Tarsal tunnel syndrome is a condition caused by damage to the posterior tibial nerve as a result of repeated pressure and compression.
- The tibial nerve is located near the ankle, runs through the tarsal tunnel (which is a passageway inside the ankle) and branches off of the sciatic nerve.
Symptoms of Tarsal Tunnel Syndrome
Signs of the condition may include:
- Pain, numbness or tingling near the tibial nerve, in the sole of the foot, or inside the ankle
Pain that feels like:
- Pins and needles
- An electric shock
- Sharp, shooting pain
- A burning sensation
Causes of Tarsal Tunnel Syndrome
The tibial nerve may be compressed as a result of:
- Severely flat feet that stretch the tibial nerve
- Varicose veins in the membrane surrounding the tibial nerve
- Benign bony growths in the tarsal tunnel
- Lesions and masses resembling tumors or lipomas near the tibial nerve
- Inflammation caused by arthritis
- Injuries or trauma such as ankle sprain or fracture, which can lead to inflammation and swelling
- Diabetes, which increases the risk of compressing the tibial nerve
If left untreated, the condition may cause permanent and irreversible nerve damage.
Risk Factors for Tarsal Tunnel Syndrome
Certain individuals have a greater risk of developing the condition:
- Jobs that require standing or walking for a prolonged period of time, such as retail, teaching, manufacturing, mechanical and surgical jobs
- Nerve disease
- Metabolic conditions
- Wearing poorly fitting shoes that allow the foot to pronate forward or do not support the arch and ankle
- Foot deformities
- Peripheral neuropathy conditions
- Generalized leg edema or swelling
- Being overweight
Diagnosing Tarsal Tunnel Syndrome
Patients experiencing symptoms should schedule an appointment with their physician. During the initial visit, the physician will evaluate the symptoms, review the patient’s medical history and examine the foot and ankle for physical characteristics that could indicate tarsal tunnel syndrome. The physician may perform a Tinel’s test by tapping the tibial nerve. If the patient feels a tingling sensation or pain, then they likely have tarsal tunnel syndrome.
The physician may order an electromyography and MRI scan to rule out nerve dysfunction and bony growth.
Treating Tarsal Tunnel Syndrome
The condition may be treated with:
- Anti-inflammatory medications to reduce inflammation
- Rest, ice, compression and elevation
- Surgery (in severe cases)
Patients that don’t experience relief after taking medication or resting their leg, may benefit from a tibial nerve injection.
Risks and Side Effects of a Tibial Nerve Injection
The procedure is relatively safe. Common or possible side effects include infection, increased pain and weakness. Patients should speak to their physician to determine if a tibial nerve injection is an appropriate treatment for them.
What to Expect During a Tibial Nerve Injection Procedure
The physician will begin by cleansing the injection site with an antiseptic. An ultrasound machine will be used to ensure the needle is inserted in the correct place. Once the needle is correctly positioned, the local anesthetic and steroid will be injected.