pea's around by ankle and arch if I have no pain there?

Sharon I am one of the luckly ones and do not have severe pain with my TTC. I am hoping that my condition improves over time. I can tell that you have done your researched TTC. And I hope to do the same in the near future.
Thanks for your help Jim H..........

Re: Why didn't the MRI show that you had TTS?

Sharon W on 10/24/02 at 08:08 (098212)

Steve,

As part of that research, I suggest looking at Steve's website, as I mentioned before (link at the top of the page) and at Wendy's FAQ.

I'm glad you have no ankle swelling or major pain. Good luck to you!

Sharon

Re: Tarsal Tunnel Syndrome

Ginger L on 10/26/02 at 21:20 (098413)

THe pain in my ankle is on the OUTSIDE of the ankle and the calf all the way up my leg at times. COuld this still be TTS?

Re: Tarsal Tunnel Syndrome

Ginger L on 10/26/02 at 21:20 (098414)

The pain in my ankle is on the OUTSIDE of the ankle and the calf all the way up my leg at times. Could this still be TTS?

Re: Why didn't the MRI show that you had TTS?

Des L. on 10/27/02 at 13:10 (098433)

James H. & Sharon W. -- Does TTS have different degrees and places of pain and numbness/tingling or electric shocks? Mine began with pain in heel and arches (sometimes shooting pains also) and then progressed to the ball of my foot and toes. My feet always 'feel' swollen with numbness and pain at the same time. There is no pain in my ankles as James mentioned.

I have had TTS confirmed with NCV/EMG tests by a neurologist. The Podiatrist also thinks I have plantar fasciitis. Any comments to help would be appreciated.

Re: Why didn't the MRI show that you had TTS?

Sharon W on 10/27/02 at 23:19 (098466)

Des,

Yes, the symptoms you described can be related to TTS and plantar faceitis (PF). Pain (and sometimes swelling) at the inside of the ankle is also common with TTS but not everyone with TTS has it. Numbness is very typical of TTS. Pain, numbness, etc. with these conditions often seems to move around, and most people have 'bad days' and 'good days,' as well.

Please read 'The Heel Pain Book' on this website for PF. And as I mentioned before, both Wendy's FAQ and Steve's website are good sources of information about TTS. There are links for both of them conveniently located at the top of the Tarsal Tunnel Syndrome board.

Sharon

Re: Why didn't the MRI show that you had TTS?

James H on 10/29/02 at 23:09 (098637)

Des: For me the degree of numbness/tingling increases if I am on my feet for a long time. But my numbness has alway's stayed around by sole and or toe area. I have no real pain but do take an occasional ibuprofen. The food doc had given me a cast of my feet for orthotics and I just threw them away. I just had a custom set of orthotics made for me. And boy is there a big inprovement. My problem is move complex because I have a bulging disc on L5 in my back from a fall in Jan 2001. The MRI show compression of both L5 nerve roots. I do not know if this is having an effect on my feet. My neurologist
nerve test show no relation but indicated that it might be a low level possibility, that is low enough that is insturments could not sense a reading.
Thanks Jim

Re: Why didn't the MRI show that you had TTS?

Des L. on 11/05/02 at 22:32 (099473)

James: Thanks for replying. That was interesting information. Helps to hear another's story. Hope you will improve each day.

Sharon: I'll be working on your good suggestions. Thanks.