Tarsal coalition

This is an abnormal connection between the tarsal bones (two bones in the back of the foot). This can lead to limited motion and pain in one or both feet.

Usually, tarsal coalition occurs before birth, resulting in a failure of the bones to form properly. Other causes  (relatively rare) include infection, arthritis, or a previous injury to the area.

Symptoms
While many people are born with the condition, the symptoms generally don’t  appear until around ages 9 – 16, when bones begin to mature. Although there may be no symptoms during childhood, pain and other symptoms may develop later in life. These symptoms can include:

  • Pain (mild to severe) when walking or standing
  • Legs that are easily tired
  • Muscle spasms in the leg
  • Flatfoot (in one or both feet)
  • Walking with a limp
  • Foot and ankle stiffness

Treatment
Any of the following may be used:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
  • Physical therapy, including massage, range-of-motion exercises, and ultrasound.
  • Steroid injections (cortisone). Sometimes more than one injection is necessary.
  • Orthotic devices – these can be beneficial in distributing weight away from the joint.
  • Immobilisation. The foot is placed in a cast and crutches are then used to avoid placing weight on the foot.
  • Injection of an anaesthetic agent to relax spasms. These may be given before immobilisation.
  • If non-surgical treatments are ineffective,  surgery is an option.