Tarsal tunnel syndrome is a condition that occurs when the posterior tibial nerve or its branches are damaged by compression. This nerve, and supporting blood vessels and tendons, go through the tarsal tunnel along the ankle bones. It’s similar to carpal tunnel syndrome of the hand, but less likely to be caused by repetitive motions.
There are many potential causes for this type of excessive pressure within the tarsal tunnel structure. Conditions that can trigger tarsal tunnel pain include lipomas, varicose veins, ganglion cysts and schwannomas (tumors in the nerve sheath). Other potential causes are benign bony growths in the tarsal tunnel, inflammation of the synovial membrane, ankle sprains, valgus foot deformity, and even flatfoot.
The symptoms of tarsal tunnel syndrome vary from one person to the other. Some may feel a sharp, shooting pain along the inside of the ankle or the bottom of the foot, forcing them to limp. There may be numbness in the affected foot or a burning or tingling sensation similar to electric shock. The symptoms can worsen when standing or walking for long periods of time.
Tarsal tunnel syndrome can be treated by using the RICE method, NSAIDs (non-steroidal anti-inflammatory drugs), orthotic devices (shoe inserts), or wearing supportive footwear to reduce tightness and pain related to tarsal tunnel syndrome. Injection therapy using corticosteroids or local anesthetics can reduce pain and inflammation levels. Physical therapy treatments such as ultrasound therapy have proven to be effective in pain management as well.
Tarsal tunnel release surgery may be necessary for people with severe symptoms of tarsal tunnel syndrome that are not responding to conservative treatment.