Sinus Tarsi Syndrome

What is Sinus Tarsi Syndrome?

Sinus Tarsi Syndrome (STS) is a condition that involves pain and inflammation in the sinus tarsi, a small cavity or channel located on the outer side of the foot, just below the ankle joint. This syndrome often arises from injury or overuse and can lead to persistent foot pain, especially on the outer (lateral) side of the foot and around the ankle.

Symptoms of Sinus Tarsi Syndrome:

The main symptom of STS is pain, typically experienced on the outside of the foot or ankle. Other common symptoms include:

Pain on the Outside of the Foot: The pain can radiate to the outer side of the ankle and foot.
Swelling and Inflammation: Swelling can occur around the sinus tarsi, often after activity or injury.
Instability: The ankle may feel weak, unstable, or as though it might give way, particularly during physical activity.
Pain with Prolonged Standing or Walking: The pain may increase with prolonged standing, walking, or running.
Tenderness to Touch: Pressing on the sinus tarsi region may provoke pain, and there may be sensitivity to palpation.
Reduced Range of Motion: The pain and swelling can limit the range of motion of the foot and ankle.

Treatments We Offer:

Ultrasound Guided Cortisone Injections

Ultrasound-guided cortisone injections can be an effective treatment for Sinus Tarsi Syndrome (STS), particularly when the condition causes persistent pain or inflammation that doesn’t respond well to conservative measures such as rest, physical therapy, or anti-inflammatory medications. The ultrasound guidance allows for precise placement of the cortisone (steroid) injection directly into the affected area, providing targeted relief from inflammation and pain.

How Ultrasound-Guided Cortisone Injection Works for Sinus Tarsi Syndrome:

An ultrasound-guided cortisone injection involves using ultrasound imaging to help the healthcare provider visualize the sinus tarsi area and deliver the cortisone directly to the inflamed tissues around the talus, calcaneus, and surrounding ligaments and soft tissues. This targeted delivery maximizes the effectiveness of the cortisone and minimizes the risk of injecting the steroid into the wrong area or causing harm to nearby structures.

Benefits of Ultrasound-Guided Cortisone Injection for Sinus Tarsi Syndrome:
- Precise Delivery: The use of ultrasound ensures the cortisone is injected exactly where it’s needed, increasing the likelihood of success.
- Targeted Pain Relief: The cortisone works directly on the inflamed tissues in the sinus tarsi, providing targeted anti-inflammatory effects that can significantly reduce pain and swelling.
- Minimally Invasive: The procedure is non-surgical, requires only a small needle, and is performed as an outpatient procedure with minimal downtime.
- Quick Recovery: Most patients can resume normal activities after a brief rest period, and the recovery time is typically much quicker than with surgery.

Your Care Pathway With Us

To book an appointment you can call our reception line, 0142084487, or email to info@altonpainclinic.co.uk or click the button given below.
Comprehensive Musculoskeletal examination and testing.
Same day Ultrasound Guided Injection for pain relief.
Discussion of your treatment plan, treatment plan can include advanced treatments for example Cortisone Injections, Hyaluronic injections and various other options tailored to your specific needs.

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Anatomy of the Sinus Tarsi:

The sinus tarsi is a small, bony tunnel located between the talus (the bone that sits on top of the heel) and the calcaneus (heel bone). It serves as a passageway for various important structures:

Ligaments: The anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL) both play a role in stabilizing the ankle joint and are located in the region around the sinus tarsi.
Tendons: The tibialis posterior tendon also runs nearby and helps support the arch of the foot.
Nerves: The deep peroneal nerve and other sensory nerves provide feeling and function in the area.
Blood vessels: These supply nutrients to the surrounding tissues.

What Causes Sinus Tarsi Syndrome?

