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causes of TTS

Posted by lauriel on 1/20/04 at 11:31 (142448)

My Dr did not seem to have answer on why I developed TTS. There was no obstruction. I went thru the surgery and athen my PT sai I was over pronated ( I knew that) and the I had a very flexible foot with an extreme forfoot varigous (sp)? and to make sure I got orthodics, which I did and were horrible could never wear them.

I got a new prescritpion for new place for orthodics, the person is also also PT that makes orthodics. He thinks that the over pronation along with the flexible foot w/ the forfoot vargous is what cause my TTS. I dont know if this is the case, but Ihave no other explanation on why I developed TTS.


Re: causes of TTS

lara on 1/20/04 at 16:53 (142474)

My impression is most people don't know why - or at least a lot of people don't know why.

Some people have a varicose vein that doesn't show up on an MRI so the only way you know is if surgery is done (which is risky if it turns out you don't have a varicose vein). My podiatrist says this is actually a proportionatly large group of TTS sufferers. It's also my impression from this board, but not from from research, that many TTS sufferers were more active than average - jogging, tennis, whatever. Someone came up with the sloga - lazy people don't get Tarsal Tunnel Syndrome

There are also a few of us that suspect menopause as a contributing factor - again no research. There is some indication that thyroid deficiency may be related too.

I suspect genetics also contribute, but only in that they relate to thyroid problems, varicose veins, etc.

TTS is relatively recently recognized. I looked in a Med School Text book (went to the local Med SChool bookstore) and looked in the 2-in-thick, 9 x 12 textbook on Ankles & feet for those studying to be orthopedic surgeons, and there was about 1 page of information. That was a few years ago - this may have advanced since then, but there is just a lot we don't know.

Re: causes of TTS

Claire on 1/21/04 at 07:13 (142519)

gosh i do hope its not likned to the menopause !! i'm far too young for that ;o). I do find it mind boggling how little is known about TTS, the causes, cures etc. and there is so much conflicting information from different sources etc!

Re: causes of TTS

chrisb on 1/21/04 at 10:42 (142538)

Last month when I was diagnosed with TTS the doctor was interested that I'd broken my ankle a decade ago. That (together with nerve conduction test etc) seemed to contribute to his diagnosis. Apparently when such injuries heal they can thicken the tissue near the tunnel, etc.

There's no clear indication of whether I have an obstruction in the tunnel area. The doc who finally dignosed me is quite well regarded, so I'm trusting the diagnosius.
I'm scheduled for TTS surgery in March.

Re: causes of TTS

lauriel on 1/21/04 at 11:17 (142542)

Chrisb, good luck on your surgery, just be aware healing is a very slow process and dont get discouraged, it can be frustrating at times. It took me almost a year to be 90% and at the six month mark I was about 40%. I didnt have an obstruction

As for my TTS. I think it makes sense with the the PT says about the way my foot is built. I think it was a combo of this and wearing the the wrong type of tennis shoes that caused it. I am a walker, never strenous excercise on my feet. As for menopause, I was 38 when it started, and I am 42 now. I have had my thyriod check because of problems I thought it might be.

Re: causes of TTS

lara on 1/21/04 at 12:36 (142544)

Claire wrote: gosh i do hope its not likned to the menopause !! i'm far too young for that ;

I doubt (she says in an understated way) that's the cause or contributing factor in all cases - after all, there are a lot of guys on the board too : )

Re: causes of TTS

Pam S. on 1/21/04 at 17:01 (142564)

My PT told me today that many PF sufferers also have TTS because of the biomechanics of your foot. For example, I have very flat feet=little arch support. This also causes tendonitis in inside of the ankle area. These inflammed tendons cause little room for nerves in there to be happy. That is my unprofessional take on the whole nightmare!!!

Good luck on the surgery, Chris. Laurie is so right. You have to be very patient with this very slow healing and recovery process. Your chances of success will be much greater that way. Take care. Pam

Re: causes of TTS

wendyn on 1/21/04 at 20:07 (142581)

Interesting lauriel - I too pronate, have a very flexible flat foot, and forefoot varus. Hmmm.

Re: causes of TTS

lauriel on 1/22/04 at 11:01 (142633)

I think there really could be a link here. And I also have recently developed PF ARRGH, if it isnt one thing it id another.
Wendy, thanks for the clarification it is varus, not whatever I said but I am bad at pronunciations and sp.

