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02/21/2011 11:57 AM

Tarsal Tunnel Surgery Information

DrP
Posts: 69
Member

I am relatively new to MD Junction and have been helping people with various peripheral nerve problems for over three years. I am a peripheral nerve surgeon and I have done quite a few tarsal tunnel procedures (among other peripheral nerve cases). I noticed that many people's posts here are many months old, but thought I would start a discussion to see if people had any specific questions about TTS and what can be done about it surgically, how the surgery is performed, etc. Hope I can be of help.

Cheers.

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03/23/2011 10:08 PM
Tarragon
Posts: 7
New Member

Hi Dr. P,

I am wondering if you have any information about accessory soleus muscles and TTS.

Thank you,

Tarragon


03/26/2011 12:41 AM
DrP
Posts: 69
Member

Tarragon,

I have not heard of or run into this clinical entity although I have seen other anomalies causing TTS. Usually there are anomalous muscle attachments. In principle, anything "accessory" in the tarsal tunnel would increase the pressure therein and potentially cause TTS. Hope that helps. Do you have any imaging of it?


04/30/2011 07:47 PM
Jewelz2011
Posts: 4
New Member

Hello, I'm not sure what to do!!! December of 2010 my left foot started feeling like it was alseep all the time and gradually went from that to having pain and even more loss of sensation in my foot as well as shooting pains up my leg. I made an appointment with a foot specialist and before that appointment came around the pain was so bad I went to the Emergency room where they had me do an MRI of my back which turned out to be fine. Then I seen my regular doctor who referred me to this podiatrist/Surgeon who immediatly scheduled me for Tarsal Tunnel Surgery. My surgery was on the 15th of April and I've been stuck in bed for 2 weeks and my pain now is alot worse than it was before my surgery! I see my Podiatrist/surgeon again on Monday but am wondering if it is normal for me to be having more pain onw than before surgery? and what I can do about it?

Any suggestions would be helpful as I feel extremely helpless at the moment!

thank you and Have a Good daySmile


04/30/2011 08:53 PM
Tarragon
Posts: 7
New Member

When you go on Monday, ask your doctor for a copy of your Operative Report. That will tell you exactly what was done. What did they say was the cause of your pain? It is still very early in your recovery, so give it time.

05/01/2011 06:49 AM
Jewelz2011
Posts: 4
New Member

Thank you for responding I will ask for a copy of my operative report on monday. They said the cause of my pain was from Tarsal Tunnel Syndrome thats why they did surgery, as far as the cause of my pain now the ER did not say they just gave me enough pain meds to make it to my dr appointment.

I will let you know more when I do!

Thank you soooooo Much for responding

Have a great day!


05/01/2011 09:23 AM
Tarragon
Posts: 7
New Member

Hi there,

Usually right after surgery, the surgeon tells you what he/she saw that would have caused your pain. Tarsal Tunnel Syndrome could be caused by a number of factors. For example, something taking up space in your tarsal tunnel and pushing on the nerve (cyst, veins, muscles, fluid). It could be systemic, such as diabetes. It could also be caused by nerve problems further down into your foot (the medial or lateral plantar nerves, the first branch of the lateral plantar nerve, also called Baxter's nerve etc.).

It's a good idea to have a list of questions written out prior to your appointment, such as:

1. Did you see an obvious reason for my pain?

2. Did you check the nerves further down into my foot?

3. Did you touch my posterior tibial nerve during the surgery?

4. What should I be doing to ensure the best possible recovery? For example non-weight-bearing range of motion to keep the nerve gliding and avoiding scar tissue build up.

5.What is my prognosis?

Did you have an MRI prior to the surgery?

Keep in mind that it is so early in your recovery. It is hard not to get down, but TTS surgery is often a long recovery. Try to be patient, and if you have questions, don't be shy to call your doctor, even if it is not appointment time.


05/01/2011 09:45 AM
Jewelz2011
Posts: 4
New Member

Again thank you I think those questions will be good to bring with me! After surgery all she said was that (I cant remember the name of it) but it was very tight against the nerve!(I was still kinda out of it at the time). For diagnosis all they did was an MRI of my lower back to make sure the pain wasnt coming from there, when that MRI was clean my podiatrist/surgeon diagnosed TTS without any other tests just by my description of the symptoms. Also my podiatrist told me she was doing a tarsal tunnel release surgery and when I showed up for surgery they said they were doing a tarsal tunnel decompression surgery(I dont know if that is the same or not!). Thank you for you recommendations I feel that I will be ready for tomorrows appointment thanks to you!

Thanks for everything and I will let you know how it goes tomorrow ♥

Post edited by: Jewelz2011, at: 05/01/2011 10:01 AM


05/01/2011 12:09 PM
DrP
Posts: 69
Member

Dear Jewelz2011,

Tarragon has some good points. In addtion, if the duration of and/or the severity of the compression of the contents (i.e. nerves) within the tarsal tunnel are long/high, it can take weeks or months for the nerves to "calm down". I often put it to my patients this way:

Think of your situation as having fallen asleep on your arm for a long time and waking up to find that moving your arm is difficult and the arm is numb. It may take a few minutes of shaking your arm for the motion and sensation to return. This scenario is in contradistinction to the situation in which you've fallen asleep on your arm for a short time and when you wake up, it is a little numb and shaking it out only for a few seconds restores sensation. After surgery, if the nerves have been completely released and they were still viable, sensation should return, but it may take some time.

Hope that helps.

Dr.P.


05/02/2011 03:06 PM
Jewelz2011
Posts: 4
New Member

Smile Thank you both for the information!!! My Dr appointment went really good today. She explained alot of things to me and I start physical therapy next week! She said It will probably hurt more than before the surgery until my nerves heal all the way and told me not to worry about pain meds that she will give them to me as long as I need them! It was a big relief hearing that but not looking forward to the pain of recovery and physical therapy Unsure! She also said 3 to 6 months I should be fine. I was getting really mad and depressed but am feeling better now ty for all your help and support! I'll keep you updated on progress Cool

I cant say thank you enough this is harder to go through than I thought it would be! "(^.^)"

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