Tarsal Tunnel Syndrome

Similar to carpal tunnel there is a lower extremity analog known as tarsal tunnel syndrome. The posterior tibial nerve courses behind the calf, through a fibrous canal known as the tarsal tunnel, near the heel, behind the medial malleolus. If inflammation occurs in the tissues adjacent to the tarsal tunnel, swelling can cause compression of the nerve, resulting in pain. Any conditions that may affect ankle swelling may cause or contribute to tarsal tunnel syndrome.  Such disorders may include, hypothyroidism, rheumatoid arthritis, heart failure and kidney failure. There are biomechanical factors involved that may contribute, such as the ankle rolling inward, stressing the nerve in the tunnel.

Tarsal tunnel syndrome can cause pain in the foot and ankle. Pain may be accompanied by tingling and burning that usually occurs to the bottom of the heel and may extend to the toes. The burning and tingling may be exacerbated or elicited with certain shoe gear, standing, or walking. Pain is usually relieved by rest, but as the condition worsens, pain may also be present even with rest.

When examining your foot, the health care provider may tap over the area of compression, eliciting possible tingling in the heel, arch, or toes. Your podiatrist may also order nerve conduction studies to determine the source or magnitude of the injury. Treatment for tarsal tunnel syndrome may include corticosteroid injections into the area for pain relief. Other treatments include strapping the foot and the use of orthotics to better position the foot to relieve pressure to the nerve. If pain persists even with treatment, surgical decompression may be necessary. Call your podiatrist today if you have questions or concerns about tarsal tunnel syndrome.

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