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Tarsal Tunnel Syndrome and Heel Pain

Posted by heatherj on 8/12/04 at 23:32 (157739)

I was diagnosed with Tarsal Tunnel Syndrome four months ago. My podatrist ordered nerve conduction studies to confirm his diagnosis. He also did xrays of my foot which showed a huge heel spur on the bottom of my foot. I was given some removeable orthotics which only made the pain worse causing cramps in both legs. I received a local injection of cortisone which did provide some relief for about a month. Is it possible to have plantar fascia and tarsal tunnel syndrome at the same time? I am in a lot of pain which is made worse when walking or standing. I was told to take over the counter Advil for the pain and inflamation. It hasn't even touched the pain and I am not sleeping over a few hours at night because of this. I elevate my feet whenever possible and try to ice them at least twice daily since that provides temporary relief. Is there any type of foot exercise I can do to relieve whatever is wrong with my foot--should I see a physical therapist? I used to be a fairly active person and this has been extremely hard to adjust to. Any suggestions would be greatly appreciated. I am seeking a second opinion/help from another podatrist within the next few weeks--what questions should I ask him? Thanks for your help--I really appreciate it.

Re: Tarsal Tunnel Syndrome and Heel Pain

Ed Davis, DPM on 8/13/04 at 14:34 (157764)

heather:
Calf cramps are usually caused by othotics when they are dipsensed to a patient who has inadequate ankle upward motion (dorsiflexion) so have the new doc check that. Also, you did not mention any specific plan for treatment of the TTS -- what did the first doc suggest? Was the cortisone injected around the plantar fascia/heel spur or into the tarsal tunnel?
Ed

Re: Tarsal Tunnel Syndrome and Heel Pain

Suzy Q on 8/13/04 at 18:56 (157790)

I have also been dxed with sensory peripheral neuropathy. The cortisone injections were done in both TTS area and PF area under the arch..6 in all. Relief lasted about an hour at the most and repeat of injections resulted in the same thing. Of course the neuropathic pain causes a lot of confusion re what is causing what. I also have the tingling and stinging under my feet, as well as all the symptoms of TTS and PF...Would the new Shock Wave Therapy be of any benefit for pain relief or would it cause more neuropathic symptoms and escalate the pain? I am trying NOT to go the SCS route, but the meds I take have no real effect on the pain anymore. I have has this idiopathic neuropathy since 1994 and am still seeking better pain control. Any suggestions? Contact Suzy aka (email removed)

Re: Tarsal Tunnel Syndrome and Heel Pain

Ed Davis, DPM on 8/13/04 at 19:02 (157793)

Suzy:
Injections would be relatively ineffective for sensory peripheral neuropathy as would ESWT. ESWT would be potentially effective only for the PF. What reason was given for the peripheral neuropathy?
Ed

Re: Tarsal Tunnel Syndrome and Heel Pain Sensory PN

Suzy Q on 8/13/04 at 21:15 (157798)

Ed-thanks-No reason ever found for the sensory PN. I have had every test known and nothing conclusive has ever shown up. It has been dxed entirely by symptoms alone. All lab work, NCT, and EMG have always been normal as has the TTS testing. Right now I am just seeking effective pain control.
I have seen at least 50 physicians in the past 10 years. Thanks,
Suzy

Re: Tarsal Tunnel Syndrome and Heel Pain

heatherj on 8/15/04 at 04:53 (157938)

The injection was closer to the tarsal tunnel area, and I only had one injection. I ended up with a large bruise over the area for about a week--not sure if that is considered normal or not. This doctor did not give me any information unless I asked him--so as far as I was able to pick up the next step would be surgery. I am very much against this since from what I've read this is always considered as a last resort with mixed results at best. Would a walking cast provide any pain relief? I was very disappointed in the quality of care I received. He didn't ask my medical history or order any blood tests to rule out possible causes of this condition. Is this normal?

Re: Tarsal Tunnel Syndrome and Heel Pain

Julie A on 8/15/04 at 15:45 (157998)

Hello, I have a question, do you have any problems with your toes burning, going numb?I have the same issue with being active and this is torture, I sometimes lay down and cry, I am so frustrated, my feet ache all the time,this toes issue is getting to be annoying though and not sure what to do.
(email removed)

Re: Tarsal Tunnel Syndrome and Heel Pain

heatherj on 8/15/04 at 19:21 (158024)

Hi Julie,
That is the only thing I don't have. I have read that the tingling is a very common symptom of tarsal tunnel but I have no idea how to fix it. I would try massage, but since this is probably related to the nerve compression of TTS it probably won't too effective. I am not a medical person, although I have read a great deal about this condition lately trying to find some help for myself. I know what you mean about the pain--it is excruciating. One hopeful thing I have read is that the majority of people CAN be helped and treated--it can take fom a few months to up to a year in some instances. The real trick is to find a good podiatrist who will listen and give information/instruction on what will help you. I am seeing a new podiatrist next week to get a second opinion and hopefully much more help than the first doctor I saw. Hang in there--don't give up!