Tarsal coalition is a congenital condition that occurs when the tarsal bones in the foot fail to separate. The tarsal bones are the seven bones in the heel and mid-foot and are necessary for the foot to function properly. Since tarsal coalition affects the way the bones move as we walk, it can put stress on the joints resulting in pain and muscle spasms. About 1 percent of the population suffers from tarsal coalition.

Causes of tarsal coalition

Tarsal coalition is an inherited condition that occurs during fetal development, when the cells that form the tarsal bones do not separate properly. In some cases, tarsal coalition can occur later in life as a result of trauma, arthritis, or infection.

Tarsal coalition symptoms

Symptoms of tarsal coalition do not usually present themselves until the bones are more fully developed. While the disorder is sometimes not diagnosed until adulthood, symptoms are often first noticed between the ages of 9 and 16. Symptoms may include:

• Flat feet.
• Muscle fatigue in the legs. 
• Muscle spasms that cause the feet to turn outward. 
• Pain on the outside and top of the foot.
• Pain when weight is placed on the feet. 
• Stiffness of the ankle and foot.

Since many symptoms of tarsal coalition are also associated with other conditions, an MRI or CT scan may be necessary to confirm the diagnosis.

Treatment of tarsal coalition

Tarsal coalition can usually be treated without surgery. The goal of treatment is to reduce pain and muscle spasms by limiting joint movement.

Non-surgical treatments

Often, non-surgical treatments are effective in treating tarsal coalition. Some of these treatments may include: 

• Anti-inflammatory medications. 
• Cast or boot to immobilize the foot, allowing it time to heal. 
• Cortisone injections to reduce pain and inflammation. 
• Exercises and gentle massages to help improve range of motion.
• Orthotic devices to help relieve pain and limit motion at the joint. 
• Pain relievers.

Surgical treatment

If non-surgical treatments are unsuccessful, surgery might be considered. Surgery usually involves removing the coalitions of bone to allow for normal range of motion. However, if severe arthritis is involved, the bones can be fused together to limit the motion of the joint thereby reducing pain. Following surgery, the foot will be kept immobilized in a cast or splint while it heals. During this time, exercises can help promote muscle tone and increase range of motion.

If you are suffering from tarsal coalition, speak with your doctor to find the best treatment plan.