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Does this sound like Tarsal Tunnel...Help Please!!!

Posted by Todd W. on 6/15/04 at 18:10 (153127)

Hello,
I have had heel pain for a while now and was thinking maybe I have TTS instead of PF. My heels do hurt in the morning, but don't get better as the day goes on. The more I stand or walk at work the more they hurt. I did the ankle tap test and it did send a shock all the way to my big toe(atleast in the left foot, not for sure on the right)
Some more background, I have had pain in my right since Mar. 2003, left Feb. 2004. I had ESWT done March 24th this year. Right fascia was 5.0 left 5.6. I don't know if that means I have PF or not. ESWT doesn't seem like its helped, I feel about the same. Actually, things are worse in my right forefoot ever since I had the ESWT, it swelled up and is painful and red, getting a nerve block done Tue. to check for RSD :( (ESWT must of triggered it) Maybe, if I have TTS nerve block will take that pain away. Anyway, that's another problem.
I was wondering if any of you thought my heel pain sounds like TTS. I have done all conservative methods for PF..ice, stretch, $350 orthotics, pray, only thing that helps is sitting or laying down. Also, is the only way to tell for sure with NCT?? Thanks in advance.
Todd W.

Re: Does this sound like Tarsal Tunnel...Help Please!!!

Ann L on 6/15/04 at 18:23 (153129)

Todd,

You could have both TTS and PF at the same time - I did/do - had surgery 02/04, results still pending. (In the meantime, I'm in physical therapy). I had the same problems - first thing in the morning heel pain, severe - which slightly improved after walking, but worsened the more I was on my feet. Had definite positive Tinel's sign (ankle tap test.)

Nerve conduction testing is the only sure method I've heard of to prove TTS. If it is positive, then you definitely have it, but if it is negative, you might still have it. In mild or in early cases, you can have a false negative.

Ann

Re: Does this sound like Tarsal Tunnel...Help Please!!!

Todd W. on 6/15/04 at 18:37 (153130)

Ann,
Thanks for responding I really appreciate it, I think I do have it, but have that other problem right now, which I 'm trying to fix...anyway, what did you have done to treat yourself for TTS? My heels just hurt all day and I'm getting sick of it. If it was PF I think it would get better as the day goes along. Did any creams or anything conservative work for you or help a little.
Thanks
Todd

Re: Does this sound like Tarsal Tunnel...Help Please!!!

dud on 6/16/04 at 10:25 (153167)

Todd..

Your symptoms sound a lot like mine. I was diagnosed with PF in both feet in 11/2002. My Pod tried all the conservative measures (orthotics, anti-inflammatories, ice, stretching, etc) and nothing seemed to work. Like yours..my heels hurt all day long and are only better when I am lying down or sitting with no pressure on my feet. In fact..the orthotics seem to make them worse!!

He did an ultrasound in 03/2004 and my fascia on both feet measured 2 to 3X more than normal. He also did a nerve conduction test and was negative for Tarsal Tunnel.

I had ESWT done on my right foot on 06/02/04.. The heel pain seems to be better..however I too developed the 'pins and needles' sensation in my right foot. When I tap on my ankle, it sends shock waves down to my big toe. I saw the doctor yesterday and he thought it was inflamed from the foot block he gave me. He said if it isn't better in a couple of weeks..to call him. I too fear that I now have TTS.

My left foot continues to hurt and I am now reluctant to have the ESWT done on it. The heel burns all day long and only feels better after icing it and lying down. My doctor told me that because the fascia measured so thick..I definetly had PF and the ESWT should help. He is now making me some different orthotics and I too will continue to pray.
Hope you get better..

Re: Does this sound like Tarsal Tunnel...Help Please!!!

Ann L on 6/17/04 at 12:33 (153296)

Todd,

Before I had surgery - TTS and partial PF release on both feet, plus neuroma excision on my left, bunion repair on my right - I tried many different things with limited success. All I was able to do was extend the time before surgery and probably in doing so, I made things worse - not that I'm saying to jump into surgery! But, circumstances in my family required that I wait - too many patients in the family at one time.

Before my official diagnosis of TTS, I was diagnosed with PF. I tried anti-inflammatories (couldn't tolerate any that I tried, over the counter and prescription - either tore up my stomach or made my ankles swell - yea!) I took a month off work to see if rest would help, icing, elevation. I tried orthotics, ankle braces - with laces from top to bottom and criss-crossing straps around ankle and under arch. I started Elavil and later Paxil for Fibromyalgia (my podiatrist sent me to a rheumatologist because he felt I had something systemic), and they help with nerve pain. I also started on Neurontin and Ultracet, which made things a little more bearable, but still left with a significant level of pain.

I did not try any creams and I did not try cortisone injections - some say they help temporarily, but both my podiatrist and my surgeon do not do cortisone injections for PF or TTS. There is a risk of tendon/ligament rupture with injections and they felt that the risk outwayed what limited benefit they could provide.

