Tarsal Tunnel Syndrome

The tarsal tunnel is a narrow space that lies on the inside of the ankle next to the ankle bones. The tunnel is covered with a thick ligament (flexor retinaculum) that protects the structures contained within the tunnel—arteries, veins, tendons, and nerves.

Tarsal tunnel syndrome is a painful condition of the foot caused by pressure on the posterior tibial nerve as it passes along the tarsal tunnel just below the bony bit on the inside of the ankle. It produces symptoms anywhere along the path of the nerve running from the inside of the ankle into the foot. It is similar to carpal tunnel syndrome, which occurs in the wrist. Both disorders arise from the compression of a nerve in a confined space.

Tarsal tunnel syndrome is caused by anything that causes pressure on the posterior tibial nerve, including;

• An injury, such as an ankle sprain, which often produces swelling in or near the tunnel, results in nerve compression
• An enlarged or abnormal structure that occupies some of the space in the tunnel can cause pressure on the nerve. These include a ganglion, varicose veins and a bony spur.
• The outward tilting of a foot which is 'flat' can cause the tunnel to narrow and put pressure on the nerve
• Diseases such as diabetes or arthritis can cause swelling and compress the nerve

People who suffer with tarsal tunnel syndrome complain of tingling, burning, or a sensation similar to an electrical shock which is ,mainly felt on the inside of the ankle or the sole of the foot. Sometimes there is pain - usually a shooting pain which may extend to the heel and the toes and there can be numbness. The symptoms often appear very suddenly.
It is advisable to consult your podiatrist if you suffer from any of the symptoms of tarsal tunnel syndrome. It can be confused with other conditions and if left untreated it may cause unwanted and unnecessary permanent damage.

Treatment advice would always start with resting the affected foot. It promotes healing without causing further damage. If it is very painful or inflamed, applying an ice pack to the area may reduce swelling. Always put a thin towel between the ice pack and the skin. Your podiatrist may suggest some exercises for you to do and a biomechanical assessment may be necessary. The biomechanist may prescribe orthotic devices to be worn inside your shoes to reduce the nerve compression. Sometimes, immobilising the foot with a cast or walking boot, may be necessary.
The symptoms often subside very quickly, especially if the problem was caused by injury. As ever, don't suffer in silence...

The Footcare Clinic can help!