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plantar fascitis as a causal factor in tarsal tunnel?

Posted by Margie B on 6/04/03 at 08:37 (120871)

In August 2001 I was diagnosed with PF in my L foot. I've been through orthotics, taping, physical therapy,cortisone injections,anti-inflammatories, Ossatron, (twice!)acupuncture etc.
Symptoms in right foot minimal. I work on cement floors, (20 years) in a standing job. Pain persisted especially in lateral area of heel when walking and standing and symptoms of burning,throbbing,prickling,have been getting worse especially at night.Doctors concluded the PF is work related. About April, 03, I noticed less heel pain and more pain near my ankle and much more burning, prickling pain in both feet. At night the burning kept me from sleepng. The specialist I was sent to in April says the diagnosis is Tarsal Tunnel with possible some pf in left and right foot. I had a pos. Tinel's sign. My podiatrist isn't sure it's TTS and wants another EMG.(A year ago it was negative) My question, finally!,is:
Could unresolved plantar fasciitis from continuing to work full time on cement floors have contributed to the development of Tarsal Tunnel Syndrome? Can the inflammation of PF cause the pressure on the Tibial nerve and related branches to create TTS? Please advise. Thank you,
Margie

Re: plantar fascitis as a causal factor in tarsal tunnel?

Ed Davis, DPM on 6/04/03 at 14:46 (120942)

Margie:

Excellent question! I am convinced that the chronic inflammation in the area can cause medial calcaneal nerve (a branch off the post. tibial nerve that goes to the heel) entrapment -- I have no proof though.

Another thing to consider is that TTS can have a very insidious course and can, at times, mimick PF. Cases of PF that are intractable and have not responded to conventional treatment should reaise the level of suspition that another cause exists. Most electromyographers are not able to measure entrapment of the medial calcaneal nerves.
Ed