Keck C: The Tarsal tunnel syndrome J Bone Joint Surg Am 44: 180, 1962.
DiGiovanni BF, Abuzzahab FS, Gould JS: Plantar fascia release with proximal and distal tarsal tunnel release: a surgical approach to chronic, disabling plantar fasciitis with associated nerve pain. Tech Foot Ankle Surg 2: 254, 2003.
Fernández-Gibello A, Moroni S, Camuñas G, et al.: Ultrasound-guided decompression surgery of the tarsal tunnel: a novel technique for the proximal tarsal tunnel syndrome—part II. Surg Radiol Anat 41: 43, 2019.
Heimkes B, Posel P, Stotz S, et al.: The proximal and distal tarsal tunnel syndromes: an anatomical study. Int Orthop 11: 193, 1987.
McGill DA: Tarsal tunnel syndrome. Proc R Soc Med 57: 1125, 1964.
Edwards WG, Lincoln CR, Bassett FH III, et al.: The tarsal tunnel syndrome: diagnosis and treatment. JAMA 207: 716, 1969.
Dellon AL: The four medial ankle tunnels: a critical review of perceptions of tarsal tunnel syndrome and neuropathy. Neurosurg Clin N Am 19: 629, 2008.
Franson J, Baravarian B: Tarsal tunnel syndrome: a compression neuropathy involving four distinct tunnels. Clin Podiatr Med Surg 23: 597, 2006.
Ghosh SK, Raheja S, Tuli A: Potential sites of compression of tibial nerve branches in foot: a cadaveric and imaging study. Clin Anat 26: 768, 2013.
Inthasan C, Mahakkanukrauh P: Tarsal tunnel syndrome: anatomical facts and clinical implications. J Anat Soc India 68: 236, 2019.
Mullick T, Dellon AL: Results of decompression of four medial ankle tunnels in the treatment of tarsal tunnel syndrome. J Reconstr Microsurg 24: 119, 2008.
Oh, Shin J: Neuropathies of the foot. Clin Neurophysiol 118: 954, 2007.
Appiah-Ankam J, Hunter JM: Pharmacology of neuromuscular blocking drugs. Contin Educ Anaesth Crit Care Pain 4: 2, 2004.
Baxter DE, Thigpen CM: Heel pain: operative results. Foot Ankle 5: 16, 1984.
Brown MN, Pearce BS, Vanetti TK, et al.: “Medial Planter Nerve Entrapment,” in Peripheral Nerve Entrapments: Clinical Diagnosis and Management, edited by AM Trescot, p 844, Springer International Publishing, Cham, Switzerland, 2016.
Schon LC, Baxter DE: Neuropathies of the foot and ankle in athletes. Clin Sports Med 9: 489, 1990.
Antoniadis G, Scheglmann K: Posterior tarsal tunnel syndrome: diagnosis and treatment. Dtsch Ärztebl Int 105: 776, 2008.
Brown MN, Pearce BS, Vanetti TK, et al.: “Lateral Planter Nerve Entrapment,” in Peripheral Nerve Entrapments: Clinical Diagnosis and Management, edited by AM Trescot, p 832, Springer International Publishing, Cham, Switzerland, 2016.
Hendrix CL, Jolly GP, Garbalosa JC, et al.: Entrapment neuropathy: the etiology of intractable chronic heel pain syndrome. J Foot Ankle Surg 37: 273, 1998.
Lee CH, Dellon AL: Prognostic ability of Tinel sign in determining outcome for decompression surgery in diabetic and nondiabetic neuropathy. Ann Plast Surg 53: 523, 2004.
Rinkel WD, Cabezas MC, van Neck JW, et al.: Validity of the Tinel sign and prevalence of tibial nerve entrapment at the tarsal tunnel in both diabetic and nondiabetic subjects: a cross-sectional study. Plast Reconstr Surg 142: 1258, 2018.
Trepman E, Kadel NJ, Chisholm K, et al.: Effect of foot and ankle position on tarsal tunnel compartment pressure. Foot Ankle Int 20: 721, 1999.
Gould JS: Tarsal tunnel syndrome. Foot Ankle Clin 16: 275, 2011.
Watson TS, Anderson RB, Davis WH, et al.: Distal tarsal tunnel release with partial plantar fasciotomy for chronic heel pain: an outcome analysis. Foot Ankle Int 23: 530, 2020.
Hochman MG, Zilberfarb JL: Nerves in a pinch: imaging of nerve compression syndromes. Radiol Clin N Am 42: 221, 2004.
Oishi C, Ichikawa Y, Chiba A: The usefulness of electrophysiological examinations in the diagnosis of tarsal tunnel syndrome. Clin Neurophysiol 129: e34, 2018.
Patel AT, Gaines K, Malamut R, et al.: Usefulness of electrodiagnostic techniques in the evaluation of suspected tarsal tunnel syndrome: an evidence‐based review. Muscle Nerve 32: 236, 2005.
Sodani A, Dube M, Jain R: Value of motor nerve conduction studies in the diagnosis of idiopathic tarsal tunnel syndrome: a single-center prospective observational study from India. Ann Indian Acad Neurol 21: 35, 2018.
Takakura Y, Kumai T, Takaoka T, et al.: Tarsal tunnel syndrome caused by coalition associated with a ganglion. J Bone Joint Surg Br 80: 130, 1998.
Hong JT, Lee SW, Son BC, et al.: Surgical experiences of the tarsal tunnel syndrome. J Korean Neurosurg Soc 36: 443, 2004.
