Tarsal Tunnel

[marytm]

I am really don't know how I live my life day to day and still feel this amount of pain. Does this sound familiar to you? Anyone?

I am taking Neurontin, Trilisate, and Percoset - and it just barely helps. Barely. I still go to work most days, and I have to be on my feet at work quite a bit. But some days I just can't do it. Or I go, and I leave in tears from the pain. I drive using cruise control as much as possible because it is just agonizing to use the accelorator and the brake. At night, I take a ton of medication so I can sleep.

My feet are on fire. Mostly my heels. On my feet it starts as a burning, crawling, fiery, fierce pain, that bends around the side of the foot and shoots up the inside of the ankle, where the pain takes on a different tone. It gets worse and worse as the day goes on.

I have custom orthodics. I have tried Diclofenac, Indocin, Feldene, Vicodin, and the current stuff (neurontin, trilisate, percoset). I wear TED hose. I have Z-Coil shoes. I have New Balance wide shoes. I wear different shoes walking than driving, because it seems to make a tiny difference. When I am not at work I limit my activities to avoid standing and walking.

BUT THE PAIN. The pain is out of control. I don't think anyone I know can imagine this pain, because if you haven't felt it I don't think you will understand. I just want to hear from anyone who can relate. I had a kidney removed and half a rib with it, and this pain is right up there with it. Except this does not respond to medication.

What other suggestions does anyone have? Is there anything I am not doing or trying that you have done?

[ising365]

Dear Mary,

I was just diagnosed with TTS from the 2nd pod. I have seen. I suffered an inujury demonstrating soccer drills in Sept. '08 and have suffered since. It sounds as if you have taken a great deal of anti-inflam. and pain meds. You need to see a podtrst. if you have not done so. I was first diag. with plantar faciitis and treated with PT, anti-inflam., patches, etc. I have resorted to NEw Bal. tennis shoes as well 24/7. It sounds like you really need to seek an addtnl. diag. and help. Maybe PT, steroid injectns. etc. may help. Maybe surgery. I don't know from what you've written what may work. I do know the feeling of pain all the time and what a pain it can be! No pun intended. Hope my commiserating with you at least helps you feel like you're not alone. I was glad to find this site. Take care.

[turtledove]

For some reason I should count my lucky stars that I am not in as much pain as you but I do find myself "popping pills" (Advil, etc.) towards the end of the day just to have somewhat of a normal existence even though I know what I have isn't normal. I find I have to get off my feet too. I think we take walking pain-free for granted but when you're struck by lightening then your lightbulb goes on and you realize you shouldn't take it for granted. In early Feb. I found myself in Disney World and noticed myself saying ouch alot because of the "burning" I was experiencing. I also couldn't stand in a line for more than 30 minutes for a ride. I associated this to the Plantar Faciitis that I was originally dianosed with. Now since my pain isn't gone the doctor seems to think TTS since I have alot of the symptoms. Although after reading alot on this forum I'm beginning to think this is not the place for me since I don't nearly have as severe symptoms as some but I can pick things out here and there what people are saying and relate it to me. Believe me you're not the only one. I'm getting the impression that symptoms are pretty severe and I'm not the norm.

[marytm]

You know, you are really lucky that your case isn't too severe. If I really look back at the first time I was diagnosed with "plantar fasciitis" it was a full three years ago. So, at that time I significantly limited my activities and never did gain any ground in between. Of course, I now know it was tarsal tunnel. It seems like it must be commonly misdiagnosed.

About eight months ago I changed jobs, and the symptoms became much, much worse. I recently had steroid shots, and have seen about a 10% improvement. It isn't enough of a difference to notice when I am standing, walking or driving, but when I am off my feet I have less pain. It might not sound like much... but just that little bit is worth it to me. I am still taking Percoset, Trilisate, and Neurontin. I don't know what the next step will be, I suspect surgery.

When it comes down to it, my thought is... You are lucky that your symptoms aren't overwhelming. My advice is to do everything possible to keep your symptoms from progressing. I hope you find a treatment that provides solutions for you!

[turtledove]

Mary;

I know it kind of gets bad when you start popping pills first thing in the morning as opposed to at night because your foot is hurting. That's what happened this morning so I emailed my doctor to get a new referral to a doctor that could perform the nerve conduction study since there was a 2-wk wait for this test from another doctor. I'm so over this because it's taken so long since all this pain originally started (summer 2008). I'm fortunate that my doctor is on top of things and hasn't misdiagnosed this condition unless you want to call misdiagnosing the plantar faciitis that was disguised as TTS. I honestly don't think so though. I'm trying to avoid surgery but am also keeping on top of things. Are you actually free and clear now and did you have to go through surgery?

[marytm]

I hope you get the nerve conduction test soon! If you look it up in relation to TTS, it seems like it only accurately diagnoses the condition about half the time - so don't be too concerned if it isn't positive. So, what have you tried so far? And what are your doctor's ideas if the test is positive? Maybe there are options I haven't heard of!

