Tarsal Tunnel Syndrome

What is it?

It is a condition caused by repeated pressure that results in damage to the posterior tibial nerve, an important nerve in the foot. Tarsal tunnel is a narrow passage inside the ankle. The bone and soft tissues bound it. The posterior tibial nerve runs through the tunnel and damage or compression to it causes tarsal tunnel syndrome.

What are the symptoms?

• Sharp shooting pains
• Pins and needles
• Electric shock like sensation
• Burning sensation

are all seen in the sole of the feet or inside the ankle. These are the areas supplied by the posterior tibial nerve.

These symptoms are aggravated by physical activity. But in long standing cases these symptoms may occur at rest also. 

What are all the causes?

• Severe flat feet causing stretch of the nerve
• Benign bony growths in the tarsal tunnel
• Inflammation in the ankle
• Lesions or masses near the nerve
• Diabetes and varicose veins

Diagnosis:

• Proper clinical history and detailed neurological examination
• Nerve conduction studies and electromyography to see for the severity of the compression
• MRI to look for the cause of the compression

Treatment:

• R – rest
• I – icing
• C – compression
• E – elevation
• Steroid injections
• Bracing, splinting and physical therapy
• Surgery: the ligament over the posterior tibial nerve is released. It can be done by an open surgery or through an endoscope and is called tarsal tunnel release.

Authored By Dr. Sai Sudarsan