Tarsal Tunnel Syndrome
Foot & Ankle Care of Colorado
Tarsal tunnel syndrome (TTS) occurs when the tibial nerve in the ankle is damaged or compressed within the tarsal tunnel—a passage formed by bones and ligaments. This condition typically leads to symptoms such as pain, tingling, numbness, or weakness in the feet.
TTS can develop due to overuse of the foot and ankle, especially in individuals who engage in strenuous or frequent exercise. Those with very flat feet are at a higher risk of developing TTS due to the altered biomechanics and increased pressure on the tibial nerve within the tarsal tunnel.
Causes of Tarsal tunnel syndrome
Tarsal tunnel syndrome occurs when something damages your tibial nerve. Causes of tibial nerve damage can include:
- Flat feet.
- High arches.
- Injuries, such as an ankle sprain or fracture.
- Irregular growths, such as ganglion cysts, bone spurs or varicose veins.
- Masses such as lipomas or tumors near your tibial nerve.
- Body-wide (systemic) conditions, such as hypothyroidism, diabetes or arthritis.
Tarsal Tunnel Syndrome Symptoms
Tarsal tunnel syndrome causes signs of nerve pain. TTS usually causes pain in the inside of your ankle or the bottom of your feet. You may also experience:
- Burning sensations.
- Numbness.
- Tingling or “pins and needles” sensations.
- Weakness in your foot muscles.
Often, symptoms worsen during or after physical activity. If TTS is severe or long-lasting, you may experience symptoms all the time.
Tarsal Tunnel Syndrome Diagnoses
To diagnose tarsal tunnel syndrome, your healthcare provider will ask you to describe your symptoms. They may examine your ankle or look for injuries, as well.
Nonsurgical Treatments
Many people can manage tarsal tunnel syndrome symptoms with at-home or over-the-counter treatments. You might try:
- Rest: Staying off of your foot for a few days or weeks can promote healing and prevent further injury.
- Ice: Use ice packs for up to 20 minutes, a few times a day. Icing your foot can reduce swelling and pain.
- Compression and elevation: You may wear a supportive elastic bandage or brace around your ankle. Elevating your foot above your heart whenever possible can reduce inflammation.
- Nonsteroidal anti-inflammatory medications (NSAIDs): Over-the-counter NSAIDs such as ibuprofen (Advil®, Motrin®) may decrease pain and inflammation.
- Braces, casts or splints: A cast or splint keeps your foot in place to encourage nerve healing. If you have flat feet or severe symptoms, your healthcare provider may recommend a brace to reduce pressure on your feet.
- Orthotics: You may use custom-made shoe inserts (orthotics). Orthotics can help your foot maintain a proper arch. This position reduces the movements that cause nerve compression. A stability or motion-controlled shoe also keeps your foot from rolling inward (pronation) and reduces tension on your nerve.
- Physical therapy: A physical therapist prescribes exercises and stretches to improve your strength and range of motion.
- Steroid injections: Your healthcare provider may prescribe oral steroids or steroid injections to reduce pain and inflammation.
When Is Surgery Needed?
If TTS symptoms are still severe after trying nonsurgical treatments, your healthcare provider might recommend surgery. Operations are available that can release your tibial nerve or widen your tarsal tunnel. If a mass is putting pressure on your nerve, your surgeon will remove it.