When I replied, I really did just have the steroid shots March 3 , so I got back on the 24th to discuss the next plan. As I said, I think we will probably be planning surgery, but you never know. I already have the ugly shoes, custom orthotics, and support stockings (those really do make at least some difference if you haven't already tried them - you just need the firm knee high support stockings, they are made for men and women). I have been on all sorts of different medicines.

And I totally understand what you mean about popping pills when you get up. It is part of my routine every morning, about half an hour after I get up I take all of the medicines that I can take. That way, at the beginning of my workday I have the most pain relief - I have to be on my feet more at the beginning of the day than at the end. It is something to think about though, the idea of really planning exactly when to take medicine compared to when you are the most active. When you think about it, a lot of life passes by without having a chance to participate - fewer social events, no trips to the gym, and no walks with the dogs, to start. It's very frustrating.

It's nice to hear from someone else who is going through this process! I hope things are going well -

Mary

[turtledove]

Mary;

I don't feel as down in the dumps today as maybe yesterday because I'm not popping pills this morning. As you know tomorrow may be a whole new experience.

I was able to schedule the test for Wednesday which is at least sooner. Location-wise it's further away but oh well. When pain is involved you'll literally do anything. I didn't know that this study comes out positive for TTS only "half" of the time but that's good to know.

Now that I think of it actually the TTS was probably prevalent in about March 2008 (OMG that's a year). The doctor and I thought it was something else from a surgery I had over 10 yrs ago but now I'm not so sure. It felt like my foot was being squished whether it be in closed shoes or not. I'll mention this to the doctor next time I go to him though.

I went to Disney World early last month and that place is known for walking. Actually I did fine there even though I walked over 8 miles one day. I know this because I wear a pedometer. I did experience the "burning" that is mentioned on websites when I was on vacation. I wasn't popping pills at this point athough I always travel with Advil. I was just getting over the plantar faciitis and its treatment (orthotics, anti-inflammatories and finally the cortizone injections) so didn't make any connection that it could be something else but now I'm not so sure. I remember specifically at Disney that I couldn't wait on lines for more than 30 minutes though. I've learned that standing is definitely different than walking throughout the parks.

As I said previously this morning I haven't had to pop pills because the pain isn't that bad yet but I'm sure tonight will be another story. I have the pills on the windowsill just in case but will probably take them soon anyway so I don't get to that really painful stage. I'm just so over this since it's been going on for so long and I'm sure you're just as frustrated as me.

What's the story with surgery for you? Have you found out yet? I'd really like to try the shots first then even deal with surgery! Thank heavens my doctor believes in injections as opposed to surgery but another doctor in the practice believes in the surgery from the getgo. Thank heavens I have the injection one. He specifically mentioned 3 injections of "saline." Did I hear right? I think I remember this because he injected cortizone for the PF.

I've read up on that treatment for TTS is rest (at least one of the treatments). Who are they kidding? I don't even work but I don't have time for that. From what I can see neither do you.

Holly

[marytm]

Holly -

I'm glad you had less pain today! I can't remember the last day that I went without medicine. Months, anyway. I think it is the nerve pain that creates a feeling of fire inside my heel - but when I touch my foot, the pain is not better or worse. The inner ankle is another thing - I guess where the tarsal tunnel is.

It's great that you can get the test done on Wednesday. The test itself is uncomfortable, but not that bad. You'll have to tell me what you think. My feet were in horrendous pain when I went, and I still made it through the test just fine. Did you look up the whole accuracy issue? It is amazing what you can google!

It's interesting that you indicated that you didn't personally relate to the severity of symptoms other people reported on this forum. Really, to listen to you... It's been going on for a year, you take medicine regularly, you have difficulty standing, you are using orthotics... And you sound really ready for some serious relief!

So, here is what I experienced with the shots. My doctor injected cortisone into the inner ankle area in a couple of places about 10 days ago. My feet went entirely numb for about four hours afterwards, because mixed in with the cortisone there was some lidocaine, or something similar. I think the lidocaine is included to numb the area as the cortisone goes in. My feet were much worse for the first two days, which I did not know was possible. I think the volume of the shot in such a small area exerts even more pressure on the nerve intially, and then the body absorbs the additional fluid and you start to see results. And, after a few days I did see a small improvement. I was hoping for more. As far as saline goes, that is a mystery to me. Let me know!

Resting as a cure for tarsal tunnel is an interesting idea. I had a back injury this past year and during August, September, and October of 2008 I was barely on my feet. I did no standing at work, and very little otherwise. And yes, I did notice that with rest my feet seemed a lot better. However. My first day back to regular duty at work my feet were 100% as bad as they had ever been - which is to say, totally intolerable. So, I don't know, I guess I can't recommend rest as anything more than temporary symptom relief, from my own experience.

Let me know how things go for you!

[turtledove]

Mary;

Sorry it's been a while. This week seems to be full of doctors commencing with my son going to the oral surgeon. Naturally mom has to be there to pick up the pieces just in case whether or not she's in pain or not. Remember, moms don't get sick.

