Most common cause of tarsal tunnel syndrome:
a. Tarsal tunnel syndrome is caused idiopathic (Most common) followed by flat foot followed by trauma. (Secondary osteoarthritis)
b. May also be associated with diabetes. Tarsal tunnel syndrome is a compressive neuropathy where tibial nerve is compressed beneath the flexor retinaculum.
c. Tarsal tunnel extends from the medial malleolus posteriorly and inferiorly to the medial side of calcaneum.
1. Anterior tarsal tunnel syndrome
a. It is entrapment of deep peroneal nerve beneath the inferior extensor retinaculum
b. Symptoms: paresthesia in first web space
Treatment:steroid injection, immobilization, surgical release.
2. Morton’s metatarsalgia:
a. It involves the plantar nerve between 3rd or 4th metatarsal bones.
b. Treatment is surgical excision of interdigital neuroma.