Painful burning, stinging, electrical shocks and possibly numbness in the plantar foot, especially with weight bearing and activity may be tarsal tunnel syndrome. This is an often misdiagnosed condition since the symptoms overlap with many other pathologies. 

Diagnostic testing such as MRI, CT, ultrasound and EMG/NCV studies are not consistently diagnostic, leading to many alternate theories for pain in this region. Many practitioners will often overlook double crush situations where the peripheral nerves are already hypersensitive due to more proximal level compression. Systemic disorders such as diabetes and thyroid disease may also make peripheral nerves more susceptible to compression injuries. 

Careful history and physical exam, and occasionally a diagnostic block are used to confirm the diagnosis and rule out others. 

Treatments are also difficult because there is no consistency in response to any one method. Occasionally surgery is required for pain relief, although expectations for surgical outcome must be guarded. In advanced stages the post-operative prognosis worsens, and patients often will gain some but not complete relief. This is true even if space occupying lesions are the causative factor and can be removed.

The content of this podcast is for educational and informational purposes only and does not constitute medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.