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Tarsal Tunnel Non-Surgical

The goal of treatment is to take pressure off the posterior tibial nerve and its branches. While there is no splint that can be prepared for the foot, as it can for the hand, it may be appropriate for you to try orthotics, or small inserts for your shoes. The function of these nerves can be followed over time with non-painful quantitative sensory testing. There is a great likelihood that either your sport activities or your work activities may need to be altered to give you more time off your feet. You may need to wear support stockings to help keep the swelling controlled in your feet. However, this may also increase the pressure on your nerves. Thus, a trial of this type of treatment must be watched closely. Any medical condition that you have that is known to affect the nerves must be given the best possible care. This includes arthritis such as rheumatoid or lupus, alcoholism, thyroid gland dysfunction, and diabetes. both heart and kidney conditions can cause your legs to swell and contribute to tarsal tunnel symptoms. It will be necessary to be sure that you do not have any back problems, such as lumbar disc disease that may be the cause of your foot symptoms. Often, tarsal tunnel syndrome and these other medical conditions or injuries are both present at the same time.

There is a place for a trial of anti-inflammatory medication if overuse or tendonitis is suspected. However, since no tendons actually pass through the tarsal or plantar tunnels, injecting a steriod preparation into these areas is not done frequently. Still, in selected cases, and with care not to inject the nerves themselves or the adjacent blood vessels, a cortisone injection may be tried. If the overwhelming sensory symptom is pain in the foot, and you have diabetes, a trial of medications of medications useful for treating "neuropathic pain" is indicated. Such medications include Elavil, Dilantin, Neurontin, and Tegretol.

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