Tarsal Tunnel Syndrome

Tarsal tunnel syndrome is a painful foot condition that is similar to the hand condition of carpal tunnel syndrome in that the pain occurs through a nerve entrapment. In the case of tarsal tunnel syndrome, the nerve being compressed is one of the major nerves in the foot called the posterior tibial nerve. This nerve runs through an area in the foot called the tarsal tunnel located inside the medial aspect of the ankle joint just beneath the medial malleoli bone. Patients often report pain along with an abnormal sensation behind the foot medially to the heel or plantar foot to where the arch of the foot is.

The following are other symptoms of tarsal tunnel syndrome that patients may experience:

  • Burning pain
  • Numbness
  • Paresthesia
  • Pins & needles or tingling sensation
  • Discomfort worsened with standing or at night
  • Relief with shoe removal

This condition may be more common in athletes such as runners or dancers especially those with over-pronated foot types. Biomechanically, overpronation causes the foot to roll in when walking which can over-stretch the posterior tibial nerve. A podiatrist will be able to do a biomechanical foot exam to determine if overpronation is the provoking cause of the tarsal tunnel syndrome. Your doctor may also order a nerve conduction test and do a clinical exam called the Tinel’s test, which involves tapping the tarsal tunnel area and eliciting the radiating pain, to confirm the diagnosis of the tarsal tunnel syndrome. Some conservative treatments your doctor may recommend is icing, resting from any aggravating activities, and/or taking NSAIDs to help with pain relief. A series of corticosteroid injections may also help alleviate the pain. If the pain continues to persist despite these conservative treatment efforts, then surgical decompression of the nerve may be indicated. The surgical procedure is called tarsal tunnel release that involves freeing the soft tissue structures to make more space for the nerve. Call your podiatrist today if you are experiencing the similar symptoms listed above to help best access and address tarsal tunnel syndrome.

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