Tarsal Tunnel Syndrome

By Matt Paulus, MS, ATC, LAT

What is Tarsal Tunnel Syndrome?

Tarsal tunnel syndrome is a condition in which an individual may feel pain or numbness/tingling in their foot. This condition is caused by either compression or irritation to the posterior tibial nerve; a nerve that branches off of the sciatic nerve and is located near the ankle. The tarsal tunnel is a small pathway, made up of bone and other soft tissues, that the posterior tibial nerve travels through (along with blood vessels). If the space of this pathway decreases or causes irritation to the nerve, it can lead to this condition. Pain in the foot will tend to worsen with standing, walking, and running due to increased pressure to the tibial nerve.

Heel pain can be a symptom of tarsal tunnel syndrome.

Image of a man with Tarsal Tunnel Syndrome.

Symptoms of Tarsal Tunnel Syndrome

Individuals with tarsal tunnel syndrome may feel pain along the path of the tibial nerve (inside of the ankle), but can also experience pain around their heel or the bottom of their foot. This condition can create problems with day to day activities, including walking and standing. It can also limit athletes and prevent them from participating in their specific event or game.  Symptoms can vary, but may include:

  • Burning.
  • Sharp pains.
  • Numbness/tingling.
  • Pins and needles.

Potential Causes of Tarsal Tunnel Syndrome

This condition can be caused by chronic issues over time or from traumatic injury. Some of these causes may include:

  • Osteoarthritis.
  • Rheumatoid arthritis.
  • Postural deviations.
  • Cyst formation.
  • Ankle sprain or other trauma to the ankle.
  • Diabetes.
  • Foot deformities.
  • Poorly fitting shoes.
  • Obesity.
  • Jobs that require an individual to stand for long periods of time.

How can Tarsal Tunnel Syndrome be Diagnosed?

Your doctor will obtain a subjective history and perform a physical exam; looking at strength, range of motion, and foot positioning. Other diagnostic tests that can confirm tarsal tunnel syndrome may include:

  • MRI (magnetic resonance imaging).
  • X-Ray.
  • Nerve conduction.
  • Electromyography

Treatment options of Tarsal Tunnel Syndrome

If you suspect that you may be dealing with tarsal tunnel syndrome, it is important to see a doctor. A doctor can help you identify the cause and provide treatment options. Some treatment options may include:

  • NSAIDs (non-steroidal anti-inflammatories).
  • Ice.
  • Physical Therapy.
  • Steroid injections.
  • Surgery.
  • Braces / Splints.

Physical Therapy as a Treatment Option

Physical therapy may include stretching and strengthening exercises and activities to address the underlying cause of tarsal tunnel syndrome as well as pain control with modalities (ultrasound, E-Stim, ice, and massage). Balance exercises to improve foot strength is also something that your physical therapist might incorporate into treatment.  Many people respond positively to physical therapy and other conservative treatments. Physical therapy or other conservative routes are recommended prior to having surgery.

If you suspect that you may be dealing with this condition, it is important to see a healthcare provider. More severe cases cases left untreated can cause permanent damage. This is a condition that is often treated by our Doctors and Physical Therapists here at Jacksonville Orthopaedic Institute. Come in and see one of our Doctors for an evaluation today!

JOI Fracture and Injury Care

JOI Physicians are currently offering ASAP fracture and injury care. This is a new option for patients who would like to avoid the emergency room if they have suffered a fracture or soft tissue injury. To learn more about this service, read this article about fracture and injury care. Make an appointment by calling (904)JOI-2000.

Author: Matt Paulus, MS, ATC, LAT

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