Question
I am a 41 year old female . I worked on my feet in cheap shoes for 19 yrs. Four years ago I started to develop a slight pain on the inside of my foot just below and a little behind my ankle bone. I ignored it until one day the pain knocked my to my knees. It felt like someone was squeezing my nerve and popping me with a rubberband. The pain had no obvious rhyme or reason. It would come and go, lasting nywhere from a few seconds to minutes. It seemed to be worse at night. I saw a Podiatrist who diagnosed me with posterior tibial tendonitis dysfunction. He fitted me for orthotics and gave a cortisone injection (which did not help) I saw an orthopedic surgeon who had no clue and 2 didderent neurologists who did nerve conduction studies. They both said nothing wrong with my nerves. I took steroids and pain meds(niether helped). I also wore a boot which made my pain worse.I finally after 6 weeks just started to walk on crutches staying off my right foot for three weeks. The pain stopped. Since then I have twines of pain in the same spot and also pain in my heel and numbness under my foot and in my toes. I recently went back to the podiatrist(pain was coming back). He sid I have Posterior Tibial Nerve Entrapment.Fitted me for new $425 orthotics which make my pain worse. I am now at a lost on what I can do! Is this fixable?  he says he's not a fan of surgery!

Answer
Hi Connie,

It certainly sounds like tarsal tunnel syndrome/entrapement of the nerve.  All of your symptoms are nerve related.  The sudden sharp, shooting pain and radiation into your heel are common symptoms.

You should have an MRI done of your foot and ankle with and without contrast.  This will allow examination of the nerve in the ankle and foot.  Also, you may have a mass or inflamed tendon in the tarsal tunnel(area behind the ankle bone-big toe side. This can cause pain.  Nerve conduction studies may be normal in this condition.

Injections when performed properely should be helpful.  Physical therapy may be helpful.  If the orthotic devices cause pain then take them back to your Dr for adjustment.

Finally, surgery may be necessary to release the nerve.

I would consider seeing another Podiatrist if you are not getting results.

Hope that helps.

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
www.thetampapodiatrist.com
www.tampacryosurgery.com
www.fix-my-foot.com