Does tarsal tunnel syndrome sound like a misprint? Like it was supposed to be carpal tunnel syndrome? Not true. Tarsal tunnel syndrome is very much like carpal tunnel syndrome but where the more familiar carpal tunnel is found in the wrist, the tarsal tunnel, which is made up of bone and bands of ligaments, runs along the inside of the ankle.
Both conditions result from the contents of their respective tunnels, nerves, tendons, and blood vessels, becoming compressed or squeezed together. The symptoms associated with this condition come from the compression of the tarsal tunnel nerve, the posterior tibial nerve.
Causes of Tarsal Tunnel Syndrome
While there are cases in which it is not possible to determine the exact cause of the narrowing of the tarsal tunnel, some of the most common causes leading to the symptoms associated with compression of the nerve include:
- Fallen arches or having flat feet causes the heel to tilt in an outward direction which may result in additional strain or pressure on the posterior tibial nerve.
- Varicose veins, enlarged tendons, ganglion cysts, bone spurs from arthritis, or other abnormal structures within the tarsal tunnel can be the cause of the nerve compression.
- Inflammation from a sprained ankle or similar injury may put extra pressure on the tunnel, either from the inside or the outside.
- Systemic diseases in the body, such as arthritis, diabetes, or hypothyroidism can cause swelling that then compresses the nerve.
Symptoms of Tarsal Tunnel Syndrome
The symptoms of tarsal tunnel syndrome are also similar to those associated with carpal tunnel syndrome and often include some or all of the following:
- Pain, which may be in the bottom of the foot or in the toes
- Tingling, burning, numbness, or other abnormal sensations in the bottom of the foot or the toes
- Weakness in the muscles of the foot or in the toes or ankle
- Muscle weakness may, in the most severe cases, lead to foot deformity
Treating Tarsal Tunnel Syndrome
It is important to seek treatment from your orthopedist for tarsal tunnel syndrome. Left untreated, it can lead to permanent damage of the nerve. There is a range of non-surgical options available and your orthopedist will base treatment on the cause and severity of your condition. These options, often used in combination, include:
- Rest, which prevents additional injury and promotes healing
- Icing to reduce swelling and help relieve pain
- Pain and anti-inflammatory medications
- Immobilization with a cast to restrict movement and encourage healing
- Physical therapy
- Custom orthotics devices, especially when the cause is due to a fallen arch or flat feet
- Supportive footwear
In particularly severe cases or those that do not respond to more conservative treatment, your orthopedic surgeon may recommend a surgical procedure such as tarsal tunnel release in which an incision is made behind the ankle so that the nerve can be released.
If you have questions or concerns about any foot or ankle issues, Dr. Christopher Hubbard is a board-certified Orthopedic Surgeon with Ortho-Care Wayne in Passaic County New Jersey, and is the former Chief of the Foot and Ankle Service at Mount Sinai Beth Israel in NYC.
To schedule an appointment, or if you just have questions, please use our convenient online contact form by clicking here.