Sinus Tarsi Syndrome

Sinus Tarsi Syndrome

Q:

Age: 32 Sex: M Concern: Occupational injuries

I am completely flat footed and have recently been diagnosed as having sinus tarsi syndrome. I really can't pinpoint when it all began, it may have been when I jumped off a 4 foot stage, or when I banged the inside of my ankle against the leg of a chair while I was sitting down (coming from behind the chair) - but I was complaining of ankle pain that was progressive and persistent.

After an MRI, the radiologist and the orthopedic surgeon I consulted suspected SST. The surgeon then consulted with a foot and ankle specialist who concurred after seeing the MRI results and recommended the following treatment:

1) Injection with a local anesthesia and then observation.

2) If that doesn't work, then surgical intervention - 'a simple clean up job'

My first question is - should surgery be a consideration?

Secondly, why try only one injection of anesthesia? If symptoms return after the initial dose, why not try a second or more? If yes, then can the second or third dose be co-administered with a cortisone injection?

Thirdly, I was told that the benefit of an anesthetic is that it 'may kill off the affected nerves' and thereby alleviate the symptoms long term. Is this true? If yes, would there be a danger of 'turning a blind eye' to the underlying cause?

Fourth - what about surgery?

I am a bit apprehensive about this. My doctor told me that this is a very rare condition, and that there have probably only been around 4,000 cases in recorded history. I live in a developing country, and so I feel that I really need to get expert advice, especially when surgery is being considered as an option. I would really appreciate your reply and thank you for your kind attention.

Yours sincerely,

-- Anonymous

A:

I would try one or two cortisone injection to see if it would help before considering surgery. The condition is not as rare as what you quoted.

-- Sherman Nam Tran, M. D.

to ask Dr. Tran.