Tarsal Tunnel Syndrome is a condition caused by the compression of the posterior tibial nerve within the tarsal tunnel, a narrow passageway located on the inside of the ankle and foot. This condition is often confused with posterior tibial neuralgia since both involve irritation or compression of the tibial nerve, yet tarsal tunnel syndrome only applies to the nerve inside the tarsal tunnel. The tarsal tunnel is made up of several structures, including the heel bone, the ankle joint, and the surrounding ligaments and muscles. The posterior tibial nerve, which is responsible for sensation in the foot, passes through the tarsal tunnel and can become compressed due to inflammation or a structural abnormality. This is a common cause of foot and ankle pain, which can be very debilitating when left untreated.
Symptoms may include:
At Foot & Ankle Centers of Frisco, Little Elm, and McKinney, our podiatrists will ask about your medical history, symptoms, and lifestyle habits. There are a variety of factors that can aggravate your tarsal tunnel syndrome, such as:
To ensure an accurate diagnosis, your podiatrist will include a physical exam and a nerve conduction test. The information gathered by your podiatrist will include your foot's range of motion, your ability to move your toes, and the strength and function of your tibial nerve. Lastly, imaging tests may be used to see the severity of inflammation and compression in your tarsal tunnel. These tests may include an X-ray, MRI, or CT scan.
Your podiatric treatment will focus on the goal of restoring comfort and mobility back to your ankle and foot. Depending on the severity and underlying cause that has compressed the tarsal tunnel, your treatment may include both conservative treatment and surgery. Treatment options may include:
The goal of treatment is to relieve your pain by reducing inflammation and allowing the tarsal tunnel to regain function and heal naturally. Other times, the underlying cause of your tarsal tunnel syndrome can only be healed with surgery.
Tarsal tunnel release surgery will allow your podiatric surgeon to create more space for the posterior tibial nerve and remove any abnormalities that are placing pressure on the nerve. This procedure will relieve the pain, numbness, and tingling in the foot caused by compression on the tibial nerve. The surgery is done by making an incision on the inside of the ankle to create a tunnel and relieve the pressure on the nerve. During the surgery, your podiatrist may remove a piece of the flexor retinaculum, which is the band of connective tissue that holds the nerve in place. After the release, your surgeon will close the incision with sutures or staples and dress the wound. Following the surgery, you will need to wear a protective boot for about one to two weeks to keep the area immobilized. Physical therapy is usually recommended after the surgery to help restore strength, flexibility, and mobility to the foot.