Tarsal Tunnel Syndrome... What Causes It?

What Is Tarsal Tunnel Syndrome?



This is a syndrome of the foot and ankle which can be thought of in a similar way to "carpel tunnel syndrome" which affects the hands.

Heel pain or inside ankle pain which can radiate down the foot to the toes are common symptoms of Tarsal Tunnel Syndrome (TTS)or posterior tibial nerve entrapment.

TTS is defined as "an entrapment neuropathy or inflammation of the posterior tibial nerve." This nerve is found alongside the posterior tibial tendon on the inside of the foot and ankle.

Tarsal Tunnel Syndrome picture

What Causes Tarsal Tunnel Syndrome?



The cause of this syndrome can include a number of factors such as:

  • excessive pronation or flattening of the foot arches. This can increase stress on the posterior tibial nerve.

  • Obesity or excessive weight gain can cause poterior tibial nerve strain and thereby give rise to symptoms of TTS.

  • Some arthritic conditions such as rheumatoid arthritis can predispose individuals to this syndrome.

  • Sudden increases in activity level can also contribute to tarsal tunnel inflammatory disorders.

  • Tumours or soft tissue lesions can also increase pressure on the poterior tibial nerve which can also give rise to tarsal tunnel symptoms.

    Symptoms can include burning pain, numbness, radiating pain along the nerve path through to the toes, ankle pain and heel pain. This condition is often mistaken for heel spurs and/or plantar fasciitis because heel pain is a common symptom with this disorder.

    Pain is usually worse with increased activity and with prolonged periods of stance.

    How Is Tarsal Tunnel Syndrome Treated?

    Treatment for tarsal tunnel nerve entrapment involves a combination of:

  • ice;
  • taping;
  • anti-inflammatory medication;
  • exercises ( posterior tibial nerve stretching );
  • orthotic devices; and
  • supportive footwear.

    If conservative treatment mentioned above fails, cortisone injections and/or immobilisation using a walking boot may need to be considered as a treatment option.

    Surgery for tarsal tunnel disorders can be considered if all other conservative treatment measures fail. An accurate assessment and diagnosis is important to exclude possible tumours. See your Podiatrist if symptoms do persist.

    Click on the following link for more information on tarsal tunnel syndrome and foot pain.


    WARNING : This information is for educational purposes only and is not intended to replace professional podiatric advice. Treatment will vary between individuals depending upon your diagnosis and presenting complaint. An accurate diagnosis can only be made following personal consultation with a Podiatrist, your Doctor or your foot specialist.

    Still have a question about your foot problem, leg pain or you just need some footwear advice?

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