Tarsal Tunnel Syndrome Test

What is tarsal tunnel syndrome?

Tarsal tunnel syndrome (TTS) is a condition caused by the compression of the posterior tibial nerve or one of its branches, the lateral plantar nerve or the medial plantar nerve, as it travels through the tarsal tunnel located along the medial foot and inner ankle. This condition can lead to various symptoms, including pain, tingling, numbness, and a burning sensation in the foot and ankle.  Tarsal tunnel syndrome shares similarities with carpal tunnel syndrome, a condition that impacts the hand and wrist.

The causes of tarsal tunnel syndrome can vary but often include repetitive stress or overuse of the ankle, injury or trauma to the area, and anatomical abnormalities such as flat feet or varicose veins. Systemic conditions like diabetes and arthritis can also contribute to the development of TTS by causing inflammation or swelling that compresses the nerve.

What is a Tarsal Tunnel Syndrome Test?

The Tarsal Tunnel Syndrome Test is a clinical assessment to diagnose tarsal tunnel syndrome. This test involves several maneuvers to identify symptoms such as pain, tingling, or numbness that indicate posterior tibial nerve compression. The primary components of the test include Tinel’s Sign, the Dorsiflexion-Eversion Test, and the Compression Test.

During the Tarsal Tunnel Syndrome Test or Tinel’s Sign, the clinician taps lightly over the tarsal tunnel to elicit any tingling or pain that radiates into the foot. This involves holding the foot in dorsiflexion and eversion to assess for symptoms. This test also evaluates the tibialis posterior muscle, which plays a crucial role in foot stability. The Compression Test compresses the area behind the medial malleolus to detect any pain or numbness. This area includes the flexor hallucis longus tendon, which is significant within the tarsal tunnel.

Positive results in any of these tests suggest the presence of tarsal tunnel syndrome and warrant further diagnostic testing or treatment.

How to use our Tarsal Tunnel Syndrome Test template

The Tarsal Tunnel Syndrome Test template is designed to help healthcare professionals systematically assess and document potential cases of tarsal tunnel syndrome. Follow these steps to ensure accurate and thorough evaluation:

Step 1: Fill in patient information

Start by entering the patient's name, date of birth, examination date, height, weight, and gender. This ensures all relevant information is recorded before beginning the assessment.

Step 2: Explain the test overview

Briefly explain the purpose of the Tarsal Tunnel Syndrome Test to the patient, including the significance of evaluating symptoms such as pain, tingling, and numbness in the foot and ankle.

Step 3: Conduct the test procedure

Follow the steps outlined in the template to perform the test:

• Perform Tinel’s Sign by lightly tapping the tarsal tunnel and noting any tingling or pain.
• Conduct the Dorsiflexion-Eversion Test by holding the foot in dorsiflexion and eversion and monitoring for symptoms.
• Perform the Compression Test by compressing the area behind the medial malleolus and recording any pain or numbness.

Step 4: Interpret the results

Evaluate the test results to determine if they are positive or negative for tarsal tunnel syndrome. Document whether the test indicates potential compression of the posterior tibial nerve, which suggests tarsal tunnel syndrome, or if the results are negative, reducing the likelihood of the condition.

Step 5: Provide recommendations and additional notes

Make appropriate recommendations for further diagnostic testing or treatment based on the test results. Add any additional notes that could aid in the patient’s care plan, ensuring all observations and decisions are well-documented.

Benefits of conducting this test

Conducting the Tarsal Tunnel Syndrome Test provides several key benefits that enhance patient care and diagnostic accuracy.

Accurate diagnosis

The Tarsal Tunnel Syndrome Test helps accurately diagnose the condition by pinpointing the exact location and cause of nerve compression. This precise identification is crucial for developing an effective treatment plan and ensuring the best possible outcomes for the patient.

Early intervention

By detecting tarsal tunnel syndrome early, healthcare professionals can initiate treatment sooner, preventing the progression of symptoms. Early intervention can significantly reduce the risk of chronic pain and permanent nerve damage, improving the patient’s quality of life.

Tailored treatment plans

The test results enable clinicians to create personalized treatment plans based on the specific findings. This tailored approach ensures that each patient receives the most appropriate and effective therapies, whether physical therapy, medication, or surgical intervention.

Common treatments for tarsal tunnel syndrome

Treatment for tarsal tunnel syndrome aims to relieve symptoms, reduce nerve compression and heel pain, and improve overall foot function. Here are some common treatments:

• Rest and immobilization: Resting the affected foot and using immobilization devices like braces or splints can help reduce inflammation and prevent further irritation of the posterior tibial nerve.
• Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen can help reduce pain and inflammation. In some cases, corticosteroid injections may provide more significant relief.
• Physical therapy: Physical therapy exercises can strengthen the muscles around the ankle and improve flexibility. Techniques such as stretching, ultrasound therapy, and nerve gliding exercises can help alleviate symptoms.
• Orthotics: Custom orthotic devices can support the foot’s arch and reduce pressure on the tibial nerve. These devices can benefit patients with flat feet or other structural abnormalities.
• Surgical intervention: In severe cases where conservative treatments fail, surgery may be necessary to relieve nerve compression. Surgical options include decompression of the tarsal tunnel or removal of any space-occupying lesions that may be causing the nerve compression. The lateral plantar nerves are often involved in these surgical treatments.
• Lifestyle modifications: Advising patients to wear supportive footwear, avoid activities that exacerbate symptoms, and maintain a healthy weight can help manage and prevent symptoms. These modifications are essential to treat tarsal tunnel syndrome.