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Ongoing pain on the front side of the ankle between the ankle and heel could indicate that you are suffering from sinus tarsi syndrome (STS.) Sinus tarsi syndrome is considered a syndrome because there are a group of symptoms occurring at the same time. This condition is created when there is a traumatic injury to the ankle. Chronic ankle sprains seem to be a major contributing factor in most cases of STS.

The hollow area between the ankle and heel bone has many soft tissue structures including ligaments, muscle, nerves, blood vessels and fat that make up the sinus tarsi. An injury to the ligaments in this area can cause pain and result in the instability of the joint. Normally the foot is able to move from side to side because of the subtalar joint, but painful swelling of the sinus tarsi make such movement difficult.

Treatment for this condition most often begins with anti-inflammatory medication to address the pain, swelling and inflammation. Occasionally, a steroid injection may be necessary to relieve the pain when other treatments fail. An arch support may be recommended. This support is used to relieve the pinching of the subtalar joint. Sometimes a brace is used on the ankle and back of the foot so the subtalar joint can rest and be supported.

Surgical procedures are used if the severity of the injury is extensive. Minimally invasive surgery may be used to remove the inflammation and scarring of the sinus tarsi. When a flatfoot is the cause of the pain in the sinus tarsi, your doctor may recommend that that flatfoot issue be corrected. A subtalar fusion may be necessary if advanced arthritis has affected the subtalar joint.

Causes of Sinus Tarsi Syndrome

Flatfoot deformity is one of the most common causes of sinus tarsi syndrome. In this condition, the arch of the foot drops, causing the two bones on the outside portion of the subtalar to pinch against one another. The increased pressure on the soft tissues of the sinus tarsi causes inflammation of the joint lining or the tissue outside of the joint.

Another cause of sinus tarsi syndrome is arthritis in the joint. Scar tissue from previous injuries and joint instability can also cause STS.

Ongoing pain in your foot or ankle should be addressed by a qualified medical professional. For exceptional foot and ankle care, contact Dr. Stuart Mogul, one of New York City’s premier foot and ankle surgeons, to schedule time for a consultation.

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