Tarsal Tunnel Syndrome: symptoms & treatment options

Tarsal tunnel syndrome is the compression of the posterior tibial nerve and is one of the most common nerve entrapments that affect the foot and ankle. The most common area of entrapment of this nerve is on the inside or medial aspect of the ankle. The nerve in this area runs through a tunnel that also houses an artery, vein, and 3 tendons. Thus any trauma or inflammation of any of the structures in that tunnel can compress the nerve and cause symptoms to of a compressed nerve to occur.

Signs and Symptoms of Tarsal Tunnel Syndrome

Patient with tarsal tunnel syndrome will often present with numbness to the bottom of the foot, and shooting or burning pain into the foot or up the leg.   It is often worse with any type of pressure to the area.

Tarsal Tunnel Symptoms

Diagnosing Tarsal Tunnel Syndrome

Tarsal tunnel syndrome is often tested by percussion of the nerve in the area of compression. A positive result would result in shooting or radiating pain down into the foot or up the leg. This diagnosis is often confirmed with nerve conduction studies to measure the function of the nerves. Although there can be false negative results in terms of local compression of the nerve, these studies can help reveal or distinguish whether or not there is any lower back involvement that are causing symptoms. A magnetic resonance image (MRI) or ultrasound may be helpful in identifying any soft tissue masses or swelling in the structures in the tarsal tunnel that may be compressing the nerve.

Tarsal Tunnel Treatment Options

Tarsal tunnel syndrome is treated by removing the source of compression on the tibial nerve. Physical therapy, rest, ice and anti-inflammatory medication can help reduce swelling of the tendon sheath and reduce pressure on the nerve. Local steroid injections are often used to reduce inflammation of the nerve. Additionally, custom inserts for shoes may help reduce strain on tendons that are swelling and causing compression. Surgery may be indicated if conservative measures fail. Surgery may sometimes involve removing a soft tissue mass if that is the source of compression. The most common surgical treatment for tarsal tunnel syndrome is to release the ligament that forms the tarsal tunnel that houses the nerve, allowing more space for the structures in the tarsal tunnel and thereby reducing the compression on the nerve.

To improve the success of this procedure, a new product (amniotic membrane) is now being used to wrap around the neurovascular bundle, reducing scar tissue and inflammation after the surgery. This prevents adhesions from forming and thus would help reduce irritation of the structures in the tarsal tunnel after surgery.

Conclusion

Tarsal tunnel syndrome is a painful condition of the foot and ankle that can affect ambulation and gait. It is a condition that can easily be misdiagnosed as heel pain or plantar fasciitis. It is important to have your foot and ankle evaluated by a specialist in order to get the best care and appropriate treatment for your feet.

If you are in need of expert foot or ankle care, make an appointment with a doctor at one of our nine Greater Los Angeles locations. Please call 877-989-9110 or visit us at www.footankleinstitute.com

Dr. Sydney K. Yau

Dr. Sydney K. Yau

Dr. Yau received his initial medical training at Temple University in Philadelphia where he specialized in diabetic limb salvage, sports medicine, foot and ankle reconstruction and trauma.

He then went on to complete his surgical reconstruction fellowship with the University Foot and Ankle Institute, one of only a few fellowships recognized by the American College Foot and Ankle Surgeons.

Now playing an integral role at the University Foot and Ankle Institute, Dr. Yau’s treats various sports injuries, including sprains, arthritis and fractures. He also is passionate about helping diabetic patients avoid amputation through correction of deformities and wound healing.

Dr. Yau is available for consultation at our Simi Valley location.
Dr. Sydney K. Yau

Latest posts by Dr. Sydney K. Yau (see all)

Leave a Reply

Your email address will not be published.

one × 3 =

  • Yelp
    What a great medical experience. They were running early and I saw Dr. Baravarian within 5 minutes.  A very high tech operation, and a great bed side manner.
    John K.
  • ZocDoc
    Professional, to the point, pleasant. Very happy with the service and the ability to schedule via ZocDoc.
    Deborah F.
  • CustomerSure
    Love Dr. Briskin! He was so reassuring and helpful. Had a fantastic experience!
    Shana F.
  • ZocDoc
    Very professional and very knowledgeable. I will recommend him to any one!
    Anonymous
  • Google+
    Great doctors. Easy to make an appointment. Great staff.
    Francheska A.
  • CustomerSure
    Doc Briskin was a great doctor and a straight shooter in the advice he gave to me. My toe/bone spur problem is greatly improved, and we shall see how far the healing process goes!
    David M.
  • Yelp
    Doctors are great. Easy to make an appointment. Highly recommend.
    Francheska A.
  • Yelp
    Hi again and I just wanted to thank the Doctors at the University Foot and Ankle Institute. I suffered a very severe tear of my ankle around 8 months ago whilst playing with my kids and was getting frustrated with the...
    Russell W.
  • CustomerSure
    I have had a hard time finding a doctor that is not rushing and truly listens. Dr. Campbell is really the best doctor I have been to in Santa Barbara. He listens, is thoughtful, and wants to make sure I understand. I ...
    Pauline C.
  • My surgery was an amazing success, and I was treated with great care. Thorough follow-up care brought me to a complete & painless recovery. I couldn't be happier!
    E.S.
Same day appointments now available!
or call 24/7:
  • University Foot & Ankle, a Preferred Provider to:
  • UCLA Health System - UCLA Medical Group
  • MPTF - Member Industry Health Network
  • Cirque du Soleil
  • ATP - Association of Tennis Professionals
  • And consulting physicians for:
  • C&S - Cedars-Sinai
  • Saint John's Health Center