Tarsal tunnel is the gap formed between the underlying bones of the foot and the overlying tough fibrous tissue. Tarsal tunnel syndrome refers to a condition where the posterior tibial nerve that lies within the tarsal tunnel is compressed or “pinched.”
The exact cause of tarsal tunnel syndrome is not known, but certain conditions can increase the risk, including:
- Bone spurs
- Benign tumors
- Muscle impingement
- Foot deformities
Other medical conditions, such as arthritis, can cause swelling of the joints that can compress the nerve. Scar tissue formed after an ankle injury and growth of abnormal blood vessels can also press against the nerve, resulting in compression.
Symptoms and Diagnosis
Most children with tarsal tunnel syndrome complain of pain, numbness and burning or tingling sensation at the bottom of the foot and heel.
Tarsal tunnel syndrome can be diagnosed by Tinel’s test. Tinel’s test is performed by tapping the posterior tibial nerve lightly which produces pain and other symptoms indicating tarsal tunnel syndrome.
Tarsal tunnel syndrome may be treated with conservative approaches, including:
- Nonsteroidal anti-inflammatory medications to relieve pain and reduce swelling
- Corticosteroid injections into the area around the nerve to decrease the swelling
- Orthotics, such as specially designed shoe inserts or change in footwear, to help support the arch of the foot and take the tension off the tibial nerve
Surgery is often considered a last resort and is only considered when conservative treatments fail to resolve the condition and relieve symptoms. Your doctor may perform tarsal tunnel release surgery to treat the condition. During this surgery, an incision is made in the tarsal tunnel and the pressure on the tibial nerve is released.