Tarsal tunnel syndrome – also known as TTS, refers to a condition involving a tibial nerve irritation or compression as the nerve passes through the tarsal tunnel - a tight and limited space located on the inner side of each ankle. Although it is the most commonly reported nerve entrapment issue related to the ankle, tarsal tunnel syndrome is best understood compared to a similar, more commonly-known condition in the wrist – carpal tunnel syndrome.
Tarsal Tunnel Symptoms
The symptoms of tarsal tunnel syndrome, which is also known as posterior tibial neuralgia, tend to vary but may include –
Pain
Foot and ankle pain is the most common tarsal tunnel syndrome symptom. Descriptions and pain levels vary but often concern areas near the inner part of the ankle and the bottom of the foot. It gets aggravated as night approaches, with the potential to disrupt routine sleep patterns. In addition, weight-bearing activities or standing for extended periods of time tend to increase the related pain and discomfort.
- Numbness/Tingling
Many people experience numbness around the foot or ankle, often radiating toward the affected foot’s toes.
- Electric Shock/Burning Sensations
Tarsal tunnel syndrome may generate electric shock-like jolts or a burning sensation in and around the foot or ankle.
Weakness
A tibial nerve compression or a foot/ankle injury may cause the development of weakness in the affected foot.
Swelling
TTS may cause a foot and/or ankle to swell in certain situations.
Note that tarsal tunnel syndrome’s symptoms may resemble those created by other conditions, such as plantar fasciitis, peripheral neuropathy, etc. As such, a proper diagnosis from a podiatrist, often with imaging tests, is vital to properly –
- Diagnose the underlying cause of the manifested symptoms.
- Develop or tailor a customized podiatric treatment plan.
What Causes Tarsal Tunnel Syndrome?
While the fundamental cause of TTS is pressure or a strain on your tibial nerve, this noted compression of the tibial nerve may be caused by various factors that include -
- Abnormal foot mechanics – for example, fallen arches, flat feet, etc.
- Swelling from an ankle injury or overuse
- Tendinitis in the ankle region
- A cyst/tumor
- Bone spurs development
- Varicose veins
- Systemic autoimmune conditions, such as hypothyroidism, or inflammatory conditions like diabetes or arthritis
Treating Tarsal Tunnel Syndrome
Many people, with the assistance of at-home or over-the-counter treatment techniques, can successfully manage the symptoms of tarsal tunnel syndrome. These options include -
- Rest – Limiting motion and keeping off the affected foot for a few days tends to promote healing and help prevent future or further injury. However, doing it for too long creates a risk that muscles will start to tighten.
- Ice – an ice pack is a simple but effective way to decrease swelling and dampen pain. Consider using a towel-wrapped ice pack for 15 minutes a few times per day, while also removing the ice for 15 minutes after each application.
- Compression – A brace or elastic support bandage is helpful in reducing inflammation from TTS.
- Elevation - When possible, keep your foot elevated to help overcome inflammation.
- Nonsteroidal Anti-Inflammatory Medications (a.k.a. NSAIDs) - Over-the-counter NSAIDs can reduce inflammation and pain.
A podiatrist can also help manage TTS symptoms using one or a combination of these nonsurgical treatments –
- Orthotics – A podiatrist can prescribe custom-made shoe inserts, which are known as orthotics. Orthotics help support or stabilize the foot, which reduces the compression of the nerves in the foot and the pain associated with TTS and other conditions.
- Braces/Splints/Casts – These keep your foot in place, which helps promote nerve healing by reducing the pressure caused by flat feet, etc.
- Physical Therapy – Specific exercises can be prescribed that allow you to improve your foot’s range of motion and strength.
- Steroids – These meds aid in the reduction of inflammation and pain. They may be prescribed orally or delivered as an injection.
If your symptoms from tarsal tunnel syndrome remain chronic and severe after conservative, nonsurgical options, a podiatrist may recommend a surgical option that offers pain relief from TTS.