Tarsal Tunnel Syndrome

Tarsal Tunnel Syndrome

What is Tarsal Tunnel Syndrome?

Tarsal tunnel syndrome is a condition that causes ankle pain along with neurological symptoms such as burning, numbness and tingling sensation. It occurs when the tibia nerve is compressed at the inside (medial) of the ankle, at an area referred to as the “tarsal tunnel“. This condition is very similar to carpal tunnel syndrome, which occurs at the wrist.

 

Causes of Tarsal Tunnel Syndrome

Tarsal tunnel syndrome is caused by the compression of the tibial nerve at the tarsal tunnel. Compression occurs when the space within the tarsal tunnel becomes smaller and could be due to several risk factors:

  • Swelling of the ankle
  • Inflammation of surrounding tendons
  • Excessive pronation (e.g flat feet) or excessive supination (e.g high arch feet)
  • Joint hypermobility
  • Prolonged periods of walking or running (e.g athletes)
  • Tight-fitting high-top footwear
  • Underlying tarsal coalitions
  • Soft tissue growths in the tarsal tunnel (e.g tumour, ganglion)
  • Obesity or high BMI
Tarsal Tunnel Syndrome Symptoms

Signs and Symptoms of Tarsal Tunnel Syndrome

Tarsal tunnel syndrome produces pain along with other neurological symptoms as it is a nerve-related disorder.

Signs and symptoms of tarsal tunnel syndrome include:

  • Sharp, stabbing or “shooting” pain in the ankle
  • Often an “electric shock” feeling when pain occurs
  • Pain that radiates up the lower leg or down the feet
  • Numbness, tingling or burning sensation down the feet
  • Pain worsens with activity
  • Pain worsens with dorsiflexion (lifting foot upwards) and eversion (ankle rolling inwards)

Conditions Similar to Tarsal Tunnel Syndrome

Diagnosing tarsal tunnel syndrome can be tricky and podiatrists would normally conduct specific assessments to determine the likelihood of this condition. Further diagnostic imaging or investigation is often required for confirmation (e.g MRI, nerve conduction study).

Conditions that tarsal tunnel syndrome are often misdiagnosed include:

  • Plantar fasciitis
  • Baxter’s nerve neuritis
  • PTTD
  • Flexor hallucis longus or flexor digitorium longus tendinitis
  • Spinal nerve compression
  • Sciatica

Tarsal Tunnel Syndrome Treatment

Treatment for tarsal tunnel syndrome involves addressing the factors leading to the compression of the tibial nerve and treating the inflamed tibial nerve. In cases where non-surgical treatments are unable to reduce the compression, surgery may be required.

Treatment options for tarsal tunnel syndrome include:

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