Tarsal Tunnel

[worknonjoy]

I have just been diagnosed with TT and my podiatrist said that I need surgery. I have had two foot surgeries in the last year. The first was to remove scar tissue in my right heel and to correct bunions in both feet. The surgery was a mess. The surgeon over corrected the bunions and I should have never had all that work in one surgery. I can't even list all the problems there were from the surgery. He also made an incision on my right heel across my heel. I developed massive scar tissue there and couldn't even walk without severe pain. I went to my current Podiatrist who I really like. He went in and cleaned out the scar tissue, released my plantar fascias completely (the last surgeon had done that partially). He also removed the spur in my heel. He took out a nerve that was entrapped.

I still have problems in my feet however. I have Morton's Neuroma in my left foot - but my doctor gave me a shot of cortisone and I'm hoping that will be taken care of. The first surgeon somehow cut the length off of my big toes in the bunion surgery and this is causing pain in my other toes and maybe even the neuroma My left big toe is over corrected and is bent outwards which messes up my balance.

I have an electrical feeling around the area of my first surgery. I have pain in my calf - especially at night after being on my feet. I have a feeling of walking on something sharp in the inside area of my arch - most nights I'm in misery. When I tap below my ankle the outside of my heel tingles. We did an nerve conduction test and it was negative, but my podiatrist said that he is certain with the symptoms I have that I have TT. I also have pretty severe pain on the right side of my right foot. It's on the top part. He said that a bone there is getting out of joint. He can put it back in but it only stays in for a few days. He said that it is caused by compensation from the TT. He said that if we don't get it fixed that pretty soon we won't even be able to get it back in joint and it will cause further problems.

I do really trust him, but am still very concerned. I didn't pop back quickly from either of the surgeries, and this one sounds worse than the others. He said that I would be in splints for the first week or so and then in a cast for several weeks.

Do my symptoms sound like TT? What is the splint situation? How painful is all of this? I live by myself, but I guess I will have to move in with my parents until I can get around. How long should that be? Thanks for any input!

[foootdoc]

tarsal tunnel syndrome is a clinical diagnosis. the emg/ncv nerve tests are often negative.
sound like it might be it. there are some podistrists that can do this through a very small incision, i usually put patients in a bulky bandage and a surgical sandal. then after i take the sutures out in about 2 weeks if everything is healing fine they go right back into a normal shoe. unless they are doing bone work you should not be in a splint or off weight bearing after a nerve decompression because that makes it easier for the nerve to scar back in. il be happy to answer any questions u may have
-good luck

[worknonjoy]

Footdoc - Thanks for the reply. Oh, it sounds like my doctor is doing things really different. He said that he will be making an incision about 4 inches long. He said that it would go from the side of my foot up past my ankle possibly. He said he had to go in to look at the nerve. Depending on the condition of my nerve, he might have to go further up past my ankle. I think he is planning on taking a nerve out.

He said I will be in a splint for 12 days and then a cast for I think 6 weeks. He isn't sure about physical therapy because that can aggravate the nerve - at least I think that's what he said. He said we would play it by ear after the surgery.

The top side of my foot that hurts so much is the cuboid bone. It is getting out of joint. My doctor said from compensation from TTS. He said that I may have a damaged ligament there. I broke my foot about five years ago by walking off a curb and my foot bent all the way under. I have had problems since then.

I am concerned that you would do things so differently from my doctor. I am nervous anyway about this surgery. I had a really bad experience with another foot surgeon who put me in this mess, but my current doctor has really helped me to walk again. Is there any reason in your experience to do things the way my doctor is describing?

[foootdoc]

thats really impossible to say without looking at you xrays, and a real exam. what kinkd of injury was it? a lisfrancs joint injury? is there arthritis in the joints around the cuboid? do you need surgery in that area as well? is it rally a tarsal tunnel syndrome. where do you live?

[worknonjoy]

I'm not sure really what kind of fracture I had - I saw a different doctor - but it was in the lisfranc area I know. The doc I now have is the first to even pay any attention to the pain I'm having on that side as the x-rays look fine, and no arthritis I'm told. But he jiggles my foot and can tell when it is out of joint and then he throws it back into joint. He said there is probably a ligament that is damaged there, but not enough to doing anything about. He feels pretty certain that the TTS surgery will correct the problems I'm having with the Cuboid bone.

He sent me to a neurologist to rule out RSD and the EMG was negative, but he said he feels pretty certain based on my symptoms and his experience that it is TTS. He has ordered an MRI as a back up.

I live in the Houston, Texas area.