STS typically develops due to trauma, repetitive strain, or instability in the ankle. Common causes include:

Ankle Sprains or Inversions: A sudden ankle sprain, especially when the ankle is twisted inward (inversion injury), can damage the structures around the sinus tarsi, leading to inflammation and irritation.
Chronic Overuse: Repetitive activities, such as running, jumping, or sports involving quick changes in direction, can stress the sinus tarsi and its surrounding ligaments.
Ankle Instability: Individuals with chronic ankle instability, where the ankle is prone to “giving way,” may develop sinus tarsi syndrome. This is often a result of ligaments or other structures being weakened by previous injuries.
Foot Deformities: Conditions like flat feet or high arches can alter the biomechanics of the foot, placing additional stress on the sinus tarsi and surrounding ligaments.
Previous Ankle Injuries: After an ankle injury, such as a severe sprain, there may be damage to the ligaments or structures surrounding the sinus tarsi, causing long-term pain and dysfunction.

Diagnosis of Sinus Tarsi Syndrome:

Diagnosing STS usually involves:

Physical Examination: A clinician will assess the foot and ankle, looking for areas of tenderness, swelling, and instability. They will also check for any signs of injury, such as bruising or deformity, and may test the range of motion.
Palpation of the Sinus Tarsi: A key part of diagnosis involves pressing on the sinus tarsi to identify areas of pain or tenderness.
Ultrasound Imaging: This may be used to visualize soft tissue inflammation or damage to the ligaments and tendons around the sinus tarsi.

Treatment Options for Sinus Tarsi Syndrome:

The treatment for sinus tarsi syndrome typically starts with conservative (non-surgical) methods. In severe cases, surgical intervention may be considered.

Rest and Activity Modification:

Avoiding activities that place excessive stress on the ankle, such as running or jumping, can help alleviate pain and allow the inflamed tissues to heal.
Resting the foot and reducing weight-bearing activities, especially during flare-ups, can be beneficial.

Ice Therapy:

Applying ice to the affected area can help reduce swelling and inflammation, particularly after activity or when pain flares up.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs):

Over-the-counter pain relievers, such as ibuprofen or naproxen, can help manage pain and inflammation.

Ankle Bracing or Taping:

A brace or taping technique can help stabilize the ankle and prevent excessive movement, allowing the ligaments and tissues to heal. This is especially helpful for individuals with ankle instability or after an acute injury.

Physical Therapy:

Strengthening exercises for the ankle and foot muscles can help restore stability and prevent future injuries.
Range-of-motion exercises and stretching can reduce stiffness and improve flexibility.
Balance training exercises can help improve proprioception and reduce the risk of further ankle sprains.

Orthotics:

Custom insoles or arch supports may be recommended to correct foot mechanics, redistribute pressure, and provide better alignment of the ankle, reducing stress on the sinus tarsi.

Cortisone Injections:

If pain persists, a cortisone injection may be administered to reduce inflammation in the sinus tarsi. This can provide temporary relief, especially in cases where inflammation is severe.

Surgical Treatment:

If conservative treatments fail to provide relief and symptoms persist, surgery may be considered. Surgical options may include:
- Sinus Tarsi Decompression: This procedure involves removing some of the tissues or structures around the sinus tarsi to relieve pressure and improve movement.
- Ligament Repair: If there is damage to the ligaments around the sinus tarsi, repair surgery may be needed.
- Fusion: In rare cases, a procedure to fuse bones in the affected area (arthrodesis) may be performed to stabilize the joint and reduce pain.

Prevention of Sinus Tarsi Syndrome:

To help prevent sinus tarsi syndrome or reduce the risk of recurrence:

Proper Footwear: Wear shoes with good arch support, cushioning, and stability to reduce stress on the foot and ankle.
Strengthen the Foot and Ankle: Regularly performing exercises to strengthen the ankle and foot muscles can improve stability and help prevent injuries.
Avoid Overuse: Gradually increase activity levels to avoid overloading the ankle joint and the sinus tarsi.
Foot Orthotics: Custom-made insoles can help correct abnormal foot mechanics and provide added support.
Stretching and Warm-Up: Before engaging in physical activity, it’s important to properly warm up and stretch the muscles and tendons of the foot and ankle.