Tarsal tunnel syndrome – a disease ignored by doctors and totally unknown for the patients

Abstract

Tarsal tunnel syndrome (TTS), or tibial nerve compression at the internal malleolus level, is a frequently missed disease among clinicians, although it can be found in diabetic pa­tients (almost half of them will develop peripheral neu­ro­pa­thy and related complications) and in non-diabetic pa­tients due to the existence of tumors and anatomical ac­ces­sory elments. The aim of this paper is to increase the le­vel of awareness regarding the TTS diagnostic tools and treat­ments among doctors. The main source of literature re­view was PubMed database and the author’s per­so­nal ex­­pe­­rience. Although it is considered a rare di­sease, for sure underdiagnosed, left without treatment, TTS will lead to foot sensitive and motor deficits with dra­ma­tic ef­fects on patients quality of life and survival. Pa­tient’s his­to­ry, cli­ni­cal examination (positive Tinel sign, ob­jec­tive test­ing of in­creased sensibility threshold) and pa­ra­cli­ni­cal exa­mi­na­tion (soft tissue ultrasonography and ner­vous conduction stu­dies) highlight the diagnostic. The con­ser­va­tive and mi­ni­mally invasive therapeutic methods are effi­cient, but limited in time, the surgical solution – tarsal tun­nel de­com­pre­sion – being still the elective procedure, even in cri­ti­cal peri­pheral neu­ro­pa­thy.