Tarsal Tunnel Syndrome

What is ​Tarsal Tunnel Syndrome?

Tarsal Tunnel Syndrome is a compression of the nerves in the tarsal tunnel, the area of arteries, veins, tendons and nerves surrounded by ligament on the inside of the ankle leading to under the foot. 


Tarsal tunnel syndrome is caused by the compression on the posterior tibial nerve. This has several causes including:

  • Flat Feet - due to the outward tilting of the heel that occurs with fallen arches individuals with flat feet are at a higher risk of experiencing tarsal tunnel syndrome. 

  • Abnormal compression of the nerve - examples include a varicose vein, ganglion cyst, swollen tendon or  even arthritic bone spur.

  • Injury - such as an ankle sprain, may produce inflammation and swelling in or near the tunnel, compressing the nerve.

  • Systemic diseases - such as diabetes or arthritis, can cause swelling, compressing the nerve.


Common symptoms of tarsal tunnel syndrome may include one or more of the following:

  • A tingling or burning sensation 

  • Numbness - A lack of sensation in the area

  • Pain - including shooting pain

Symptoms are felt on the inside of the ankle and/or the bottom of the foot. 


Various treatments of tarsal tunnel include:

  • Ice - the use of ice to reduce inflammation of the tendon is recommended. An ice pack can be wrapped in a towel and applied to the area (never apply ice directly to the skin) for periods of no greater than 20 minutes. 

  • Rest - stay off the foot to encourage healing and prevents further injury.

  • Immobilization - restricting and protecting the foot in a cast, splint, or boot is commonly used to allow the nerve and surrounding tissue to heal.

  • ​Oral Medications - Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, may be used to reduce symptoms. 

  • Physical Therapy - Common therapy may include stretching and ultrasound therapy.

  • Injection therapy - local anesthetic injections provide pain relief, and injected corticosteroid may be useful in treating inflammation.

  • Orthotic Insoles - Custom orthotics, sometimes with additional bracing are used to limit the movements of the foot and ankle so they do not compress the nerve.

  • Shoes - a change to shoe gear, especially to a shoe which provides more support.

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