Prevalence of Tarsal Tunnel Syndrome Among Diabetic Patients of Sargodha

Abstract

Background: Tarsal Tunnel Syndrome (TTS) is an entrapment neuropathy of the posterior tibial nerve that may be underdiagnosed in diabetic populations due to overlapping symptoms with peripheral neuropathy. Chronic hyperglycemia and microvascular changes in diabetes increase nerve susceptibility to compression, potentially impairing function and quality of life. Objective: To determine the prevalence of TTS and its clinical correlates among diabetic patients in Sargodha using validated clinical assessment tools. Methods: A cross-sectional observational study was conducted over six months in government and private hospitals in Sargodha. Two hundred adults with type 1 or type 2 diabetes were recruited by convenience sampling. Screening used the Michigan Neuropathy Screening Instrument (MNSI); neuropathic pain was assessed via the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS), functional impairment with the Functional Foot Index (FFI), and focal nerve compression using Tinel’s sign and the Triple Compression Test (TCT). Associations were analyzed using chi-square, t-tests, odds ratios (ORs), and Pearson correlation. Results: Neuropathic pain (LANSS ≥12) was present in 64.5% of participants. Positive Tinel’s sign (48.0%, OR 5.42, p<0.001) and positive TCT (37.0%, OR 2.13, p=0.026) were significantly associated with neuropathic pain. Bilateral foot involvement (42.5%) was the most common presentation. LANSS scores correlated moderately with functional impairment (r=0.337, p<0.001). Age and gender showed no significant associations. Conclusion: TTS is highly prevalent among diabetic patients in Sargodha, and simple bedside tests demonstrate strong diagnostic utility. Incorporating targeted neurological screening into diabetic care may enable earlier detection and intervention to prevent disability.