Re: causes of TTS

marie on 1/22/04 at 16:12 (142656)

My understanding is that these are the basic causes of tts: Genetics (bio-mechanics), poor shoes, standing and walking on cement floors, ankle injuries, vascular problems, varicose veins, tumors, back problems, heavy alcohol use and overweight.

Hope this helps!

best wishes marie

Re: causes of TTS

Pam S. on 1/22/04 at 17:02 (142665)

This TTS thing is so bizarre. My foot burns at the end of the day whether I have been walking alot or not. Excercising or not. I have no mass there. I guess it just stays in an inflammed state. Anyone want to guess why this is and do you have the same thing happening to you? My buring starts about 2 in afternoon. I guess I should be grateful it is not 24/7. Funny what you learn to be grateful for. THX ALL, pam

Re: causes of TTS

ehren on 1/22/04 at 19:40 (142669)

my feet alternate from pain and burning to feeling cold. i have no idea why i have tts, i can only guess genetics and activity and some biomechanical element. i dont have flat feet, but i do have high arches. does anyone know whether high arches are also a contributing factor to tts? i recovered mostly from plantar fascitis, but it graduated to tts.

Re: causes of TTS

marie on 1/22/04 at 19:55 (142672)

I don't have the burning sensations anymore....try massage....in the evening if that's when it hurts more. My feet are cold alot to...they've always been like that. I wonder if circulation was one of the influences in my case. Plus I've never had very flexable feet...just the way I was made...I've had problems with tight muscles and tendonitis all my life. I should have known better! If only I had continued to wear my Earth Shoes!!!!!!LOL.

Re: causes of TTS

lara on 1/22/04 at 21:40 (142680)

I think (from my unscientific observations of myself) that my TTS gets worse the more I 'flex' my foot - the motion that we make when walking that goes from a 90 degree angle to almost 180 degree angle - particularly going to the extended position (as close to 180 degrees as can be managed). The perdothist at the shoe store says this is common - as moving the foot to the extension position narrows the tunnel, increasing the likelihood that the tibial nerve is impinged.

There are many things we do throughout the day that cause our foot to flex/extend besides walking. Maybe your foot is similar and during the day you are making some motion with your foot that aggravates.

That's one hypothesis (my daughter tells me it's not a theory if you don't know whether you think it is true or not - a theory is believed to be true).

Re: causes of TTS

John F on 1/24/04 at 11:26 (142780)

Here goes my story which is unique. A year ago, I went through low back pain treatment to avoid back surgery. This treatment was VAX-D, developed in Canada years ago, approved by FDA in states. I live in Houston, and this
clinic had just opened. I went through 40 treatments, for 40 days. I went from a 9 pain, hunched over, to a 2/3 pain with better gait. But right foot had partial numbness in outer part. Prior to VAX-D, I had had 2 chiros, a pain M.D., had taken Vicodin, Celebrex, Neurotonin, Ibuprofin plus, Tylenol Plus, and found that none of those allopathics helped, but acutally accelerated pain and worse controlled substance, Vicodin, left me w/out being able to drive. All this time, I was also dealing with wife, who had terminal cancer, after 30 year marriage and 17 years breast cancer. I also had anxiety attacks and was on paxil and ativan,including ambien for sleeping. Ultimately after her death in May, 2003, she was no longer suffering. But a few months after her death, I developed Lupus. Went to a naturopath who got me on a supplement, diet regimen and in 2 months I was lupus free. But right foot numbness continued. Naturopath sent me to an ortho, had a mylogram, ortho said, 'Spinal fusion' No way, I could walk, was not in extreme pain, basically right foot numbness. Naturopath sent me to a chiro who is wholistic, body, mind spirit. Been with chiro for 2 months, til end of February. But chiro had NCV/sonogram in addition MRI of foot. Indications now are that I have TT! In addition lupus has just returned. Have restarted regimen for Lupus. Next step, chiro says, is referral to podiatrist. But with all my experiences, I am not convinced that surgery is the best solution to TT, seeing that I am not convinced that Western allopatic is the best, due to my experiences with paid meds, which I will not accede to, already walked that walk. I have an acupuncturist in El Paso who has worked with me. In addition I an an advocate of Mildred Carter's 'Reflexology'. In addition, I am into prayer, mediation, deep breathing to cope and physical fitness, treadmill, pull downs,etc. Grieving is also an issue, that I am coming to grips with. Anyone out there had similar experiences and did not resort to TT surgery and is better because of this? This is a new post for me, and excuse my rambling, but after seeing my wife go through such treatments, chemo, radiaition which ultimately would close up her esophagus, where she would not accede to a feeding tube, but had to have dilations of esophagus, etc. etc. I am determined with assistance from the Lord that I will lead a good quality of life. I just retired as an educator, have a doctorate in education and was a high school counselor at one time in my career, so I am keen on some things, but am walking the walk as anyone else. Thank you for your patience.