Ann

Re: Does this sound like Tarsal Tunnel...Help Please!!!

Todd W. on 6/17/04 at 14:40 (153310)

HI Ann,
So what helped you the most with TTS? I hope you will feel pain free very soon.
Get Well
Todd

Re: Does this sound like Tarsal Tunnel...Help Please!!!

Marty in SLC on 6/17/04 at 22:21 (153352)

Ann,

How are you doing now? I too have both TTS and partial pf release 16 months ago. Still getting better a bit each month.

Re: Does this sound like Tarsal Tunnel...Help Please!!!

Marty in SLC on 6/17/04 at 22:27 (153354)

It sure sounds like you have TTS to me but I'm not a doctor. If you had a positive taping test then I would for sure get a nerve condition test done, if that comes back positive then I would try and find the best specialist to do surgery, but get a second oppion before you do. Most here will concur, not all but most that conservative treatments don't help with tts, I might here about the last statement. LOL


I have suffered for over 7 years and am just now doing what I should of done 6 years ago. But take some time to get a concrete assurance that it indeed is TTS.

Good luck keep the board posted on what you find out.

Marty

Re: Does this sound like Tarsal Tunnel...Help Please!!!

Ann L on 6/18/04 at 12:47 (153415)

Todd,

I had very limited success with conservative treatment. The medications - a combination of Neurontin, Ultracet, Elavil, and Paxil - did offer some relief, but still had pain. The braces helped some while working. I still hurt considerably after 8 hours on my feet, but it was even worse without the braces. The month I took off early in my treatment did help until I went back to work. The difficulty I had in controlling my pain and the limitations it was placing on my life - I did my Christmas shopping this past Christmas in a wheelchair - I opted for surgery.

Ann

Re: Does this sound like Tarsal Tunnel...Help Please!!!

Ann L on 6/18/04 at 12:56 (153416)

Marty,

Right now, it is kind of hard to say how I am doing. I am in physical therapy, trying to strengthen the muscles in my feet and ankles. They are still weak enough to leave me with poor balance. It is improving, but the exercises leave me with very sore muscles, and that is part of what I'm dealing with now. And since the latest changes in therapy - my latest bump up on the level of exercise - I have noticed a return of the burning pain of TTS. If I could tolerate an anti-inflammatory, it would probably give me some pain relief, but I just can't tolerate them - stomach problems or swollen ankles. I went to see my podiatrist today - he has been managing my meds instead of the surgeon. He put me back on Ultracet for the pain - been off it since about 1 month post-op (surgery on Feb 16, 2004) and decided to try Topamax instead of Neurontin. It will be a week or so before I will be built up enough to see if I get any relief. I will try to let you know how it goes.

Good luck and best hopes in your recovery.

Ann

Re: Does this sound like Tarsal Tunnel...Help Please!!!

LARA on 6/18/04 at 15:46 (153424)

-- Most here will concur, not all but most that conservative treatments don't help with tts, I might here about the last statement. LOL

You must be a psychic. I might agree that most conservative treatments haven't helped people on this board, although my impression is that most of the people on this board have been helped by conservative treatments - or at least treatments short of surgery. However, I think most people with TTS are benefitted by conservative treatments - and then they don't come to this board but move on with life.

It's also my understanding, from remembering a post by Sharon which was not contradicted by the doctors, that most people are helped (which is not the same as cured) by surgery. ARound 70% - after a long recuperation period. If there is an identifiable mass that can be removed chances go up. About 20% are no worse off - after the recuperation period. About 10% are worse. Those kinds of odds have many of us choosing varying levels of treatments short of surgery.

Re: Does this sound like Tarsal Tunnel...Help Please!!!

LARA on 6/18/04 at 15:49 (153425)

--what did you have done to treat yourself for TTS

After orthotics & PT didn't do much, and ibuprofen blew my stomach, I was given compression socks and they were magic for me.

Re: Does this sound like Tarsal Tunnel...Help Please!!!

Todd W. on 6/18/04 at 16:34 (153435)

Hi Lara,
Just curious what do the compression socks do for TTS? Thanks
Todd

Re: Does this sound like Tarsal Tunnel...Help Please!!!

LARA on 6/18/04 at 17:25 (153437)

BEst guess is they work on the principles of hydrolics. It's fairly certain they are helpful when TTS is caused by a varicose vein (which you may or may not know about before surgery). I don't think I have a varicose vein - just a small tarsal tunnel - so maybe it just helps the blood move on up somehow.

Re: Does this sound like Tarsal Tunnel...Help Please!!!

Marty in SLC on 6/18/04 at 21:44 (153469)

You may be right Lara I may be mistaken but it seems to me Dr Z has stated that most conservative treatments don't work for TTS. Not sure about that though. However I'm sure you've seen the new buzz about Dr Sandel and how he has treated TTS patients so maybe we will get to see first hand here and I bit if there someone one this board with tts that goes to him. I'm really hopping so.

Marty