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Tarsal Tunnel Syndrome

This article will discuss what tarsal tunnel syndrome is, its common symptoms, how it’s diagnosed, and the various treatment options available. 

If you’re seeking expert care for tarsal tunnel syndrome or simply want to learn more about foot health, consider scheduling an appointment with Orthopedic Foot & Ankle Center, where our team of orthopedic and podiatric specialists is dedicated to providing exceptional care and helping you get back on your feet. Visit our offices in the Greater Columbus area today!

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Topic at a Glance

  • Tarsal tunnel syndrome occurs when the posterior tibial nerve becomes compressed as it passes through the inside of the ankle.
  • The condition can cause foot pain, tingling, numbness, burning sensations, or weakness in the foot muscles.
  • Common causes include flat feet, ankle injuries, cysts, systemic diseases, and repetitive stress on the foot.
  • Treatment often begins with non-surgical options such as rest, orthotics, medications, and physical therapy, with surgery considered in severe cases.

 

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What is Tarsal Tunnel Syndrome?

Tarsal tunnel syndrome is a condition where a nerve in your foot called the posterior tibial nerve gets squeezed or compressed. This nerve runs down the inside  of your leg and into your foot, helping with movement and sensation. Think of it like carpal tunnel syndrome but in your foot instead of your wrist.

When this nerve gets compressed, it can cause pain, tingling, or numbness in your foot. You might feel like your foot is burning or that pins and needles are pricking you. Sometimes, it can even lead to weakness in the muscles of your foot.

What Causes Tarsal Tunnel Syndrome?

Tarsal tunnel syndrome happens when the posterior tibial nerve in your foot gets squeezed or compressed. This nerve runs along the inside of your ankle, helping with movement and sensation in your foot.

There are a few reasons why this nerve might get compressed:

  1. Flat Feet: When the arch of your foot collapses and becomes flat, it can put extra pressure on the nerve, leading to developing tarsal tunnel syndrome.
  2. Injuries: An injury to your ankle, such as a sprain or fracture, can cause swelling and put pressure on the nerve.
  3. Ganglion Cyst: These are noncancerous lumps that can develop along the nerve, putting pressure on it and causing pain.
  4. Systemic Diseases: Conditions like diabetes or arthritis can lead to inflammation and swelling, which can also compress the nerve.
  5. Repetitive Stress: Doing the same motion over and over again, like running or walking long distances, can irritate the nerve and lead to tarsal tunnel syndrome.
A doctor treating tarsal tunnel syndrome in Columbus, Ohio.

What Are the Symptoms of Tarsal Tunnel Syndrome?

Some common symptoms of Tarsal Tunnel Syndrome are listed below. 

  1. Foot Pain: This is the most common symptom. It can be sharp, shooting pain or a dull ache that gets worse with activity and at times even while at rest.
  2. Tingling or Pins and Needles: You might feel like your foot is “falling asleep” or have a sensation of pins and needles.
  3. Numbness: Some people with tarsal tunnel syndrome experience numbness in the sole of their feet or toes.
  4. Burning Sensation: You might feel like your foot is burning, especially along the inside of your ankle.
  5. Weakness: You may notice weakness in the muscles of your foot, making it harder to move or control your foot properly.
 

If you’re experiencing any of these symptoms, especially if they’re affecting your daily activities or getting worse over time, it’s essential to see a doctor who specializes in foot and ankle care. They can help diagnose tarsal tunnel syndrome and suggest the right treatment for you.

Don’t ignore foot pain or discomfort, as it could be a sign of a more serious problem. The sooner you get help, the sooner you can start feeling better and get back to doing the things you love.

How is Tarsal Tunnel Syndrome Diagnosed?

Diagnosing tarsal tunnel syndrome usually starts with a visit to a doctor, often a foot and ankle specialist called an orthopedic surgeon.

Here’s how they typically diagnose it:

  1. Medical History: The doctor will ask about your symptoms and any past injuries or medical conditions.
  2. Physical Examination: They’ll examine your foot and ankle, checking for areas of tenderness, swelling, or changes in sensation.
  3. Tinel’s Sign: During the physical exam, the doctor might tap on the area around your ankle to see if it causes tingling or pain. This is called Tinel’s sign and can be a sign of tarsal tunnel syndrome.
  4. Nerve Conduction Studies: If the diagnosis isn’t clear from the physical exam, your doctor might order special tests like nerve conduction studies. These tests measure how well the nerves in your foot are working.
  5. Imaging Tests: In some cases, your doctor might order diagnostic imaging tests like an MRI or ultrasound to get a better look at the soft tissue in your foot and ankle.
 

