Sinus Tarsi Syndrome

What is it?

Sinus Tarsi Syndrome refers to pain that is localized to an area of the foot known as the sinus tarsi. The sinus tarsi is located on the top of the foot on the lateral side, just distal to the ankle, and refers to an area between the ankle and the heel. This area is filed with soft tissue, and is a common site of inflammation. With sinus tarsi syndrome, the pain is usually apparent during weight-bearing activities such as running or walking, and is apparent when palpating the area or turning the foot inwards and outwards. Patients with sinus tarsi syndrome have problems with uneven surfaces like gravel and grass in particular, as these surfaces force the foot to turn inwards and outwards to a greater extent than flat surfaces. Those with sinus tarsi syndrome may complain of a feeling of loss of balance when walking on these types of surfaces.

What causes it?

Sinus tarsi syndrome may be caused by a variety of problems with the foot and ankle. Most often it is associated with excessive pronation, or someone who walks primarily on the insides of their feet, usually with a collapsed arch. The excessive pronation causes more movement in the joints of the foot, which can aggravate soft tissue like that found in the sinus tarsi.

Sinus tarsi syndrome is also often associated with recurrent lateral ankle sprains. These sprains generally occur very close to the sinus tarsi, and can aggravate the soft tissues as well.

How is it diagnosed?

Sinus tarsi syndrome is diagnosed by first ruling out other possible causes of pain. An x-ray or CT scan is often used to rule out any fractures of the bone. An MRI may be used as well to visualize the soft tissue inflammation in the area. Most commonly, a local anesthetic is injected into the area of the sinus tarsi. This allows a doctor to isolate the pain, and conclude that the pain is in fact coming from the sinus tarsi.

How is it treated?

Treatment of sinus tarsi syndrome is usually conservative. The pain and inflammation is usually treated with a non-steroidal anti-inflammatory drug (NSAID), ice, and/or immobilization for a brief period. If it is a biomechanical issue that is causing sinus tarsi syndrome, which it commonly is, prescription orthoses may be used to help correct the biomenchanical dysfunction. These conservative treatments are usually very effective, and surgery is rarely needed for sinus tarsi syndrome.

If you believe that you have sinus tarsi syndrome, or are having any other foot and ankle pain, contact an APMA member podiatrist. If you need help finding a doctor in your area, check out the APMA website at apma.org.

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com