The tarsal tunnel is a gap that is located between the underlying bones and the tough overlying fibrous tissue of the foot. Tarsal tunnel syndrome is a condition where the posterior tibial nerve which lies within the tarsal tunnel becomes compressed / pinched.
The exact cause of tarsal tunnel syndrome is unknown but conditions such as fractures, bone spurs, ganglions, benign tumors, muscle impingement, and foot deformities have been known to increase the risk of tarsal tunnel syndrome. Other medical conditions such as arthritis in joints of the foot, scar tissue following ankle surgery, or the growth of abnormal blood vessels can press against the posterior tibial nerve and lead to compression.
Common symptoms of tarsal tunnel syndrome include pain, numbness, and a burning or tingling sensation at the bottom of the foot and heel.
Tarsal tunnel syndrome is diagnosed by performing Tinel’s test. During the exam, the posterior tibial nerve is tapped lightly which produces pain and other symptoms indicating tarsal tunnel syndrome.
Tarsal tunnel syndrome can typically be treated with non-surgical options such as:
- Corticosteroid injections or non-steroidal anti-inflammatory medications to relieve pain and reduce swelling.
- Orthotics such as specially designed shoe inserts or a change in footwear to help support the arch of the foot and relieve tension from the tibial nerve.
As a last resort after conservative treatments have failed, a tarsal tunnel release procedure may be considered to release and relieve pressure from the pinched posterior tibial nerve.