Tarsal Tunnel Syndrome

Tarsal tunnel syndrome is compression of the posterior tibial nerve at the level of the ankle. The postorier tibial nerve, 3 tendons, 2 veins and 1 artery occupy a tight space called the tarsal tunnel. As they course through this fibro-osseous tunnel bounded by a thick band of tissue called the flexor retinaculum into the bottom of the foot, pressure on the nerve by swelling and inflammation of tendons, veins or a space occupying lesion may cause symptoms ranging from numbness and tingling to severe pain to the entire foot. It is similar to Carpel Tunnel Syndrome in the hands and wrist. Diagnosis of this condition may require nerve studies and imaging such as EMG, NCV and MRI.

There are four conservative steps to relieve symptoms of this condition. The first line of conservative treatment is directed toward reducing inflammation. The use of anti-inflammatory medication and cortisone injections may be used to reduce inflammation around the nerve tissue.

Other conservative measures may involve physical therapy providing deep massage to break up scar tissue within the tunnel and to assist in mobilization of the constricted nerve. An orthotic may also be utilized to support the foot to take tension away from the nerve. If conservative treatment fails to relieve the symptoms, surgical decompression of the nerve may be required.