Edinburgh hotelsWhat is tarsal tunnel syndrome?
Tarsal tunnel syndrome (TTS) refers to an entrapment of the posterior tibial nerve as it descends from the leg to the foot. This condition was first described by Keck and Lam in 1962. The terminal aspect of the posterior tibial nerve (L4-S1 nerve distribution) supplies the motor function to the muscles of the foot and the sensory innervation to the bottom of the foot. Varying degrees of entrapment of this nerve may effect either motor function, sensory function or both. There are any number of reasons that tarsal tunnel occurs. Contributing factors include trauma, varicose veins, bone spurs and soft tissue tumors such as ganglionic cysts. Other contributing factors include biomechanical instability of the foot and ankle. Each of these contributing factors places pressure on the posterior tibial nerve creating the symptoms of tarsal tunnel syndrome. Most cases are ideopathic, meaning that the entrapment appears to be due to direct pressure from the lacinate ligament with no other visible cause. Treatment of tarsal tunnel syndrome
Conservative care for tarsal tunnel syndrome includes injectable cortisone, and most importantly, support of the arch. Many studies have shown that the pronated or flat foot is much more prone to tarsal tunnel syndrome. Rigid arch support has been shown to decrease strain on many of the structures (nerve and tendon) that pass from the leg to the foot through the tarsal canal. Tarsal tunnel syndrome may be treated surgically with a release of the lacinate ligament and exploration of the tarsal canal with decompression of the posterior tibial nerve. Most peripheral nerves are slow to respond to surgical procedures. The recovery period for patients undergoing tarsal tunnel surgery may vary from 3 months to 18 months. The outcome of the procedure varies and seems to depend upon the nature of the entrapment, the damage that the posterior tibial nerve had sustained prior to surgery and a host of other factors. | 