By combining information from your medical history, physical exam, and any tests, your doctor can accurately diagnose tarsal tunnel syndrome. Once diagnosed, they can recommend the right treatment to help relieve your symptoms and get you back on your feet.

Tarsal Tunnel Syndrome Treatment Options

Treatment for tarsal tunnel syndrome aims to relieve pressure on the posterior tibial nerve in your foot. Here are some common options to treat tarsal tunnel syndrome:

  1. Rest and Ice: Resting your foot and applying ice packs can help reduce inflammation and relieve pain.
  2. Medications: Over-the-counter pain relievers like ibuprofen or naproxen can help reduce pain and inflammation.
  3. Orthotics: Special shoe inserts or custom orthotic devices can help support your foot and reduce pressure on the nerve.
  4. Physical Therapy: Stretching and strengthening exercises can help improve the flexibility and strength of your foot muscles, reducing pressure on the nerve.
  5. Steroid Injections: Injecting corticosteroids into the tarsal tunnel can help reduce inflammation and relieve pain.
  6. Surgery: If conservative treatments don’t relieve your symptoms, your doctor might recommend surgery to release the pressure on the nerve. This is called tarsal tunnel release surgery and is usually done by a foot and ankle surgeon.

How to Prevent Tarsal Tunnel Syndrome

Preventing tarsal tunnel syndrome involves taking care of your feet and ankles to reduce the risk of developing this painful condition. Here are some tips to help prevent tarsal tunnel syndrome:

  1. Wear supportive shoes: Choose shoes with a wide toe box and good arch support. This helps reduce pressure on the nerves in your feet and ankles.
  2. Avoid high heels: High heels can put extra pressure on the nerves in your feet and increase your risk of developing tarsal tunnel syndrome.
  3. Maintain a healthy weight: Being overweight can put extra pressure on your feet and ankles, increasing your risk of developing tarsal tunnel syndrome.
  4. Use proper form during exercise: If you’re an athlete or participate in regular physical activity, make sure to use proper form and technique to reduce the risk of injury to your feet and ankles.
  5. Stretch and strengthen your feet: Doing exercises to stretch and strengthen the muscles in your feet and ankles can help prevent tarsal tunnel syndrome.
  6. Take breaks: If you spend a lot of time on your feet, make sure to take regular breaks to rest and stretch your feet and ankles.
  7. See a foot and ankle surgeon: If you have flat feet or other foot conditions that put you at risk for tarsal tunnel syndrome, consider seeing a foot and ankle specialist. Foot and ankle surgeons can recommend treatments to help prevent the condition from developing.

Schedule an Appointment with Us Today!

Taking care of your feet is essential for your overall health and well-being. If you’re experiencing foot pain, tingling, or numbness, it’s essential to seek help from a foot and ankle specialist.

At Orthopedic Foot & Ankle Center, our team of experienced orthopedic and podiatric surgeons in Columbus, Ohio, and the surrounding area can diagnose and treat tarsal tunnel syndrome, helping you find relief from your symptoms and get back to doing the things you love. Don’t let foot pain hold you back—schedule an appointment today and take the first step toward healthier feet.

Medically reviewed by Terrence M. Philbin, DO

FAQs About Tarsal Tunnel Syndrome

Tarsal tunnel syndrome is a condition in which the posterior tibial nerve becomes compressed inside the tarsal tunnel, a narrow space located along the inside of the ankle. This nerve compression can lead to pain, tingling, numbness, or weakness in the foot.

Several factors can contribute to nerve compression in the ankle, including:

  • Flat feet, which increase pressure on the nerve

  • Ankle injuries such as sprains or fractures

  • Ganglion cysts or growths that press on the nerve

  • Inflammatory conditions like arthritis or diabetes

Repetitive stress from activities such as running or prolonged standing

Symptoms may include foot pain, burning sensations, numbness, tingling, or a pins-and-needles feeling along the inside of the ankle or the sole of the foot. Some individuals may also experience muscle weakness or difficulty controlling foot movements.

Doctors typically diagnose the condition through a medical history review and physical examination. Tests may include checking for Tinel’s sign, where tapping on the nerve causes tingling sensations. Additional tests such as nerve conduction studies, MRI scans, or ultrasound imaging may be used to confirm the diagnosis.

Treatment aims to relieve pressure on the posterior tibial nerve and may include:

  • Rest and ice to reduce inflammation

  • Anti-inflammatory medications

  • Custom orthotics or supportive footwear

  • Physical therapy exercises to improve foot strength and flexibility

  • Corticosteroid injections to reduce swelling

Surgical decompression if conservative treatments do not provide relief

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