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How Tarsal Tunnel Syndrome Develops

Updated: Jul 29, 2020

If you’ve ever had to weave your way through a crowded restaurant, bar, or street—say the Spotted Cat on a Saturday night, or maybe Bourbon Street during Mardi Gras—you can appreciate how difficult it is to navigate a tight space without getting squished!


Inside your body, your nerves must also make similar tight squeezes through narrow gaps, or tunnels, between surrounding structures. They sometimes get squished too, and the repercussions can mean shooting, burning, tingling, or electric pain radiating throughout your body! One location where this happens very frequently is the tarsal tunnel in the ankle.


Here, the posterior tibial nerve has its work cut out for it. Bundled up alongside the posterior tibial artery and numerous veins and tendons, it must work its way past the inside of the ankle, sandwiched between bone and powerful ligaments. It doesn’t take much to collapse that space, leading to painful sensations.


There are many ways tarsal tunnel syndrome can develop. Here are just a few:

  1. People with flat feet may be prone to tarsal tunnel syndrome, since this foot deformity encourages excess outward tilting of the heel. This frequently reduces the space available in the tunnel for the nerve.

  2. Certain repetitive motions and stresses increase the risk of developing tarsal tunnel, especially for athletes who play sports that are tough on ankles—think tennis, basketball, or certain positions in football.

  3. A specific sports injury, such as an ankle sprain or tendinitis, can cause swelling in soft tissues near the tunnel, leading to pinching and compression.

  4. Diseases can also cause the same kinds of swelling and compression. Diabetes, prediabetes, and arthritis are the biggest culprits, although far from the only ones.

  5. Bone deformities, such as certain types of tarsal coalitions in which hindfoot and ankle bones are fused, can pinch the tarsal tunnel.

  6. An unrelated mass or enlargement may form on or near the tarsal tunnel and pinch it. Examples of this type of structure include ganglion cysts, nerve tumors, bone spurs, or varicose veins.

Your nerves don’t want to be squished any more than you do! The good news is that, with prompt care and treatment, most people will overcome their tarsal tunnel syndrome pain without any long-term repercussions. The warning, however, is that failure to get treatment may result in permanent damage, including loss of muscle strength and loss of sensation surrounding the ankle.


So don’t wait! When your ankles are hurting, burning, tingling, or prickling, stop by and see the experts at Gulf South Foot & Ankle. You can reach us in Metairie at (504) 708-4810, or in Covington at (985) 809-1464.

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