Let’s Talk About Tarsal Tunnel Syndrome

No, it’s not a typo. Though similar to carpal tunnel syndrome, tarsal tunnel syndrome is a separate condition that affects the foot and ankle.

It’s not clear how many people have tarsal tunnel syndrome because it’s often overlooked as a problem, but it’s a condition that needs proper care to prevent permanent problems.

At our office in the greater Miami area, our skilled and experienced podiatrist, Dr. Richard Hochman, takes all foot symptoms and conditions seriously. 

Because it’s an overlooked condition, we want to talk about tarsal tunnel syndrome, so you can recognize the symptoms and seek treatment right away.

About tarsal tunnel syndrome

Tarsal tunnel syndrome is a pinched nerve condition similar to carpal tunnel syndrome, affecting the tibial nerve as it passes through the tarsal tunnel in the ankle. 

Tibial nerve

The tibial nerve is a sensory and motor nerve that provides feeling and movement in the lower part of the leg and foot. It's a branch of the sciatic nerve — the thickest nerve in the body — that runs from the spine down the back of the leg to the foot. It’s called the tibial nerve because it branches out around the tibia bone (shinbone).

Tarsal tunnel

The tarsal tunnel is a narrow passageway in the ankle made up of bones and ligaments. Arteries, veins, tendons, and nerves pass through the tunnel into the foot.

Since there’s little room in the tarsal tunnel, any change in structure or swelling in or around the tunnel may limit the space, putting pressure on the tibial nerve and leading to tarsal tunnel syndrome. 

Anyone can develop the foot nerve condition, but it’s more common in athletes as an overuse injury. People with flat feet, high arches, bone spurs, and diabetes are also at greater risk of developing tarsal tunnel syndrome.

What it feels like

Tingling and numbness in the foot are some of the most common symptoms of tarsal tunnel syndrome. It’s like when your foot falls asleep after you were sitting with your legs crossed for too long. You may also experience a burning sensation or weakness in the foot.

The symptoms affect the inside of the ankle or the sole of the foot and worsen with activity. If the compression is severe or you’ve had symptoms for a while, you may have constant foot pain.

Testing for tarsal tunnel syndrome

After reviewing your symptoms, we perform Tinel’s test to determine if the tibial nerve may be the source of your symptoms. For this test, we gently tap on the tibial nerve, and if it causes pain or other symptoms, we do a nerve test — electromyogram (EMG) — to check nerve function. 

We may also do imaging tests to look at the structure of the tarsal tunnel and see if you have nerve damage. 

Getting treatment to relieve symptoms

Treatment for tarsal tunnel syndrome focuses on relieving symptoms and helping to heal the damaged nerve. Treatment may include:

• RICE (rest, icing, compression, and elevation)
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Bracing, casting, or splinting
• Custom orthotics
• Physical therapy
• Steroid injections

If you continue to have symptoms after implementing medical treatment or your symptoms are severe, we may recommend surgery to widen the tarsal tunnel, allowing more room for the nerve to pass through.

Surgery is a minimally invasive and effective treatment for tarsal tunnel syndrome.

Without treatment, tarsal tunnel syndrome may cause permanent nerve damage that can have long-term effects on your quality of life. Don’t ignore your symptoms. We can help. Call our office in Coral Gables, Florida, today or request an appointment online.