Condition Spotlight: Tarsal Tunnel Syndrome

What is Tarsal Tunnel Syndrome?

Before we dive into what tarsal tunnel syndrome is, let’s have a look at the anatomy of the tarsal tunnel.

This is located on the medial aspect, or inside of your ankle.

There are 3 tendons, a nerve, an artery and a vein that are located within this tunnel.

When studying podiatry at university, we are taught an easy way to remember these structures – Tom, Dick And Very Naughty Harry

  • Tibialis posterior tendon
  • Flexor Digitorum longus tendon
  • Posterior tibial Artery
  • Posterior tibial Vein
  • Posterior tibial Nerve
  • Flexor Hallucis longus tendon

Tarsal tunnel syndrome involves a compression of the posterior tibial nerve that runs through the tarsal tunnel.

What does Tarsal Tunnel Syndrome Feel Like?

Those with tarsal tunnel syndrome can experience a number of symptoms, most of which are neurological in nature due to the compression of the nerve.

These symptoms can be localised to the tarsal tunnel area, or can extend further into the feet. Symptoms can include:

  • Pins and needles
  • Numbness
  • Burning sensation
  • An electric shock sensation
  • Aching sensation
  • Pain during specific movements such as plantarflexion

What Causes Tarsal Tunnel Syndrome?

Tarsal tunnel syndrome can be caused by a range of factors including:

  • Pes planus foot type (flat feet)
  • Injuries or trauma to the ankle, such as an ankle sprain
  • Bony growths or ganglion cysts
  • Inflammation of the tendons in the tarsal tunnel which can compress the nerve
  • Varicose vein (posterior tibial vein)
  • Arthritis of the ankle joint which can involve swelling
  • Diabetes – this can affect the nerve and the blood vessels

How is Tarsal Tunnel Syndrome Diagnosed?

Tarsal tunnel syndrome is often diagnosed by using the Tinel’s test, whereby we tap on the posterior tibial nerve to see if it can replicate your pain. Patients will often experience a tingling sensation or even pain during this test, making it a reliable test to diagnose tarsal tunnel syndrome.

The rest of the foot and ankle will also be assessed, including the range of motion of the ankle and foot joints and the strength of the muscles that run through the tarsal tunnel.

We also perform a standing and walking assessment to identify any potential biomechanical factors that could be contributing to your pain, including flat feet or muscle weakness.

How is Tarsal Tunnel Syndrome Treated?

It is important to consult a medical professional if you are experiencing any sort of neurological symptoms in the feet.

Seeking help sooner rather than later will not only help relieve your symptoms, it will also reduce the risk of permanent damage to the nerve and further complications or injury.

Often, simple treatments can provide quick relief once pressure is taken off the nerve, however it usually takes approximately 6-8 weeks to heal depending on the extent or severity of the pain.

The symptoms may resolve on their own, such as in the case of an ankle sprain once the swelling has gone down, however most often you will need treatment to relieve your pain.

At home remedies that you can try before you come into the clinic include icing, wearing supportive footwear, taking anti-inflammatory medication and simple ankle range of motion exercises such as circles or writing the alphabet in the air with your foot.

Treatment at the clinic is aimed at addressing the factors that are causing your pain and may include:

  • Taping
  • Orthotics
  • Dry needling
  • Shockwave therapy
  • Massage
  • Footwear modification or advice
  • Strengthening exercises which target the muscles that run through the tarsal tunnel.
  • Referral for a cortisone injection to assist with reducing inflammation
  • Referral for surgery in severe cases when pressure cannot be released or if the injury is not responding to conservative treatment options

We Can Help You

If you’re experiencing anything that we’ve described today or any pain or discomfort in your feet or lower limbs, come see us at our clinic. Our podiatrists are highly trained and experienced, and able to diagnose and treat a huge variety of conditions that can affect your feet.

Book in to see us by calling us on (03) 9432 3689 or making an appointment online.