Tarsal Tunnel Syndrome

Chances are good you’ve heard of carpal tunnel syndrome which is a pinched nerve in the wrist that causes tingling and numbness in the hand. What you might not know is that the same thing can happen to your feet! This is known as tarsal tunnel syndrome, and it can produce shooting, burning, or shocking pain throughout the ankle, heels, and feet.

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What Is Tarsal Tunnel Syndrome?

Tarsal tunnel syndrome results from pressure or pinching on the posterior tibial nerve as it passes through the tarsal tunnel on the inside of the ankle. Sandwiched between ankle bones and thick ligaments, the tunnel doesn’t offer much room for the nerve, arteries, veins, and other structures that must pass through.

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When the space becomes too tight and the nerve is physically pinched or obstructed, symptoms such as pain, tingling, or even complete numbness may emerge.

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What Causes Tarsal Tunnel Syndrome?

Anything that can inflict pressure, pinching, or obstruction on the nerve through the tarsal tunnel could be a cause of this condition. There are several possibilities, including:

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• Flat feet
  ‍This foot structure is linked with excessive outward tilting of the ankle, which can reduce the available space in the tarsal tunnel.
• A direct injury to the ankle, such as a sprain or fracture
• A systemic disease that causes inflammation or swelling within or in close proximity with the tarsal tunnel
  Metabolic disorders (such as diabetes) and inflammatory arthritis are common culprits.
• Ganglion cysts, varicose veins, bone spurs, or any other abnormal or enlarged structures that may develop in or just outside the tarsal tunnel
• Complications from a previous surgery

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How Is Tarsal Tunnel Syndrome Treated?

Because tarsal tunnel syndrome can result from such a wide variety of different causes, the proper treatment protocols will depend heavily on what our examination reveals. Treatment options we may employ include some combination of the following:

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• Staying off the feet as much as possible for a few days or weeks
• Medications to control pain, such as OTC anti-inflammatories or cortisone injections
• Restricting movement or immobilizing the feet temporarily in a brace, boot, or cast. This may be necessary to allow the nerve to heal and prevent constant re-aggravation.
• Custom orthotics. These are especially helpful if fallen arches are a contributing factor, since they do a great job controlling abnormal pronation.
• Stretching, exercises, massage, or other forms of physical therapy
• Managing any underlying systemic conditions problems. For example, this would include keeping your sugar under control if you have diabetes.
• Although we like to avoid this outcome if possible, surgery may be necessary to decompress the tunnel or remove an obstruction such as a spur or cyst.

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Tarsal Tunnel Syndrome Needs Prompt Treatment

When treatment is sought early, the painful symptoms of tarsal tunnel syndrome typically resolve with no long-term consequences. However, if you allow the condition to progress, the resulting nerve damage may become permanent. Unfortunately, tarsal tunnel syndrome is sometimes misdiagnosed as plantar fasciitis or other common conditions with similar symptoms, especially by doctors less familiar with nerve conditions of the feet and ankles.

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If you notice any tingling or pain in the feet or ankles—especially of the burning, shooting, or shocking variety—please contact Gulf South Foot & Ankle, LLC, right away for an evaluation. We have three convenient locations to serve you.