What is Tarsal Tunnel Syndrome?
Tarsal tunnel syndrome is a condition analogous to carpal tunnel syndrome, with the former condition affecting the foot, and the latter affecting the wrist. The tarsal tunnel is bounded by the ankle bone on one side and a band of fibrous tissue, called the flexor retinaculum, on the other. The main nerve serving the foot, the posterior tibial nerve, runs through this tube, or tunnel. Tarsal tunnel syndrome is caused by compression of this nerve, which in turn causes the nerve to become inflamed and stop working properly.
Tarsal tunnel syndrome is one of several conditions that can cause heel pain, numbness, and tingling. It can also cause pain on the underside (plantar surface) of the sole and toes. Because several other conditions can also cause pain in these areas, correct diagnosis is essential. Tarsal tunnel syndrome is relatively uncommon, and may resolve itself spontaneously.
Causes of Tarsal Tunnel Syndrome
- Callous from a previous fracture of the ankle bone
- Inflammation of one of the tendons passing through the tarsal canal
- Excessive pronation (foot rolling inward)
Other causes include:
- Poor shoes, especially women's that encourage excessive pronation
- More generalized nerve disorders
Symptoms of Tarsal Tunnel Syndrome
Since the posterior tibial nerve serves a large area in the foot, pain, numbness, or discomfort may be difficult to pinpoint. Some patients report persistent burning pain, or pain like an electric shock that shoots down to the toes or up to the calf. There may be weakness in the muscles served by the nerve. The condition may also be associated with calf pain, especially at night. Symptoms are usually worse when standing or walking on the foot, but do not go away completely at rest. There is usually tenderness just below the bony bump on the inner surface of the ankle. Symptoms may be sporadic.
Treatment for Tarsal Tunnel Syndrome
Treatments are designed to relieve pressure on the nerve. Proper diagnosis is essential, and tarsal tunnel syndrome is difficult to diagnose. You should see a qualified physician. Conservative treatments include:
- Addressing excessive pronation, with changes in shoes and/or orthotics
- Physical therapy
- Steroid injections
- Weight loss
- Anti-inflammatory drugs, such as aspirin or ibuprofen
Surgery may be necessary if conservative measures fail. However, surgical results are mixed.
The information provided herein is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting a licensed physician.