Tarsal Tunnel Syndrome – Check-in / Follow-up

Hey everyone!

It has been about 21 months since my Tarsal Tunnel Surgery and I’m back with an update regarding Tarsal Tunnel Syndrome (TTS). It’s not really a good one, but I’m going to share it. Like I said in my last blog regarding TTS, which was 1.5 years ago, everything was going well – recovery and activity wise. However, for the last 15 months or so I started to feel all of the dreaded TTS symptoms coming back. For those following along and other TTS sufferers (I see you and appreciate all of your comments!!), you know what I mean – the pain, numbness, and burning sensations in my foot. Especially in the spot I had a TTS release surgery.

About 6 months ago, I went back to the Doctor that did the surgery and he gave me 2 options which were to rub this cream that has strong narcotics in it or a revision surgery. At the moment, I was not ready for surgery. I figured let’s try the cream and go from there. Well guess what, the cream was bull. Didn’t do a thing. I thought to myself, what was I going to do next. Not surgery. Not mentally there yet. I said to myself that there had to be something out there other than invasive surgery.

I thought a fresh set of eyes on my case would be wise. I went to a new podiatrist at Penn Medicine in Philadelphia. He couldn’t offer much and did not recommend surgery at this time but referred me to a neurologist. I did another Electromyography (EMG) and MRI. The MRI showed that I had a good amount of scar tissue laying on the nerve that was probably causing some pain. He offered a less invasive, walk in and walk out, procedure. It’s called ultrasound guided hydro dissection. I was at a point that I was willing o try anything so I went for it.

The dissection was about a 40 minute procedure. It’s where they separate the scar tissue from the nerve. It’s pretty cool to see it happening on the screen. They use the ultrasound guide and then use needles with solution and separate the nerve and scar tissue. At the end they put some cortisone in there also. The procedure was painless and fast. Unfortunately, it has been about 2 months since then and it had no effect for me.

The neurologist then recommended a procedure that is a little more complicated. It’s another surgery and this time you are put under anesthesia and go under the knife. I never heard about this technique, but I was considering taking the risk to do it. It’s where they take fat from your stomach and inject it into your ankle between the nerve and the scar tissue. This is to act like a barrier to keep them apart. I wasn’t sold completely on this procedure. It was nice to hear what he had to say but he really seemed a bit unsure as to what was going on. He told me about the one case that he had similar to mine, and that caused me to be a bit apprehensive. Only one. No thank you.

I’m not ready to give up yet. I read that many successful cases say that when dealing with TTS, you should discuss your case with only an Association of Extremity Nerve Surgeons (AENS) Doctor.  There are only 6 in the state of Pennsylvania and I’m lucky enough to have one 10 minutes from me. They are more specialized in nerves in the feet and leg. I finally got a appointment with the Doctor who is local to me. I know it sounds like I’m a doctor hunter; but at the end of the day, I’m trying to find the best treatment option available. I need to do it for my career as a fitness trainer and  dad to 2 little ones. I want to be able to run and walk for at least a couple of miles and right now I can’t do that without stopping and taking a break to keep moving.

I spoke with the AENS Doctor about my TTS and all the pain and numbness that I am having. He did some tests right there, looked at my MRI and EMG results. He came up with some treatment options that made a lot of sense. He is suggesting a revision surgery while hopefully adding something to combat the scar tissue that is pressing up on the nerves. Additionally, I am going to need a a gastrocnemius achilles lengthening. I have learned that it is important to meet with an AENS surgeon. Will keep you posted with next up details. Stay positive and remain the course.

Talk soon –

Dan