I was driving home from church Sunday and was thinking about what you said about pushing on the accelorator when driving. I guess that would bother my foot had it been my rt. foot but more of an inconvenience than anything. I must say I DO NOT have pain in my ankle but if I don't halt the progression, as you said, of this TSS it might make its way up there. My pain is half of my heel towards my toes. I also have pain on the outer part of my foot like I have been walking on that part of my foot and it's sore.

I bought these shoes (actually don't know what I'd call them because they are SO light) at Sam's Club and they are quite cushiony. When I've had it wearing my sneakers with orthotics because of the pain I just wear these cushiony shoes around the house and that helps my feet alot.

Some days are better than others when talking about pain. I'm sure it's the same for you. Some days I have to pop pills and others I don't.

Seems the pain really got bad slowly but I finally hit my threshold shortly after I got back from taking my other son up to college. Remember I said Disney wasn't that bad but I had noticed my pain was getting worse with the college trip. I was injected in the heel for the PF in early December and here I was the beginning of March and still was in pain. I knew something was up then. When I got back from the college trip I made an appointment with my foot doctor and was fortunate to get an appointment the next day. This is when he figured out there might be an underlying issue. Now do you know why I don't like going to doctors? Gosh, getting old is no picnic.

I was taking the precautionary measures (treatments) because I was diagnosed with Plantar Faciitis originally. I probably had this TSS all along but nobody ever realized it. My doctor and I thought it was PF which in essence it was but that wasn't the whole story. Not until I went back to the doctor after he injected my heel for the PF did the light go on with the doctor because I was still having pain. The PF is fine now but it's the TSS. Maybe that's why my pain isn't as severe as yours because I've been treated partially even though it was PF. I'm sure it's only a matter of time before the ankle is involved since I have a history of progression.

The test is tomorrow and I am looking forward to it to hopefully put an end to this pain. People take for granted walking without pain and as you and I know that isn't the case. I did google the accuracy of the test and all I came up with was it all depends on the skill of the person performing the test and also the precision of the equipment. We'll see if I strike gold though. I'm just going to go with an open mind. What else can I do?

After your injection how are you doing now? I guess we want it to work so bad because we don't want to go the next step which is more drastic. I'm thinking the doctor won't inject into my ankle since I don not have pain there but I can't be sure. He was describing something to me but it went in one ear and out the other because he lost me with all thet medical stuff. As far as the mention of saline I could be mistaken which is not unusual. I'll keep you posted in that area though.

I do notice that, I guess you'd call it rest, does help to an extent. I was on my feet basically till around 3pm yesterday. I honestly didn't know how I'd be able to walk the dog without limping but got off my feet for about half an hour. This little bit of rest did help. It's those dam orthotics because alot of times they push on the bottom of my foot and render me somewhat helpless. I'm not saying they help something though. That's where those cushiony shoes come into play. When I got home after walking the dog I kicked off my sneakers and went to my comfortable shoes.

Just like you I just I dream of the day where I can wear normal shoes. Summer is coming and I want to wear sandles and NOT sneakers.

Holly

[diam-inc]

Hi Mary,
I have read the many replies to your original post. It seems that you are in a lot of pain and nothing seems to help. Well, I have two suggestions and I'm fairly certain that one of them will work. With the pain that you are in they are certainly worth looking into.

POSSIBLE OPTION #1. There's a DPM in Taylor, Michigan (I don't think they will let me tell you his name) that you need to contact. I don't know where you live but a trip there would be a small price to pay to get rid of this pain. This Dr. is very experienced in Cryosurgery for treating foot ailments. I have done a lot of research on Cryotherapy and I am convinced that he can help you. You can google "cryosurgery" and easily find him. Call his office and they will fax you an article that will explain the procedure for plantar fasciitis. He has people coming from all over the country, and indeed, from other countries. Cryosurgery is minimally invasive and outpatient. It is not surgery as it sounds.

POSSIBLE OPTION #2. I am not a doctor. However, I have searched and searched for doctors that could help me with the awful burning that you describe. This is only my opinion but I believe that you might be suffering from tarsal tunnel nerve compression. The nerve comes down your leg, then to the inside of the ankle and progresses forward to the front part of your foot. They come together just below the ankle bone on the inside of your foot. They become compressed at this point. If this is your problem, and I believe it very possibly could be, then Nerve Decomprssion Surgery could very easily fix it. This is minor outpatient surgery as the Dr. would simply make an incision and separate the tissue that surrounds the nerves and decompress it. I have neuropathy in me feet and I have had the nerve decompression surgery on my left foot. Neuropathy is tough to deal with but the one thing that I did accomplish was stopping the awful burning. If you become interested then just google Nerve Decompression Surgery. My first choice would be a Dr. in St. Louis. You will find him. (He's not a DPM).

I am blessed with Neuropathy AND Morton's Neuroma. I just had the Cryosurgery three days ago for the Morton's Neuroma. I have a lot of faith in this procedure. That would be my first suggestion in your case. They don't make an incision and if for any reason it didn't work then you could proceed with other options that you may have. Hope it works out for. - Lonnie