Clearwater, Tampa, St Petersburg, Florida
Tarsal coalition is a relatively common abnormality, in which a connection develops between two bones in the back of the foot (the tarsal bones). This abnormal connection, which can be composed of bone, cartilage, or fibrous tissue, may lead to limited motion and pain in one or both feet.
Tarsal coalition is caused either by a congenital failure for the tarsal bones to properly segment, or it may also be seen as a secondary problem due to progressive arthritis, immune diseases such as rheumatoid arthritis, or it may also be seen as a result of repetitive trauma.
The fusion is most common between the calcaneus-navicular bones and the talus-calcaneus bones. This joint is also known as the subtalar joint, and allows the foot to articulate inward or outward. There are three types of fusions. The first is a bony fusion which is bone to bone fusion and tends to be the most rigid type of fusion. Next, is a cartilage to cartilage fusion and last is a fusion of two bones through a fibrous union which is similar to scar tissue. These fusions either restrict or completely eliminate normal joint motion which generally forces the foot into a rigid flatfoot. This fusion of bone will ultimately adversely affect adjacent joints eventually leading to arthritis of those joints.
While many people who have a tarsal coalition are born with this condition, the symptoms generally do not appear until the bones begin to mature, usually around ages 9 to16. Sometimes there are no symptoms during childhood. However, pain and symptoms may develop later in life.
Symptoms of Tarsal Coalition:
- Pain (mild to severe) when walking or standing
- Tired or fatigued legs
- Muscle spasms in the leg, causing the foot to turn outward when walking
- Flatfoot (in one or both feet)
- Walking with a limp
- Stiffness of the foot and ankle
Diagnosis is generally made through clinical examination and is confirmed through x-rays, CT scans, or MRI studies.
Treatment for Tarsal Coalition
The goal of conservative treatment is to relieve the symptoms and reduce motion at the fused joint. Some of the conservative treatments available include:
- Oral anti-inflammatory medication in an effort to reduce inflammation in the rear foot.
- Physical therapy to reduce inflammation and perhaps improve motion.
- Cortisone injections may also help reduce inflammation.
- Orthotics in an effort to reduce motion in the affected joint and keep the foot in a more neutral position.
- Immobilization through the use of a cast in an effort to reduce inflammation through rest and also to reduce any muscle spasm that may be present.
- Injection of local anesthesia in an effort to relax muscle spasm, usually performed prior to casting.
If it cannot be addressed with conservative physical medicine modalities, then preventing further degeneration of the subtalar joint is possible using platelet-rich plasma (PRP) and stem cell therapy. Platelet-rich plasma (PRP) and stem cell therapy release growth factors and may help to regenerate tissues to prevent further degeneration.
If you suffer with tarsal coalition and your current treatment plan leaves you feeling hopeless, perhaps a fresh set of experienced eyes can change your outlook. Since 1990, Dennis M. Lox, M.D has applied his personal interests in sports medicine, cutting-edge regenerative medicine and chronic pain management to helping patients increase their quality of life. Contact us for an appointment at 727-462-5582.
Dennis M. Lox, MD, and the Florida Spine Center serve patients within the greater Tampa Bay area, including Clearwater, Tampa and St. Petersburg, as well as all of Florida and the US.
All statements, information or opinions provided by this website are provided for educational purposes only. We do not diagnose nor treat through this website or by telephone. As you consider any treatment, discuss them with your physician.