Understanding Tarsal Tunnel Syndrome

What is Tarsal Tunnel Syndrome and Who Develops it?

Tarsal tunnel syndrome shares some similarities to the more commonly understood carpal tunnel syndrome that occurs in the hand and wrist. The "tarsal tunnel" is a narrow passageway that runs from the back of the leg into the foot just at the inside of the ankle — where you see the normal bony protrusion above your heel. The tibial nerve, which controls our sense of touch in the sole of the foot, passes through the tarsal tunnel along with the posterior tibial vein and artery.

A band of fibrous tissue runs across the top of these very important structures. Doctors refer to this fibrous band as the flexor retinaculum of the foot or laciniate ligament. If anything under that band becomes irritated, or if any other swelling encroaches on the space within the tunnel, the tibial nerve can become compressed. Compression of the tibial nerve may cause symptoms that range from tingling in the sole of the foot to a burning pain that radiates up the ankle or down further into the foot.

Tarsal tunnel syndrome is somewhat uncommon, but can happen to almost anyone. Some reports suggest that people with flat feet may be more likely to develop the syndrome because the tarsal nerve becomes more stressed by pronated (flattened) arches. Other factors may also be important in determining the cause of the syndrome. Changes in the foot or ankle due to arthritis or diabetes may have an impact. And, certainly, scar tissue from past trauma to the foot or ankle could also contribute to the cause.

What are the Symptoms of Tarsal Tunnel Syndrome?

The symptoms of tarsal tunnel syndrome often begin gradually and typically stem from the inside of the ankle or the heel of the foot. Initially, symptoms may be intermittent (come and go), but without intervention, they may become chronic (constant). You may feel tingling, numbness and pain in your foot. This pain may also radiate through your ankle and up into your leg. Pain associated with tarsal tunnel may feel dull and nagging, or it may seem to shoot through your foot and ankle like an electrical current. When your doctor touches your foot along the route of the tibial nerve, you may feel instant tingling and pain.

In order to diagnose you properly, your doctor will consider your symptoms and examine your foot and ankle. Your doctor may also require you to have X-rays, an MRI (magnetic resonance imaging) or a nerve conduction test to look closely at the nerve function in your foot.

Your doctor may recommend different treatment options depending on your particular symptoms and the severity of your condition.

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