Tarsal Tunnel Syndrome

What is tarsal tunnel syndrome?

Similar to carpal tunnel syndrome seen in the wrist, the tibial nerve can often become compressed on the inside of the ankle and this is known as tarsal tunnel syndrome. Tarsal tunnel syndrome is often associated with flat feet. As the arch collapses, this places additional compression of the nerve.

What are the symptoms of tarsal tunnel syndrome?

Numbness, tingling, and burning pain along the inside of the ankle and bottom of the foot.

Diagnosis

X-rays are taken to assess the foot architecture. A nerve conduction study and electromyography are ordered to diagnose the condition and rule out other conditions. An MRI is also often ordered to rule out any soft tissue mass that may be compressing the nerve.

Non-Surgical Treatments

  • Change in shoe gear
  • Custom Orthotics
  • Calf stretching 
  • Icing
  • Anti-inflammatory medication
  • Physical therapy referral

Surgical Treatment

When symptoms do not improve after conservative treatment, surgical release of the tarsal tunnel may be considered. A complete release of the tarsal tunnel  requires a period of non-weightbearing immobilization, usually 1 month. Any associated pathology such as equinus, may need to be addressed at this time as well. Physical therapy is an important part of the postoperative rehab process.