Tarsal Tunnel Syndrome

Tarsal tunnel syndrome is a condition that occurs when the posterior tibial nerve is compressed. This large nerve runs down the back side of the leg*, passes behind the medial malleolus (the ankle bone* on the big-toe side of the foot), and down to the underside of the foot, where it supplies sensation to the skin and motor function to the intrinsic foot muscles. Before entering the foot, the nerve passes through an area called the tarsal tunnel. The roof of the tunnel is a thick ligament called the flexor retinaculum. The tarsal tunnel also contains three important tendons, as well as the principal artery (the posterior tibial artery) and its accompanying veins.

People with tarsal tunnel syndrome commonly complain of pain and numbness on the outside portion of the bottom of the foot. The pain is often described as burning, aching, radiating, "pins and needles," throbbing, or tingling, like an electrical shock. Occasionally it affects the toes, making it difficult for doctors to distinguish it from a neuroma. When pressure is put on this nerve, one may feel a burning or numbness on the bottom of the foot.

Our podiatric doctors would begin treatment with anti-inflammatory medications, and possibly an injection of cortisone into the area around the nerve. Orthotics and changes in footwear may also help to relieve the symptoms.

If none of these measures helps, then a procedure called a tarsal tunnel release may be necessary. One of our podiatric surgeons would performed the procedure in the operating room and it lasts about 30 to 45 minutes. When a tarsal tunnel release is performed, an incision is made to open up the tarsal tunnel and decrease pressure on the posterior tibial nerve. This surgery is also very similar to a carpal tunnel release in the wrist.

If you have any of these symptoms, call us at Southeast Podiatry to make an appointment with Dr. Brent Harwood or Dr. Bradford Egly.