Tarsal tunnel syndrome occurs when inflammation occurs in the fibrous canal containing the posterior tibial nerve. Often caused by injury, the condition may be referred to as carpal tunnel of the foot. Tarsal tunnel syndrome is painful and can affect the comfort with which one runs or walks.

What is Tarsal Tunnel Syndrome?

The posterior tibial nerve, blood vessels, and tendons pass through the enclosed tarsal tunnel along the inside of the foot near the ankle. The nerve lies between the ankle bone on the inside and the flexor retinaculum ligament on the outside. When this nerve is compressed, a person can develop tarsal tunnel syndrome. People with the condition require prompt treatment to avoid long-term, irreversible damage.


Symptoms of Tarsal Tunnel Syndrome

The symptoms of tarsal tunnel syndrome include

  • Tingling ranging from pins and needles to electrical shock sensation,
  • Burning that originates in the foot and radiates up the leg,
  • Numbness,
  • Sensations of hot or cold,
  • Swelling

tarsal tunnel syndrome symptoms no_limit_pictures / Getty Images


What Causes Tarsal Tunnel Syndrome?

The tarsal tunnel is a small passageway, and activities or diseases that cause inflammation can compress the opening. Rheumatoid arthritis, bone spurs, tumors, cysts, diabetes, and fallen arches or flat feet are common causes of tarsal tunnel syndrome. Athletic injuries such as a sprained ankle can also trigger the problem.



When a doctor suspects tarsal tunnel syndrome, the first test he performs may be a Tinel's sign test. In this indicator, he presses on the tibial nerve to determine whether the patient feels tingling, which points to the condition. Other tests include palpitation for a mass, MRIs, and electromyography, which checks nerve and muscle health.

diagnosing tarsal tunnel syndrome Jan-Otto / Getty Images


Treatment Options for Tarsal Tunnel Syndrome

RICE is often the first course of therapy; rest, ice, compression, and elevation. Doctors often recommend the least intrusive therapies first. Treatment options vary based on the severity of the condition, with some patients responding well to analgesics and cortisone injections. Patches for pain, oral medications, immobilization, and physical therapy may produce positive results. If fallen arches or flat feet are the cause of tarsal tunnel syndrome, the doctor may suggest orthotics. Some people ultimately require surgery.

ankle compression kaanates / Getty Images


Tarsal Tunnel Syndrome Surgery

A tarsal tunnel release surgery is similar to a carpal tunnel release. The surgeon decompresses the tibial nerve and removes anything placing pressure on the nerve or tunnel itself, such as a cyst, bone spur, or scar tissue.

tarsal tunnel release Kritchanut / Getty Images


Risk Factors for Tarsal Tunnel Syndrome

Both men and women are at equal risk for tarsal tunnel syndrome, although evidence suggests female athletes run a higher risk of developing the syndrome than their male counterparts. Risk factors include people with flat feet and those who participate in track, basketball, and volleyball -- sports that require athletes to land on their feet at a high velocity. Stretching before and after high-risk activities could reduce one's likelihood of injury and inflammation.

sports affect tarsal tunnel syndrome South_agency / Getty Images


Similar or Related Conditions

Other conditions may be confused with or related to tarsal tunnel syndrome. Diabetic neuropathy can cause tingling or numbness as well as pain. Plantar fasciitis causes heel pain due to inflammation of the plantar fascia. Often, a doctor will rule out stress fractures and posterior tibial tendinosis before diagnosing tarsal tunnel syndrome.

tarsal tunnel syndrome related conditions skynesher / Getty Images


Exercises and Bracing

The doctor or physical therapist may recommend stretching and balancing exercises to reduce pain and increase mobility in patients with tarsal tunnel syndrome. Exercises such as ankle circles, ankle pumps, pencil toe lifts (using the toes to lift a pencil off of the floor), flexing heel to toe, and balancing on one foot can strengthen the injured area. The doctor may also suggest taping or bracing the foot to decrease pressure.

stretching skynesher / Getty Images


Preventing Tarsal Tunnel Syndrome

People who participate in activities or have conditions that can cause inflammation in the tarsal tunnel should take care to stretch before and after physical activity and wear proper footwear and orthotics, if recommended. Exercises for strengthening the region should be low-impact, and it is ideal to avoid long periods of standing in place on hard floors. Anyone who notices pain or other symptoms of tarsal tunnel syndrome should speak to a doctor right away.

orthotics reduce tarsal tunnel syndrome michelangeloop / Getty Images


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