Nirenberg MS: A simple test to assist with the diagnosis of common fibular nerve entrapment and predict outcomes of surgical decompression. Acta Neurochir 162: 1, 2020.
Travell JG, Simons LS: Myofascial Pain and Dysfunction: The Trigger Point Manual, Lippincott Williams & Wilkins, Philadelphia, 1993.
Scott NA, Bing G, Barton PM, et al.: Trigger point injections for chronic non-malignant musculoskeletal pain: a systematic review. Pain Med 10: 54, 2009.
Kelikian AS, Sarrafian SK: Sarrafian's Anatomy of the Foot and Ankle: Descriptive, Topographic, Functional, Lippincott Williams & Wilkins, Philadelphia, 2011.
Macchi V, Tiengo C, Porzionato A: Correlation between the course of the medial plantar artery and the morphology of the abductor hallucis muscle. Clin Anat 18: 580, 2005.
Wada JT, Akamatsu F, Hojaij F, et al.: An anatomical basis for the myofascial trigger points of the abductor hallucis muscle. Biomed Res Int 2020: 1, 2020.
Beskin JL: Nerve entrapment syndromes of the foot and ankle. J Am Acad Orthop Surg 5: 261, 1997.
Kurashige T: Hypertrophy of the abductor hallucis muscle: a case report and review of the literature. SAGE Open Med Case Rep 5: 2050313X17727638, 2017.
Menz HB: Two feet, or one person? problems associated with statistical analysis of paired data in foot and ankle medicine. The Foot 14: 2, 2004.
Williams JH, Barnes WS: The positive inotropic effect of epinephrine on skeletal muscle: a brief review. Muscle Nerve 12: 968, 1989.
Nguyen, Bang M: Trigger point therapy and plantar heel pain: a case report. Foot 20: 158, 2010.
Giamberardino MA, Affaitati G, Fabrizio A, et al.: Myofascial pain syndromes and their evaluation. Best Pract Res Clin Rheumatol 25: 185, 2011.
Qureshi NA, Alsubaie HA, Ali GI: Myofascial pain syndrome: a concise update on clinical, diagnostic and integrative and alternative therapeutic perspectives. Int Neuropsychiatr Dis J 13: 1, 2019.
Mackinnon SE, Dellon AL, Daneshvar A: Histopathology of the tarsal tunnel syndrome: examination of a human tibial nerve. Contemp Orthop 9: 43, 1984.
Naguib M, Lien CA, Meistelman C: “Pharmacology of Neuromuscular Blocking Drugs,” in Miller’s Anesthesia, 8th Ed, ed by RD Miller, p 958, Elsevier Saunders, Philadelphia, 2015.
Radovic P: Treatment of “plantar fasciitis”/plantar heel pain syndrome with botulinum toxin: a novel injection paradigm pilot study. Foot 45: 01711, 2020.
Bowley MP, Doughty CT: Entrapment neuropathies of the lower extremity. Med Clin North Am 103: 371, 2019.
Kushner S, Reid DC: Medial tarsal tunnel syndrome: a review. J Orthop Sports Phys Ther 6: 39, 1984.
Labib SA, Gould JS, Rodriguez-del-Rio FA, et al.: Heel pain triad (HPT): the combination of plantar fasciitis, posterior tibial tendon dysfunction and tarsal tunnel syndrome. Foot Ankle Int 23: 212, 2002.
Rinkel WD, Cabezas MC, Birnie E, et al.: The natural history of tarsal tunnel syndrome in diabetic subjects. J Plast Reconstr Aesthet Surg 73: 1482, 2020.
Rosenbaum AJ, DiPreta JA, Misener D: Plantar heel pain. Med Clin North Am 98: 339, 2014.
Williams EH, Rosson GD, Hagan RR, et al.: Soleal sling syndrome (proximal tibial nerve compression): results of surgical decompression. Plast Reconstr Surg 129: 454, 2012.
Background: Tarsal tunnel syndrome (TTS) can be divided into proximal TTS and distal TTS (DTTS). Research on methods to differentiate these two syndromes is sparse. A simple test and treatment is described as an adjunct to assist with diagnosing and providing treatment for DTTS.
Methods: The suggested test and treatment is an injection of lidocaine mixed with dexamethasone administered into the abductor hallucis muscle at the site of entrapment of the distal branches of the tibial nerve. This treatment was studied with a retrospective medical record review in 44 patients with clinical suspicion of DTTS.
Results: The lidocaine injection test and treatment (LITT) was positive in 84% of patients. Of patients available for follow-up evaluation (35), 11% of those with a positive LITT test (four) had complete lasting symptom relief. One-quarter of patients with initial complete symptom relief at LITT administration (four of 16) maintained this level of symptom relief at follow-up. Thirty-seven percent of patients evaluated at follow-up (13 of 35) who had a positive response to the LITT experienced partial or complete symptom relief. No association was found between level of symptom relief maintenance and the immediate level of symptom relief (Fisher exact test = 0.751; P = .797). The results showed no difference in the distribution of immediate symptom relief by sex (Fisher exact test = 1.048; P = .653).
Conclusions: The LITT is a simple, safe, invasive method to help diagnose and treat DTTS, and it provides an additional method to assist with differentiating DTTS from proximal TTS. The study also provides additional evidence that DTTS has a myofascial etiology. The proposed mechanism of action of the LITT suggests a new paradigm in diagnosing muscle-related nerve entrapments that may lead to nonsurgical treatments or less invasive surgical interventions for DTTS.