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Tarsal Tunnel Syndrome


The tarsal tunnel is a narrow space that lies on the inside of the ankle next to the ankle bones. The tunnel is covered with a thick ligament (the flexor retinaculum) that protects and maintains the structures contained within the tunnel— arteries, veins, tendons, and nerves.


Tarsal tunnel syndrome is a compression, or squeezing, on the posterior tibial nerve that produces symptoms anywhere along the path of the nerve. The posterior tibial nerve runs along the inside of the ankle into the foot.


Tarsal tunnel syndrome is similar to carpal tunnelsyndrome, which occurs in the wrist. Both disorders arisefrom the compression of a nerve in a confinedspace.Although tarsal tunnel syndrome may not be as wellknown as carpal tunnel syndrome, it is nevertheless a causeof foot and ankle pain in adults.


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Patients with tarsal tunnel syndrome experience one or more of the following symptoms:


  • Tingling, burning, or a sensation similar to an electrical shock
  • Numbness
  • Pain, including shooting pain


The symptoms are typically felt on the inside of the ankle and/or on the bottom of the foot. In some people, a symptom may be isolated and occur in just one spot. In others, it may extend to the heel, arch, toes, and even the calf.

Sometimes the symptoms of the syndrome appearsuddenly. Often they are brought on or aggravated byoveruse of the foot—such as in prolonged standing, walking,exercising, or beginning a new exercise program.

It is very important to seek early treatment if any of thesymptoms of tarsal tunnel syndrome occur. If leftuntreated, the condition progresses and may result inpermanent nerve damage. In addition, because thesymptoms of tarsal tunnel syndrome can be confused withother conditions, proper evaluation is essential so thatcorrect diagnosis can be made.

Sometimes an MRI is ordered, usually if a mass issuspected or in cases where initial treatment does notreduce the symptoms. In addition, special studies used toevaluate nerve problems—electromyography and nerveconduction velocity (EMG/NCV)—may be ordered if thecondition shows no improvement with non-surgicaltreatment.




A variety of treatment options, often used in combination, are available to treat tarsal tunnel syndrome.