Conditions We Treat
Tarsal Tunnel Syndrome
What Is It?
Tarsal tunnel syndrome is a compression of the posterior tibial nerve as it passes through the tarsal tunnel, located along the inner ankle. It’s similar to carpal tunnel syndrome in the wrist, but affects the foot.
Symptoms
- Burning, tingling, or numbness along the inside of the ankle and bottom of the foot
- Pain that worsens with standing or walking
- Symptoms may radiate to the toes
- Weakness or instability in more severe cases
Diagnosis
- Tinel’s sign: Tapping over the nerve reproduces symptoms
- Nerve conduction studies (EMG/NCS): Confirms nerve entrapment and assesses nerve function
- MRI or ultrasound: Identifies space-occupying lesions (like ganglion cysts) or inflammation within the tunnel
Treatment
Conservative Options:
- Activity modification and rest
- NSAIDs and ice for inflammation
- Orthotics to reduce nerve compression by correcting overpronation
- Physical therapy: Nerve gliding exercises and soft tissue techniques
Interventional Options:
- Corticosteroid injections to reduce swelling around the nerve
Surgical Options:
- Tarsal tunnel release surgery: Releasing the flexor retinaculum to create more space for the nerve if conservative measures fail
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