If you are suffering from pain, tingling, and numbness along the bottom of your foot and toes, you may have tarsal tunnel syndrome. This condition can often be treated with surgery such as tarsal tunnel release. Tarsal tunnel release surgery takes the pressure off a nerve in the tarsal tunnel in order to provide relief from symptoms of tarsal tunnel syndrome.
Understanding Tarsal Tunnel Release Surgery
Tarsal tunnel syndrome happens when the tibial nerve that runs through the tarsal tunnel becomes compressed. This compression can cause a variety of symptoms, such as pain and numbness in the leg and foot, and makes it difficult to enjoy your daily activities. Conservative treatments are first used to treat the condition. When conservative treatments such as injections, physical therapy, or orthotics do not provide relief, tarsal tunnel release surgery is recommended.
The purpose of tarsal tunnel release surgery is to decompress and provide space for the tibial nerve. This can increase blood supply to the nerve and help it regenerate. During surgery, the surgeon will cut a ligament in the ankle to relieve pressure on the tibial nerve. If there are bone growths or cysts that put pressure on the nerve, those will be removed as well. After the procedure, movement and feeling should be restored to the foot and leg.
Preparing for Surgery
Once you have made the decision to have tarsal tunnel release surgery, there are several things to do to prepare for the procedure. Your surgeon will give you detailed instructions prior to surgery that may include the following:
- You may need to get a nerve test done along with imaging such as an x-ray.
- Lab testing to check your glucose levels and A1c may be required if you have a condition such as diabetes.
- You may not be able to drink or eat anything after midnight on the day of your surgery.
- You should arrange for a ride home after the procedure.
- Depending on the specific medications you take, you may need to stop taking medications as directed by your doctor. Be sure to provide a list of all your medication to your doctor prior to scheduling the procedure.
- Tell your doctor about any allergies you have, such as ones to medication or if you have had a reaction to anesthesia.
Tarsal tunnel release surgery is typically performed under general anesthesia, where you will not be awake. If local anesthesia is used, the area being operated on will be numbed, and you will be awake. Tarsal tunnel release surgery takes around an hour and can either be done as an open surgery or as endoscopic surgery. The difference between the two is:
- Open surgery. For open surgery, one larger incision is made in your ankle to do the procedure.
- Endoscopic surgery. For endoscopic surgery, two or three smaller incisions are made, and tools are placed into the incisions to perform the surgery. This is less invasive than open surgery.
Once the procedure is completed, and the incision is closed either by stitches or medical tape, the ankle will be wrapped in a dressing to prevent infection. You may be in recovery for one or two hours then you will be discharged to go home.
Recovery From Tarsal Tunnel Release Surgery
Typically, you will be sent home the same day as surgery. Afterward, you can expect the following while you recover:
- It is normal to experience pain after surgery. You may be advised to take over-the-counter pain medication or, in some cases, may be prescribed a short course of narcotic pain reliever.
- You will not be able to get the incision site wet.
- You will not be able to bear weight right away on the foot that was operated on. Once you are comfortable, you may begin light walking and partial weight-bearing. You may need to use crutches or another form of support.
- After a week, any bandages or dressings may be removed, and you will be able to bear full weight on the foot. Once the bandages are removed, you can get the incision site wet.
- Physical therapy may be needed to help regain function and movement.
Every patient’s recovery time is different. For some patients, pain and symptoms may resolve within the first six weeks. For other patients with more severe symptoms, pain and symptoms may lessen after three months. Many patients report full muscle function and movement restored and being able to enjoy the activities they once did.
Dr. Williams has had much success in tarsal tunnel release surgery, and his patients are satisfied with their results. If you have questions about tarsal tunnel release surgery, contact Dr. Williams for an evaluation. To schedule an appointment in the Baltimore office, contact us at (410) 709-3868 or fill out our contact form online.
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