Hydro Dissection Therapy for the Treatment of Tarsal Tunnel Syndrome

Tarsal Tunnel Syndrome (TTS) is the entrapment of the tibial nerve and its branches at the ankle joint. It is commonly encountered focal neuropathy and should be considered in the differential diagnosis of foot pain and sensory alteration. Incident rates of TTS are unknown, studies suggest it is more prevalent in females and can occur at any age. Some studies suggest a prevalence of 0.4% - 0.5% based on electrophysiological investigations. A recent study which employed a more detailed interrogation of the tibial nerve suggests a higher prevalence rate. This thorough electrodiagnostic evaluation (EDX) can identify the location of the focal neuropathy as the tibial nerve complex has significant variability in its branching pattern at the tarsal tunnel. Surgical treatment of tarsal tunnel is invasive and has variable results. The current paper presents a noninvasive treatment, that of hydro dissection injection using ultrasound guidance. This procedure has been shown to give both short-term and long-term relief from this painful condition.