"Dr. Burton S. Schuler, Morton's Toe Expert"- Author of Why You Really Hurt, It All Starts In the Foot.

Foot Care|Tarsal Tunnel Syndrom|Podiatrist|Panama City Beach

 Authored by Dr. Burton S. Schuler, Google+

Tarsal Tunnel Syndrome is a set of symptoms that result from posterior tibial nerve compression. As implied by its term, this condition is felt on your tarsal (a Latin word for “ankle”) and the areas surrounding it. The Tarsal Tunnel is a channel that serves as the passageway for the posterior tibial nerve; artery, and tendon that has 3 different courses within the tunnel. One spreads through the heel while the others on the bottom of your feet. For this reasons, its accompanying sensations are felt on these areas as well.

The specific etiology of Tarsal Tunnel Syndrome can be very hard to pinpoint but is most commonly due to a abnormal pronatory foots that adversely effects the flexor retinaculum  When this occurs the narrowing passage causes swelling and fluid to accumulate within the tarsal tunnel, thereby producing pressure and pain. And because the heel is also affected, Heel Pain is usually felt. People with TTS (Tarsal Tunnel Syndrome) commonly complain of foot numbness originating from the big toe radiating to the next 3 toes. Along with the pain, electrical sensations, burning and tingling feelings are also felt over the foot’s base too. The degree of discomfort will depend on the severity of the abnormal pressure (entrapment) cause by a structure known as the flexor retinaculum which is pressing down on the nerve, artery and tendon. .  When the entrapment is severe, the person will suffer from ankle pain and the structures within the tunnel will be inflamed. This can even get worse considering the limited ability of to stretch normally. With increasing nerve pressure, circulation will be compromised as well. And with altered sensation, the individual will also feel numbness and tingling sensations. Because of the narrowed circulatory pathway, fluids will accumulate on the foot. This gets worse when the person is walking or standing.  The patient may as experience small muscle cramps. This is the effect of the lack of nerve supply to the affected small muscles. Other symptoms include electric shock sensations, hot and cold sensations, and a positive Tinel’s sign. One will have a positive Tinel’s sign when an electric shock sensation can be felt when tapping the affected nerve.

. The main goal of treatment is to identify the cause, and manage it as soon as possible to prevent possible complications.  This involves removing the abnormal pressure caused by the flexor retinaculum. 

There are both surgical and non surgical treatments for Tarsal Tunnel Proper control of the abnormal forces causing the stress and strain in the area of the Tarsal Tunnel is an absolute must. This can be accomplished by the fabrication of customized orthotics for the patient. There is no room for short cuts here; they must be customized Injection therapy is also valuable in treating the swelling/edema associated with this problem. Anti-inflammatory medications are also useful.

Surgery for tarsal tunnel is aimed at removing abnormal pressure from the flexor retinaculum causing the entrapment.  Many surgical techniques exist for accomplishing this.  This means no one procedure has been settled on. In general it is considered one of the more complicated surgery done by podiatrist

Complications range from unpredictable healing, bleeding and infection. And though surgery is geared towards decompression of the affected area the success of such operation has been reported to be lower than 50% in some journals.  However, this must not stop you from seeking the medical help you need.



About the Author:  Dr. Burton S. Schuler foot doctor, foot care specialist, podiatrist  of Panama City, Fl and Panama City Beach Fl the director of the Ambulatory Foot Clinics Podiatric Pain Management Center  and is a leading authority on the Morton’s Toe,  Long Second Toe and it associated problems. He is the author of the newly published book about The Morton’s Toe, Why You Really Hurt: It All Starts In the Foot. The book is published by the La Luz Press, Inc and is disturbed national by the Cardinal Publishing Group.  Why You Really Hurt: It All Starts In The Foot, is the story of how one bone in your foot could be the real reason for pains thru out your whole body”

  Dr. Schuler, graduated from the N. Y. College of Podiatric Medicine in 1975 at the age of twenty-four, and has been in private practice ever since. In 1982, he published his first book, The Agony of De-Feet: A Podiatrist Guide to Foot Care. During his thirty-five year professional career, he has written for Collier’s Encyclopedia and various podiatric journals and publications. He has been interviewed by The New York Times, First in Women, and other publications. Dr. Schuler has appeared on hundreds of radio and television programs both here and aboard. He is a Diplomate of the American Academy of Pain Management, and the National Board of Podiatric Examiners. Dr. Schuler is certified as a wound specialist from the American Board of Wound Management. His professional and civic accomplishments have earned his inclusion in the 1999-2002 Who’s Who in America (Marquis).