Tarsal tunnel syndrome is a compression neuropathy caused by pressure on the posterior tibial nerve as it passes through a narrow space on the inside of the ankle called the tarsal tunnel. This is similar to carpal tunnel syndrome in the wrist but affects the foot and ankle.
Tingling, burning, or a sensation similar to an electric shock.
Numbness in the heel or across the bottom of the foot.
Sharp, radiating pain that may travel up into the leg or down into the toes.
Symptoms that worsen during or after physical activity like walking or standing.
Pain that may flare up at night during rest.
A feeling of swelling in the foot even when no visible swelling is present.
Physical Examination
Electromyography (EMG) / Nerve Conduction Velocity: To determine if there is nerve damage and, if so, the site of that damage.
MRI: Used to check for physical obstructions inside the tunnel such as varicose veins, ganglions, or bone spurs.
Ultrasound: Effective for visualizing nerve swelling or compression in real time.
Management aims to reduce the pressure on the nerve and control the resulting inflammation.
Rest and immobilization to prevent further irritation of the compressed nerve.
Icing the inner ankle for 20 minutes several times a day to reduce swelling.
Non-steroidal anti-inflammatory drugs to help manage pain and inflammation.
Custom orthotic inserts to support the arch and take tension off the medial ankle.
Corticosteroid injections into the tarsal tunnel to reduce localized nerve swelling.
Physical therapy focusing on nerve gliding exercises and calf stretching.
Bracing or taping to stabilize the foot and prevent the arch from collapsing.
Tarsal tunnel release surgery to cut the ligament and create more space for the nerve.