Tarsal Tunnel Syndrome

Tarsal tunnel syndrome is a form of nerve entrapment in the ankle. This occurs when excessive pressure is placed on the posterior tibial nerve as it passes through a passage called the tarsal tunnel at the ankle. Excessive pressure causes the nerve to compress, leading to pain or other symptoms.

Some of the causes for the compression of this nerve include inflammation of surrounding tissues, crush or stretch injuries, fractures, dislocations of the ankle, and severe ankle sprains. This syndrome is akin to the more widely known carpal tunnel syndrome of the wrist.

Common Symptoms

• Pain radiating into the arch and heel of the foot, and occasionally the toes.
• Burning or tingling sensation similar to pins and needles
• Numbness or reduced feeling in the foot.
• Pain may be worsened when running or standing for long periods of time.
• Patients may experience increased pain at night.

This condition is directly associated with flat foot or foot hypermobility. Patients with these conditions are at greater risk for their feet to roll inward, resulting in further compression of the nerve. As a result, this condition is often easily aggravated by standing, walking or running.

Pain can eventually occur in the other foot as the person tries to alter their weight distribution to minimise existing pain. People who make sudden changes to their daily activities or those who are predisposed to foot and ankle misalignment may develop tarsal tunnel syndrome over a very short period of time.

Tarsal Tunnel Syndrome is often mistaken for plantar fasciitis as both conditions present as pain from the inside of the heel and throughout the arch of the foot. The most common way of differentiating the two is to see if neurological symptoms such as numbness or tingling are present in the patient and to accurately pinpoint the location of tenderness when the area is touched.

Left untreated, numbness and persistent pain (neuropathy) can occur. This nerve damage may be irreversible, resulting in permanent foot pain or damage.  If conservative treatment methods do not resolve the pain, the next step is to consult an orthopaedic doctor regarding surgical solutions.

Treatment Options

A podiatrist will conduct a musculoskeletal assessment of your foot to accurately assess your foot. This provides for an accurate diagnosis of your condition and allows the podiatrist to develop a suitable treatment plan for your needs.

Podiatrists utilise non-invasive methods such as shockwave therapy to reduce pain, while modalities such as customised orthotics can be used to raise your arches, reducing overpronation and subsequent compression of the nerve.

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