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

Considering Tarsal tunnel surgery

Posted by Kristen W. on 6/25/03 at 18:45 (122944)

I have been suffering from chronic foot pain since May 1998 and was diagnosed with PF. After years of consevative treatment and several Doctors who had given up on me I have found a doctor that has been fabulous and has never given up on me. We both agreed that I don't have PF simply by my description of pain...pain all along the bottom of my feet, tired ankles, burning, feels like my feet can't bear the weight of my body and the pain is worsened throughout the day as I stand and walk. My doctor now believes it could be TTS. Unfortunately, he made this discovery when I was 5 months pregnant. So we have not been able to proceed with any tests or treatments to confirm this diagnosis. I am now 7 months pregnant carrying 30 extra pounds and without my medication! I am strongly considering surgery for TT am thinking I would do it when my baby is around 4 months of age. The pain is unbearable and simple things I'd hope to do with my baby are going to be miserable because of my feet! I am just very cautious of the recovery and being able to keep up with a 4 month old as he/she becomes more active throughout my recovery. I look at the recovery being a full year in length, but is it possible with a little one? I plan on having more children and want to be the active person I used to be. I feel this would be the time for surgery, it is only going to get more hectic around my household! Any thoughts?

Re: Considering Tarsal tunnel surgery

Sharon W on 6/25/03 at 21:01 (122952)

Kristen,

The truth is, it will probably be very difficult going through TTS surgery with a little one to care for. But, if your doctor confirms this with the appropariate tests, and you've already had the conservative treatments, and you choose surgery -- well, I think I'd rather have an INFANT to take care of when I'd recently had TTS surgery, than a one year old...

Sharon
:-s

Re: Considering Tarsal tunnel surgery

BrianG on 6/25/03 at 22:08 (122962)

Hi Kristen,

I hope you realize that not all TTS operations are success's. On this board, we seem to have many more failures. Go back and take a look, or use the search feature. Has your doctor talked to you about what will happen if the operation goes bad? Anything can happen when the nerves are operated on. Believe it or not, you could end up much worse than you are now.

Please do some research, and try to get a couple more opinions. You may find there is someone in your area that is much more qualafied than your new doctor. I don't want to scare you, just want to let you know there can be a down side to any surgery.

Good luck,
BrianG

PS: Do a little reading on RSD, it can be a complication from the TTS surgery.

Re: Considering Tarsal tunnel surgery

Linda on 6/26/03 at 06:37 (122973)

I would never consider having Tarsal Tunnel Surgery. I had it done in both feet,and with me it failed. The pain is worse now than before i had the surgery. I am still in phyiscal therapy,which has been constant since 2001. I wish i had chosen E.S.W.T.,and you should ask your doctor if this is a good option instead? I would try all nonsurgical attempts to cure your foot pain. The surgery is painful,and you won't be able to keep up with kiddies.

Re: Considering Tarsal tunnel surgery

john K on 6/26/03 at 19:56 (123028)

Consider dropping as much weight as possible before TTS surgery. I think the success rate is quite low and it is painful.

John King

Re: Considering Tarsal tunnel surgery

Steve M. on 6/26/03 at 23:07 (123039)

I was diagnosed with TTS after having a EMG in May.

I've had a numb foot for 5 months. I did anti-inflammatory medication for weeks, no results. Had a cortisone shot that did not have any results at all. Had ultrasound treatment that did not work after 3-weeks in the TTS area.

I've scheduled surgery for the end of July. I'm told I'll be doing nothing for 4-5 days except the bathroom. Then it's crutches for 3-4 weeks, then therapy, is this the wrong thing to do?...Steve

Re: Considering Tarsal tunnel surgery

Linda on 6/27/03 at 05:59 (123045)

I WOULDN'T DO IT! I AM ONE OF THE PEOPLE THE SURGERY WAS THE WRONG THING TO DO. MY PAIN IS WORSE NOW THAN BEFORE THE SURGERY. IF I DIDN'T HAVE THE SURGERY, THE NEW PODIATRIST I AM SEEING SAID HE WOULD HAVE HAD E.S.W.T. DONE. YOU SHOULD TALK TO YOUR DOCTOR AND SEE IF THAT IS AN OPTION.
GOOD LUCK IN WHATEVER YOU CHOOSE,
LINDA

Re: For Steve M

Sharon W on 6/27/03 at 08:57 (123056)

Steve M,

I disagree with Linda -- but of course, I had a different result from my TTS surgery than she did! For me, it took away about 80% of my pain... and while that isn't an OUTSTANDING success, it sure beats the way things were BEFORE my surgery!!

It IS a very risky surgery, though; there are various percentages listed in the research literature for success, ranging from a 42% success rate to 94%... and I DON'T believe the 94!! Many people are no better after the surgery -- and a FEW, perhaps 15%, feel much WORSE after it. Judging by keeping track for 9 months of surgeries that patients had AFTER they first posted on these boards, and then went came back to report their results, the success rate seems to be about 50%. (But maybe people are more likely to come back and post their results, if it was NOT successful... I don't know.)

If I were you, I wouldn't RULE OUT surgery, but I would make sure I'd had all the 'conservative' treatments first (do you have orthotics, have they ever tried putting you in a cast?) and I would make sure I'd had all the appropriate TESTS to make absolutely sure that TTS is really what you have. Because if you DON'T really have TTS, if it is actulally something else, TTS surgery certainly won't help you and it might make you worse.

Sharon
.

