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Date of last update: 10/01/2017.

Forum Name: Bone trauma and fractures

Question: Sinus Tarsi syndrome? (severe ankle pain after 3 years

 Mr.Adam - Sat Aug 07, 2010 10:14 pm

Hello. For the last three years I have had unbearable pain in my left ankle (I am 17 now and the pain began when I was 14) It was a gradual pain that built up to unbearable pain where I could not walk or stand on my foot.
After two years I finally had an operation to remove some extra bone identified in a CT scan. Unfortunately this did not help the problem and if anything has made the problem worse (my foot seems to click more which seems to directly affect the stability of it).

Further scans including xrays, mri and bone scans have identified the injury is in the subtalar joint and as I result my subtalar joint is very stiff and barely moves (my right foot moves fine). The doctor has told me that the only operation available is a subtalar fusion surgery that has a lot of future risks and so has reccommended I:
1) Have steroid injections (I have already had one that allows me to stand on the spot and reduces swelling but does not remove the pain I am feeling) I should not have more then 3.
2) Have insoles put into my shoes to stop movement in my heel
3) Lose weight (I weigh 140kg)
until I cannot take it any longer and need surgery despite it's future risks.
4) Take pain killers (They do not help me at all despite being relatively strong)
I am already at this point as I haven't been able to walk for three years and I'm not sure what to do next. I can't continue like this and I was wondering if it possible there has been a misdiagnosis? Any advice would be appreciated.

After doing some internet research it seems the problem the doctor is describing is referred to as sinus tarsi syndrome
P.S. I've found that after the first surgery my ankle seems to click a lot more. My doctor has explained that it is probably due to scar tissue, but I feel as if the clicking directly affects my ankle stability
Thanks in advance.
 Tom Plamondon PA-C - Fri Aug 13, 2010 2:35 pm

User avatar Hello,
At this point besides surgery, the treatment is conservative i.e. rehabilitate the ankle (Physical Therapy), control the pain and consider proper bracing including orthotics.
This triad should provide at least 25% improvement in pain and function.

If no improvement after 3-6 months, you may need to consider surgical fusion.

Take care.

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