Re: causes of TTS

marie on 1/25/04 at 18:56 (142836)

John F,

I am so sorry to hear about your wife....my condolences to you. You have really had a time of it. I did not have surgery. I am doing extremely well. I copied and pasted the things I do and have done that allow me to walk without pain. Always get a second opinion before you go under the knife. TTS isn't the same in every person. Please feel free to ask questions.

best wishes marie

Physical Therapy

Ice (frozen peas work well) for swelling. About 5-10 minutes per ankle. Two-three times a day as needed.

Light stretches......very light.

Medications: Neurontin 300 mg 3x daily, 50 mg elavil

Vitamins that I sware by: MSM, Glucosamine, Vitamin C, Magnesium. Some have had success with vitamin B6 and 12.

Compression socks and mens support socks.

Birkenstock shoes. I am especially fond of Arizona and other soft bed styles.

Progesterone cream on my ankles and knees twice daily.

My hubby massages my meta tarsals, ankles, calves and thighs. At first this was done twice a day. Now I only ask for a massage once or twice a week. NEVER massage the tarsal area vigorously. My PT and I found that out the hard way. It was a major setback.

Some have had success with Ibuprofin creams.

Light non weight bearing exercises.

Distraction from pain. My brother, who has MS, suggested emmersing myself in activities or projects that would take my mind off my feet. It helped me maintain my sanity.
Creating this site has been one of my projects.

Everyone is different. What has helped me may not help you. Please feel free to add what has helped you.

You are in for a fight...toughen up and do what needs to be done to get well.

Re: causes of TTS

lauriel on 1/26/04 at 15:10 (142876)

John, wlecome to the board and I am sorry to hear about your wife. Youmention reflexology. I tried it after my TTS surgery to help with scar tissue and it really helped. another thing I am doing is called footsavers, they are these half round balls you do exercise with, it is a type of reflexology, here is their web site, I would check it out. Also looke at the ball rolling, it has helped my back a great deal
good luck


Re: causes of TTS

John F on 1/26/04 at 23:16 (142916)

Thank you for your response and your experiences. At this point, I was just diagnosed with TTS, even though there was numbness in my right foot a year ago. As it be, I have always walked, but now I find more discomfort, you know the feeling of glass or cactus in my foot. This is why I put out this plea as I am educating myself on ways to treat this conditon. And I would hope to avoid surgery. I do appreciate your concerns, and also recommendation of the Yumana balls. I do believe in reflexolgy and also acupuncture. As one has to do alternative, it may go slow but upon achieving relief, so much the better. You mentioned surgery, how long did it take you for post-op to notice some relief so that you could return to some sort of normalcy? Thank you once again, John

Re: causes of TTS

John F on 1/26/04 at 23:54 (142919)

Marie, thank you for your response. Might I ask a question. How long have you dealt w/TTS? And I applaud you for your gumption and your use of conservative treatment. My TTS was just diagnosed 2 weeks ago. Since then, I have noticed more discomfort. Could this have been psychological, since prior I had no handle on what I really had, just know that for a year, I have had partial numbness of right foot. Then too, I am dealing with re-0ccurance of lupus, where I sought a naturopathic doc here in Houston, where in 2 months time, August-October last year, I was scot free of lupus.
Once again, I will rid of Lupus and following alternatives will also handle TTS. What I am doing now, for TTS is meditation, also helps w/anxiety as I am on meds for that, which I am weaning off. Also, prayer, reflexolgy(self done), deep breathing (body scan); relaxing and religious music, singing, veggie, no red meat diet, where I have lost 10 pounds in recent months, am improving posture as I have had bad posture all my life.
So stretches, treadmill, pull downs, and stationary bike, @ 24/hour fitness, just started. Do foot spa before bed.Also keep a journal of my peaks and valleys, where I will also talk to my late wife. Also lean on the Lord, joined an interdominational singles group,where we started 12 week course on Song of Solomon. Have also had acupuncture which helps. As it be, I cannot handle allopathic pain meds, and rely mostly on chamollie tea and green tea.Thank you for your support and any other things you might share that would help me. John