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Tarsal tunnel syndrome is similar to carpal tunnel syndrome, but affects the foot. It involves compression of the posterior tibial nerve, causing numbness, pain, and burning sensations. Treatment depends on the cause and can range from rest and ice to surgery.
Most people are familiar with carpal tunnel syndrome, which is caused by compression of a nerve in the wrist. This can significantly affect hand function. A similar condition is tarsal tunnel syndrome. Like carpal tunnel syndrome, tarsal tunnel syndrome involves compression of a nerve that affects body function, but this time, the nerve innervates or provides feeling to the foot and travels through the tarsal tunnel, which is located near the ankle bones .
There are many things in the tarsal tunnel, but the structure involved in the syndrome is the posterior tibial nerve. Under a variety of circumstances the tunnel can narrow and this can result in quite noticeable symptoms. These include numbness in the foot and pain that radiates down the foot.
Other people report burning sensations in one foot or notice a constant pins and needles sensation. The areas where these symptoms occur are often on the inside of the foot and ankle and on the ball of the foot. Sometimes symptoms spread above the ankle or beyond the sole, or they can occur on just one area of the foot. In most cases, wherever unusual or painful sensations are present, standing for long periods of time exacerbates them. Vigorous exercise can cause a dramatic onset of symptoms.
Compression resulting in tarsal tunnel syndrome is not always caused by the same factors. In some cases overdeveloped calf muscles create compression of the posterior tibial nerve, or alternatively being very overweight could cause this problem. Ankle injury such as a fracture or sprain that creates inflammation is another way for this condition to develop. People might be more prone to tarsal tunnel syndrome if they have flatter feet and a potential cause is a large varicose vein in or near the tarsal tunnel. Growths in the tunnel, caused by cysts, could also cause these symptoms.
Treatment for this disorder depends on the cause. Sometimes the condition is temporary, such as when an ankle injury occurs. In these cases, ice and rest may be adequate to reduce the inflammation and eventually make the symptoms go away. Doctors might prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve discomfort and reduce swelling.
Doctors may also suggest shoe orthotics or specially designed shoes that reposition the foot, creating less compression on the nerve. Some prefer more stringent measures and may want a person to wear a splint or other device to keep the foot in a position that helps minimize the narrowing of the tarsal tunnel. If these measures fail or if a mass such as a cyst is present, surgery may be the best option for treatment, and there are different types of surgery depending on the underlying cause.
Ultimately, tarsal tunnel syndrome is successfully treated in many cases. Some people will be able to address the condition with very little intervention and others may need more medical care. In many cases, the need to use major measures for treatment depends on why the condition is present and how much the quality of life is or will continue to be affected.
