Information on the following diseases can be found in the Related Disorders section of this report:

• Erythromelalgia
• Gopalan Syndrome
• Carpal Tunnel Syndrome

The initial symptoms of Tarsal Tunnel Syndrome are swelling of the feet, painful burning, tingling or numb sensations in the lower legs. Symptoms can become more intense and extend to leg muscles after standing for long periods during the day. These symptoms usually diminish with successful treatment.

Tarsal Tunnel Syndrome may be caused by a number of different conditions that can compress the tibial nerve at the ankle. In addition, benign tumors (usually composed of fatty cells), bone spurs, cysts, and/or inflammation of the tendon sheath may cause Tarsal Tunnel Syndrome.

Tarsal Tunnel Syndrome can begin at any age but is usually related to activities which involve long periods of standing. This disorder seems to affect males and females in equal numbers.

Erythromelalgia is a syndrome of sudden intensive dilation of blood vessels (paroxysmal vasodilation). This causes intense burning pain, increased skin temperature, and redness of the feet and, less often, the hands. (For more information on this disorder, choose "Erythromelalgia" as your search term in the Rare Disease Database.)

Gopalan Syndrome, which is characterized by burning sensations in the feet, is thought to be caused by a possible deficiency of a B Vitamin (pantothenic acid). Severe burning, aching and cramp-like pains in the soles of the feet (and possibly palms of the hands) can occur. Often, a sensation like pins and needles appears.

Carpal Tunnel Syndrome results from compression of the median nerve in the wrist (between the tendons of forearm muscles and the carpal ligament in the hand). This compression produces abnormal sensations in the hand plus pain in the wrist, the palm, or in the forearm. Commonly, patients feel that their hand "falls asleep" often. Carpal Tunnel Syndrome is relatively common. It may occur in one or both hands and it is seen more often in women. It often occurs in patients with acromegaly, myxedema, rheumatoid arthritis and also in people with occupations that require repeated forceful wrist flexion (e.g. carpenters). (For more information, choose "Carpal Tunnel Syndrome" as your search term in the Rare Disease Database.)

When the nerve of the foot is not under continuous pressure, drugs (usually in ointment form) may be useful to treat local inflammations and ease muscle pain in Tarsal Tunnel Syndrome. Immobilizing the foot or inserting a device in the shoe to reduce tension on the nerve may improve symptoms. Surgery should be reserved for cases that do not respond to more conservative treatment. This disorder can usually be treated by Orthopedic Surgeons or Podiatrists.

TEXTBOOKS
Skinner HB, ed. Current Diagnosis & Treatment in Orthopedics. Norwalk, CT: Appleton & Lange; 1995:421-23.

Beers MH, Berkow R, eds. The Merck Manual, 17th ed. Whitehouse Station, NJ: Merck Research Laboratories; 1999:487-88.

REVIEW ARTICLES
Lau JT, et al. Tarsal tunnel syndrome: a review of the literature. Foot Ankle Int. 1999;20:201-09.

Oh SJ, et al. Entrapment neuropathies of the tibial (posterior tibial) nerve. Neurol Clin. 1999;17:593-615.

Bailie DS, et al. Tarsal tunnel syndrome: diagnosis, surgical technique, and functional outcome. Foot Ankle Int. 1998;19:65-72.

JOURNAL ARTICLES
Kohno M, et al. Neurovascular decompression for idiopathic tarsal tunnel syndrome: technical note. J Neurol Neurosurg Psychiatry. 2000;69:87-90.

Machiels F, et al. Tarsal tunnel syndrome: ultrasonographic and MRI features. JBR-BTR. 1999;82:49-50.

Pyasta RT, et al. Common painful foot syndromes. Bull Rheum Dis. 1999;48:1-4.

Nagaota M, et al. Tarsal tunnel syndrome caused by ganglia. J Bone Joint Surg Br. 1999;81:607-10.

Mondelli M, et al. Clinical and electrophysiological findings and follow-up in tarsal tunnel syndrome. Electroencephalogr Clin Neurophysiol. 1998;109:418-25.