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Tarsal tunnel syndrome

Tarsal Tunnel Syndrome

The tarsal tunnel syndrome is caused by a compression of the posterior tibial nerve and causes pain, tingling or numbness in the foot. TTS occurs when you have tibial nerve damage. Your tibial nerve runs through your tarsal tunnel, a passage of bones and ligaments in your ankle. TTS symptoms may include pain, burning or tingling in the bottom of your feet and toes. Often, nonsurgical treatment decreases symptoms.

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Tarsal tunnel syndrome (TTS) is a condition that occurs when you have a damaged or compressed tibial nerve. The tibial nerve is a nerve in your ankle. It runs through your tarsal tunnel, a passage in your ankle made up of bones and ligaments.

People who have TTS may have pain, tingling, numbness or weakness in their feet. You might develop TTS because of overuse of your foot and ankle. You’re more likely to develop TTS if you exercise strenuously or frequently, especially if you have a very flat foot.

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.

For many people who develop tarsal tunnel syndrome, TTS is part of an overuse injury. More than 2 in 5 people with tarsal tunnel syndrome have a history of injuries such as ankle sprains. A sprained ankle is an injury to your ankle ligaments.


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.

Diagnosis of Tarsal Tunnel Syndrome

To diagnose tarsal tunnel syndrome, Orthopedic Specialist at Shreya Hospital will ask you to describe your symptoms. They may examine your ankle or look for injuries, as well.

You might be asked do:

  • Tinel’s test: Your healthcare provider gently taps your tibial nerve. If you experience pain or tingling that reproduce your symptoms, it may point to TTS.
  • Electromyogram (EMG): This two-part test uses an electrical impulse to measure your nerve and muscle function.
  • MRI: MRIs use magnets and radio waves to take detailed images of soft tissue and bones inside of your body. Your healthcare provider may order an MRI to evaluate an injury or nerve damage or a mass putting pressure on your tibial nerve.

Treatment of Tarsal Tunnel Syndrome

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.

Orthopedic Specialist may also recommend nonsurgical treatments such as:

  • 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.