Tarsal tunnel syndrome develops when repeated pressure damages the posterior tibial nerve. The tibial nerve, which is connected to the sciatic nerve, runs through a narrow passageway in your ankle. The nerve usually becomes damaged because of consistent, excessive pressure on the area.

What Causes Tarsal Tunnel Syndrome?

There are many things that can cause tarsal tunnel syndrome, including:

  • Arthritis-related inflammation
  • Masses and lesions
  • Varicose veins, swollen tendons, bone spurs or another enlarged structure in that area that may compress the nerve
  • Benign growths
  • Diabetes
  • Trauma or injuries
  • Severely flat feet

Injuries or trauma can cause tarsal tunnel syndrome, including car accidents, ankle sprains and fractures. The inflammation and swelling from the injury are what cause the syndrome and can make the injury even more painful.

Symptoms and Diagnosis

Tarsal tunnel syndrome can cause a number of uncomfortable and painful symptoms, including:

  • Pins and needles
  • Sharp pains
  • Burning

These symptoms can be felt anywhere along the tibial nerve, but you may also experience pain, tingling or a burning sensation on the interior of the ankle and the sole of the foot.

Symptoms can vary from one person to another. Some people experience sudden pain or burning. For others, symptoms come on gradually. It all depends on the cause of the condition and the individual person.

The pain and discomfort usually get worse with physical activity, but if the condition progresses, some people may feel pain or tingling even when they’re resting.

Diagnosing the condition can be tricky. If you think you may have tarsal tunnel syndrome, see your doctor. Your doctor may refer you to a podiatrist or orthopedic surgeon. At your appointment, your doctor will want to know:

  • About the progression of your symptoms
  • About your medical history, including whether you have a history of trauma

A Tinel’s test will be performed, during which your doctor will gently tap the tibial nerve. If you experience tingling or pain, this is a good indicator that you have tarsal tunnel syndrome.

Determining whether you have the condition is the first step in the process. Your doctor will also want to determine the underlying cause of the syndrome, which may involve MRIs or an electromyography. Imaging may also be used after initial treatment to determine whether it is working to reduce symptoms.

Treating Tarsal Tunnel Syndrome

If left untreated, tarsal tunnel syndrome can progress and result in permanent nerve damage. That damage can make it difficult to walk or lead a normal life. Exercise and daily chores could become incredibly painful.

If the syndrome was caused by a car accident, the best auto accident attorney can help you seek compensation for injuries, including medical bills and treatment costs. No matter the cause, it is crucial to seek treatment as soon as possible to avoid potentially irreversible damage.

Doctors may use a combination of treatment options to treat tarsal tunnel syndrome, including:

  • Rest: Keeping off the foot and refraining from physical activity will give the nerve time to heal while preventing further injury.
  • Oral medication: Over-the-counter pain medications, like ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs), can provide some relief.
  • Ice: Applying an ice pack to the affected area will help reduce inflammation and alleviate pain. Apply for 20 minutes at a time, with 40-minute breaks in between each application.
  • Orthotic Devices: A custom shoe insert can help maintain an arch and limit motion that may cause further damage to the nerve.
  • Immobilization: In some cases, it may be necessary to immobilize the foot by wearing a cast. This will give surrounding tissue an opportunity to heal.
  • Injections: In cases of severe pain, a local anesthetic may be injected to provide relief. Corticosteroids can aid in the treatment of inflammation.
  • Braces: A custom brace can help patients with severe flat feet or nerve damage by reducing pressure on the foot.
  • Surgery: In long-term, severe cases, surgery may be required. During the procedure, called tarsal tunnel release, a surgeon will make a small incision inside of the ankle to release the ligament. Small incisions are made, which reduces the risk of complications and recovery time.

Tarsal tunnel syndrome doesn’t have to be a permanent condition. There are a variety of treatments available, and seeking treatment early on will help prevent irreversible damage.

Cite this article as:
Editorial Staff, "Tarsal Tunnel Syndrome: Causes, Symptoms and Treatment," in Medicalopedia, June 5, 2020, [Permalink: https://www.medicalopedia.org/8949/tarsal-tunnel-syndrome-causes-symptoms-and-treatment/].