Tarsal Tunnel Syndrome of the Foot

What is the tarsal tunnel?

The tarsal tunnel is a narrow space on the inside of the ankle that contains the Tibialis posterior, flexor digitorum longus, Tibial artery,Tibial Vein Tibial nerve, flexor hallucinating longus. These structures are covered by the flexor retinaculum (laciniate ligament) that extends from the medial malleolus to the calcaneus. 

What is tarsal tunnel syndrome?

Tarsal tunnel syndrome is the compression of the tibial nerve that causes shooting pain, tingling, numbness, and tingling that courses along the nerve distribution. 

What causes tarsal tunnel syndrome?

Compression of the tibial nerve can be caused by flat feet, an enlarged or abnormal structure pressing on the nerve (ganglion cyst, varicose vein, bone spur, enlarged tendon), traumatic injury that causes injury or swelling to the medial ankle area.  

How to diagnosis tarsal tunnel syndrome?

Compression and tapping (tinel’s) of the tibial nerve will be done to reproduce the symptoms to confirm tarsal tunnel syndrome. xray and mri are often done to rule out any object pressing against the nerve. Often your doctor will order an EMG/NCV to look for presence of nerve entrapment and presence of neuropathy. 

How to treat tarsal tunnel syndrome?

Conservatively RICE, physical therapy, custom orthotics, supportive shoes, and bracing are used to treat tarsal tunnel syndrome. Surgery will be needed if conservative treatment fails with a tarsal tunnel release or removal of the object impinging on the nerve. 

Video of a tarsal tunnel release: https://www.youtube.com/watch?v=uJ9a212S-MA&ab_channel=Dr.SarangDesai

If you have foot or ankle pain and would like a consultation. Make an appointment at Orange County Podiatry with Dr. Andrew Yang https://ocfootandankleclinic.com/appointments/ or call (949) 651-1202.