Tarsal Tunnel Syndrome – Causes, Symptoms, Diagnosis, And Treatment
What is tarsal tunnel syndrome?
Tarsal tunnel syndrome is a type of compression neuropathy caused by excessive pressure on the posterior tibial nerve. This nerve is the branch of the sciatic nerve in the ankle that allows feeling and movement to parts of the foot. Tarsal tunnel syndrome can lead to numbness, tingling, weakness, or muscle damage mainly in the bottom of the foot.
What causes tarsal tunnel syndrome?
Tarsal tunnel syndrome is caused by compression or damage of posterior tibial nerve. It is a form of peripheral neuropathy. The area in the foot where the nerve enters the back of the ankle is called the tarsal tunnel. This tunnel is normally narrow. When the posterior tibial nerve is compressed or damaged, it results in the symptoms of tarsal tunnel syndrome.
In some cases, the exact cause is not found.
Compression of the posterior tibial nerve may occur due to any of the following:
- Swelling from an injury, such as a sprained ankle or nearby tendon
- Flat feet or a high arch
- An abnormal growth, such as a bone spur, lump in the joint (ganglion cyst), swollen (varicose) vein
- Systemic (body-wide) diseases, such as diabetes, low thyroid function, arthritis
What are the symptoms of tarsal tunnel syndrome?
One or more of the following symptoms may occur in people with tarsal tunnel syndrome:
- Burning sensation in the bottom of the foot and toes
- Numbness or tingling
- Pain in the bottom of the foot and toes
- The weakness of foot muscles
- The weakness of the toes or ankle
How is tarsal tunnel syndrome diagnosed?
Your doctor will closely examine your foot and review your symptoms. The following signs and symptoms may be found during the examination:
- Weakness in the ankle, foot, or toes
- Inability to curl the toes, push the foot down, or twist the ankle inward
Your doctor may order the following tests for diagnosis of tarsal tunnel syndrome:
- X-ray, ultrasound, or MRI of the ankle
- EMG (it records the electrical activity in muscles)
- Nerve biopsy
- Nerve conduction studies (it records the electrical activity along the nerve)
How is tarsal tunnel syndrome treated?
Treatment of tarsal tunnel syndrome depends on what caused the problem. First, your doctor will recommend resting, putting ice on the ankle, and avoiding activities that cause symptoms.
Your doctor may recommend the following treatment:
- Over-the-counter pain medicine, such as NSAIDs, to help relieve pain and swelling.
- A brace or custom orthotics if symptoms are caused by a foot problem such as flat feet.
- Physical therapy to help strengthen the foot muscles and improve flexibility.
- Steroid injection into the ankle if necessary.
- Surgery to enlarge the tarsal tunnel or transfer the nerve to help reduce pressure on the posterior tibial nerve.
This feature is for informational purposes only and is not intended to substitute the expert guidance of a doctor. We advise seeing a doctor if you have any health concerns.