It is important to attempt to determine the source of the problem. It is difficult to determine the exact cause of tarsal tunnel syndrome. The sensation usually travels into the foot but can also travel up the inner leg as well. Tinel's sign is a tingling electric shock sensation that occurs when you tap over an affected nerve. "Pins and needles"-type feeling and increased sensation on the feet.Burning sensation on the bottom of foot that radiates upward reaching the knee.Pain along the posterior tibial nerve path.A feeling as though the feet do not have enough padding.Pain radiating up into the leg, behind the shin, and down into the arch, heel, and toes.Pain worsens and spreads after standing for long periods pain is worse with activity and is relieved by rest. Painful burning, tingling, or numb sensations in the lower legs.Pain and tingling in and around ankles and sometimes the toes.As small muscles lose their nerve supply they can create a cramping feeling. Fluid collects in the foot when standing and walking and this makes the condition worse. Nerves respond with altered sensations like tingling and numbness. As pressure increases on the nerves, the blood flow decreases. The flexor retinaculum has a limited ability to stretch, so increased pressure will eventually cause compression on the nerve within the tunnel. Inflammation or swelling can occur within this tunnel for a number of reasons. Ankle pain is also present in patients who have high level entrapments. If the entrapment is high, the entire foot can be affected as varying branches of the tibial nerve can become involved. Depending on the area of entrapment, other areas can be affected. Patients with TTS typically complain of numbness in the foot radiating to the big toe and the first three toes, pain, burning, electrical sensations, and tingling over the base of the foot and the heel. The tarsal tunnel is delineated by bone on the inside and the flexor retinaculum on the outside. One nerve (calcaneal) continues to the heel, the other two (medial and lateral plantar nerves) continue on to the bottom of the foot. Inside the tunnel, the nerve splits into three segments. The posterior tibial artery, tibial nerve, and tendons of the tibialis posterior, flexor digitorum longus, and flexor hallucis longus muscles travel in a bundle through the tarsal tunnel. This tunnel is found along the inner leg behind the medial malleolus (bump on the inside of the ankle). Tarsal tunnel syndrome ( TTS) is a nerve entrapment syndrome causing a painful foot condition in which the tibial nerve is compressed as it travels through the tarsal tunnel. The mucous sheaths of the tendons around the ankle.
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