What is tarsal tunnel syndrome?

Tarsal tunnel syndrome is a foot condition caused by repeated pressure or compression of the posterior tibial nerve that runs down the inside of the ankle and foot. It is a common cause of arch and heel pain.

Tarsal tunnel syndrome is similar to the well-known carpal tunnel syndrome, in that both are related to compression or irritation to a nerve in a small, narrowed space.

What is the tarsal tunnel?

The tarsal tunnel is a narrow anatomical tunnel on the inside of your ankle that is bound by bone and soft tissue. In this tunnel along with the posterior tibial nerve are tendons and arteries, and due to the restricted space this is a common site for nerve compression or entrapment, hence the name tarsal tunnel syndrome.

Do you suffer from tarsal tunnel syndrome?

Signs & symptoms of tarsal tunnel syndrome

The following signs or symptoms can indicate tarsal tunnel syndrome:

  • A tingling or burning pain around the inside of the ankle or foot, along the course of the nerve.
  • Referred tingling pain or a ‘shooting’ pain in the heel, arch or toes of the foot.
  • Numbness or altered sensation of the foot, especially around the ankle, heel or soul of the foot.
  • In more severe cases of nerve damage numbness in the foot can be constant.
  • Symptoms are often worse following activity.
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Causes of tarsal tunnel syndrome

Tarsal tunnel syndrome is caused by either compression, impingement or entrapment of the posterior tibial nerve as it travels through the tarsal tunnel on the inside of the ankle. Common causes of tarsal tunnel nerve entrapment include:

  • Poor foot mechanics or excess foot pronation (rolling inwards of the foot).
  • Flat feet
  • An injury to another structure in the tarsal tunnel such as a tendon.
  • An acute injury to the foot and ankle that results in swelling around the inside of the ankle.
  • Irregular structures arising in the tarsal tunnel area, such as ganglion cysts, tumours, lipomas, bone spurs and varicose veins.
  • Systemic diseases such as arthritis and diabetes that may lead to swelling and make the nerve more susceptible to compression.
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Tarsal tunnel syndrome diagnosis

Tarsal tunnel syndrome is usually easily diagnosed clinically by our Melbourne podiatrists, who are experts in identifying heel pain conditions of the foot. In cases of doubt or where the cause is not established (such as damage to bone, tendons, or presence of soft tissue lesions), then our podiatrists may refer you for either an ultrasound scan or an MRI to aid diagnosis.

Podiatry treatment for tarsal tunnel syndrome

Treatment for tarsal tunnel syndrome by our Melbourne podiatrists is aimed at treating the cause and reducing the compression or damage to the posterior tibial nerve in the foot.

Common podiatry treatment options include:

  • Foot strapping
  • Orthotics to address foot mechanics
  • Stretching and strengthening programs
  • Footwear advice and modification
  • Rest, ice and activity modification
  • Oral medications (such as NSAIDs)
  • Ultrasound therapy and heat

In more severe cases of tarsal tunnel syndrome or in cases that don’t respond to conservative treatment the following treatment may be required:

  • Immobolisation or CAM walker
  • Injection or cortisone therapy
  • Surgery

NB. If tarsal tunnel syndrome is not treated then ongoing nerve compression can eventually lead to permanent nerve damage.

Permanent nerve damage will result in the loss of muscles and the loss of foot function. So you should take any numbness or tingling pain in your foot seriously and book an assessment with one of our podiatrists at the earliest convenience.

Call us Melbourne Podiatrist

Do you need treatment for tarsal tunnel syndrome?

At our Melbourne foot clinic our podiatrists are experts in the diagnosis and treatment of heel pain conditions affecting the foot, including tarsal tunnel syndrome.

So if you are suffering from a burning or tingling pain in your foot or you think you may have tarsal tunnel syndrome book an appointment with one of our friendly podiatrists today!