If you feel numbness, pins and needles, or pain in the bottom of your foot, you may have a condition known as tarsal tunnel syndrome. These symptoms may also extend to the toes and heel. The cause is likely to be an obstruction under the band of tissue that attaches the inner ankle to the heel and forms the tarsal tunnel. A number of blood vessels and tendons, along with the tibial nerve, pass through the tunnel.

Pressure on the posterior tibial nerve may be caused by excess fluid following an ankle injury, fallen arches, footwear that is too tight, obesity, cysts, or bone spurs. A podiatrist can help determine the exact cause of the pain and offer treatment options such as steroid injections, orthotics, and/or braces. In some cases, surgery is necessary. It is a good idea to consult a podiatrist for an examination and diagnosis.

Tarsal tunnel syndrome can be very uncomfortable to live with. If you are experiencing tarsal tunnel syndrome, contact one of our podiatrists of Northern Illinois Foot & Ankle Specialists. Our doctors can provide the care you need to keep you pain-free and on your feet.

Tarsal Tunnel Syndrome

Tarsal tunnel syndrome, also known as tibial nerve dysfunction or posterior tibial nerve neuralgia, is an uncommon yet significant condition that primarily affects the peripheral nerves in the foot. It bears similarities to carpal tunnel syndrome, but instead of impacting the wrist, it targets the tibial nerve, a crucial peripheral nerve in the leg. 

The main cause of tarsal tunnel syndrome is nerve compression, which often occurs due to excessive pressure on the tibial nerve. Based on the location of the compression, this condition can be divided into two types: anterior and posterior tarsal tunnel syndrome. 

  • Anterior tarsal tunnel syndrome affects the top of the foot, causing pain and loss of sensation. It's due to compression of the deep peroneal nerve at the front of the ankle.
  • Posterior tarsal tunnel syndrome, on the other hand, impacts the bottom of the foot, extending to the heel and toes, caused by pressure on the posterior tibial nerve inside the ankle. It often results from tight footwear, obesity, cysts, or bone spurs.

Both types can lead to pain, numbness, and loss of sensation in different parts of the foot. The medial and lateral plantar nerves, which are branches of the tibial nerve, can also be affected, leading to further complications.

Common Cause of Tarsal Tunnel Syndrome

  • It involves pressure or injury, direct pressure on the tibial nerve for an extended period, sometimes caused by other body structures close by or near the knee.
  • Diseases that damage nerves, including diabetes, may cause tarsal tunnel syndrome.
  • Abnormal growth, like bone spur, lump in the joint (ganglion cyst), swollen (varicose) vein
  • At times, tarsal tunnel syndrome can appear without an obvious cause in some cases.

The Effects of Tarsal Tunnel Syndrome

  • Different sensations: An afflicted person may experience pain, tingling, burning, or other unusual sensations in the foot of the affected leg.
  • The foot muscles, toes, and ankles become weaker, and curling your toes or flexing your foot can become difficult.
  • If the condition worsens, infections and ulcers may develop on the foot that is experiencing the syndrome.

How To Diagnose Tarsal Tunnel Syndrome?  

A physical exam of the leg can help identify the presence of tarsal tunnel syndrome. Medical tests, such as a nerve biopsy, are also used to diagnose the condition. Additional diagnostic tests may include electrical testing (EMG or nerve conduction study) and imaging such as X-rays, CT scans, or MRI scans.

How To Treat Tarsal Tunnel Syndrome?

Tarsal tunnel syndrome can be managed with various treatments. Here are some options:

At-home Care

  • Resting and avoiding activities that worsen symptoms.
  • Applying ice packs to reduce inflammation.
  • Elevating the foot to reduce swelling.
  • Using over-the-counter pain relievers like NSAIDs.

Over-the-counter Options

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen may help reduce pain and inflammation.

Non-Surgical Approaches

  • Using orthotic inserts or supportive footwear to provide arch support and relieve pressure on the tibial nerve.
  • Physical therapy sessions that include exercises and stretches to improve foot and ankle strength and flexibility.
  • Immobilization using braces, casts, or splints to reduce strain on the tibial nerve.
  • Corticosteroid injections into the tarsal tunnel to alleviate pain and reduce inflammation.

Surgical Interventions

  • Surgery may be considered if conservative treatments do not provide sufficient relief.
  • Surgical procedures can involve decompressing the tibial nerve by releasing structures causing compression.

How to Prevent Tarsal Tunnel Syndrome?

To prevent tarsal tunnel syndrome:

  • Rest and avoid overuse.
  • Apply ice to reduce swelling.
  • Use NSAIDs for pain relief.
  • Use braces or orthotics for support.
  • Stretch regularly.
  • Wear proper footwear.

These measures may lower the risk but cannot guarantee prevention. Consult a healthcare professional for personalized advice.

Get The Care You Need Today!

If you have any questions, please feel free to contact one of our offices located in Lake in the Hills, Cary, Fox Lake, Crystal Lake, Hoffman Estates, Chicago, Elgin, and Hinsdale, IL. We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Frequently Asked Questions

Can Tarsal Tunnel Syndrome be cured?

Yes, with proper treatment, many people can fully recover from Tarsal Tunnel Syndrome. Treatment may involve physical therapy, medication, or in some cases, surgery.

What are the potential complications of Tarsal Tunnel Syndrome if left untreated?

Untreated Tarsal Tunnel Syndrome can lead to chronic pain, permanent nerve damage, and even loss of sensation in the foot. In severe cases, it could affect your ability to walk.

How does the path of the tibial nerve affect the development of tarsal tunnel syndrome?

The tibial nerve runs through the tarsal tunnel, a narrow space in the ankle. If this tunnel becomes narrow due to inflammation or overuse, it can compress the tibial nerve, causing tarsal tunnel syndrome.

Why might I need to see a foot and ankle surgeon for tarsal tunnel syndrome?

If non-surgical treatments for tarsal tunnel syndrome, such as physical therapy or medication, don't alleviate the symptoms, surgery may be necessary. A foot and ankle surgeon can perform a tarsal tunnel release surgery to relieve pressure on the tibial nerve.

Can the flexor retinaculum be surgically altered to relieve Tarsal Tunnel Syndrome?

Yes, one surgical treatment for Tarsal Tunnel Syndrome involves cutting the flexor retinaculum to relieve pressure on the tibial nerve. This procedure is typically considered when non-surgical treatments have failed.