Re: Considering Tarsal tunnel surgery

Carol D on 6/27/03 at 09:27 (123058)

My understanding is that the outcome of TTs surgery can be quite high if there has been a finding of an obstruction. I struggled with pain for a year. I did all of the conservative measures. I had many tests that were negative, finally an MRI showed a tumor in the TTS area. I am 3 weeks post-op and doing well. I think the key is to have a really good MD and to be certain that your condition is one that has a high liklihood of responding. I chose a foot and ankle orthopod who had written medically on problems of nerve compression in the foot. Don't give up hope!!!

Re: Considering Tarsal tunnel surgery

Kristen W. on 6/27/03 at 10:04 (123062)

I did not go into the details of my long foot pain history but have tried all the conservative methods of treatment...many of them more than once! I have custom orthodics, I have had cortisone (too many times!) I have been through numerous PT courses, I have worn night splints, I do daily ice baths and give myself daily ultrasound treatments, I have seen I message therapist regularly and have tried my foot was in a non-weight bearing cast for 9 weeks, I have had E.S.W.T. 3 times with no results I spent a month at Northwestern's pain clinic, have taken anti-inflamatories and an EMG. I am sure there is more methods I am forgetting. I have been working conservatively for 5 years on my pain and have been with my current doctor for 3 of those years. I do aggree that I need more test to confirm the TTS for example an MRI and a 3 phase bone scan to begin, but I have to wait until I deliver my baby before doing that. What I am gathering is that better outcomes are found when there is a known cause for the TTS. I am most concerned about my ability to recover with a new baby if I decide surgery is the way to go. Thanks for all the replies!

Re: Considering Tarsal tunnel surgery

Marty on 6/27/03 at 13:58 (123076)

Kristen,

It sounds as if you have suffered and gone through allot. Only you can make the decision .... but I'm 4 months post op and still in worse shape then I was before. I do believe that I will recover but plan on more time then the doctor tells you. Also you may want to confirm the finding with other doctors. I went to 3 pods, a foot and ankle orthopedic surgeon and 2 neurologists. I suffered for 7 years and still suffer. But there comes a time when one will to take the risk. If the tests come back positive, emg, nvc etc then I would have it done while you have a small baby. Plan on 3 months to get a bit mobile.

I wish you luck

Re: Considering Tarsal tunnel surgery

BrianG on 6/29/03 at 21:30 (123165)

Hi Kristen,

May I ask what treatment you received at Northwestern's Pain Clinic? I noticed you mentioned anti-inflamatories, but did they try anything else? After the baby is born, you may want to start on very small doses of pain meds, and work you way up to stronger meds, as time allows. You can buy youself some time this way, so you can have the surgery at a later date, if thats what you still want.

Good luck,
BrianG

Re: Considering Tarsal tunnel surgery

Kristen W. on 6/30/03 at 10:47 (123198)

Actually, one of the main purposes of Northwesterns Pain Clinic is to help people get off their medications and deal with the pain in other ways such as biofeedback, PT, a stress management class, support group. This was not the best program for me b/c I was not on any major pain medication or narcotic for pain unlike many of the people in the program. They did try topical creams and Lidoderm patches with me. The program did run other test on me to help define my diagnosis, which at that time was plantar fascitis. Of course, they could not find anything to support PF so they released my with subcutaneous nerve pain.
Because I plan to nurse I do not know if medication is an option. I have an appointment next week with a pediatrician to see what my options are as far as medication, nursing and how it might affect my baby. I have already been without medication for 2 months and am very limited. If I have to continue staying off for a couple months after the baby is born before I go through with surgery I can do it....if I know it is best for my child and there is a possible end to my pain soon!

Re: Considering Tarsal tunnel surgery

chris on 6/30/03 at 14:29 (123213)

hi! Just wanted to let you know that I did have sucessful pf/tts surgery. Still pain free since Nov '00.

You have and will receive more great information from the folks on this board.

Hope you have a healthly pregnancy and baby!

Re: Considering Tarsal tunnel surgery

BrianG on 6/30/03 at 19:48 (123254)

Hi Kristen,

I went to Northwestern's home page, to read a little about their pain management progam. What you said, was just about exactlly what I read. Did you happen to see Dr. Mark Gordon, at Sister Kenny's Rehab?

I have personally tried just about everything they offer. The one treatment they did not mention was opiates, which you alluded to. If thats the case, it would seem to me that their program is incomplete. Many, many people have no choice but to take daily opiates to manage their pain. I did drop them an e-mail, to see what they offered.

Good luck with the baby, and the healing / pain control.
BrianG

Re: Considering Tarsal tunnel surgery

Kristen W. on 6/30/03 at 23:55 (123279)

Chris-
It is so good to hear from someone with a positive result! I know these sights tend to attract those still struggling, but it is good to know that there are people out there with success stories.
Thanks!

Re: Considering Tarsal tunnel surgery

chris on 7/01/03 at 07:42 (123287)

I actually found this website after my surgery. I like to read the posts and offer whatever info I can. Before the surgery I was in so much pain that I would have prefered to have had my foot cut off than suffer any longer.

Re: Update

BrianG on 7/01/03 at 17:39 (123368)

Hi Kristen,

Just an update. They did answer my e-mail, and confirmed what you said about helping to wean patients off opiates so they could try other methods of pain control. He (Tom Kern) did mention that if a patient needed opiates long term, they referred them to MAPS 800-775-7246, or United Pain Center, 651-220-7246.

Good luck
BrianG