What is Tarsal Tunnel Syndrome?

Most people have heard of carpal tunnel syndrome in the wrist. Tarsal tunnel syndrome is less common but equally painful. The difference is that tarsal tunnel syndrome occurs in the ankle and foot rather than the wrist.

Foot and ankle pain are very common. An estimated 77 percent of Americans will experience foot pain in their lifetimes. If you have pain in your ankle and the bottom of your foot, you may wonder if it could be tarsal tunnel syndrome. Here’s what you need to know about tarsal tunnel syndrome, and what you can expect if you’re diagnosed with the condition.



What is Tarsal Tunnel Syndrome, Exactly?

To understand tarsal tunnel syndrome (TTS), you have to learn a little bit about the anatomy of your foot and ankle. Your tarsal tunnel is a fibrous channel located inside your foot. It runs from your ankle to the bottom of your foot. Nerves, veins, tendons, and arteries are located within the tarsal tunnel, including a large nerve called the posterior tibial nerve. TTS occurs when the posterior tibial nerve becomes compressed or squeezed. This is normally caused by inflammation in the tissues surrounding the posterior tibial nerve.

What Are the Symptoms of Tarsal Tunnel Syndrome?

Pain is one of the first clues you may have tarsal tunnel syndrome. This pain may occur on the inside of your ankle, the sole of your foot, or the bottom of your toes. The pain may feel like it’s shooting in your foot and ankle, particularly when you’re standing or exercising. Burning, numbness, and tingling in the foot and ankle are also common symptoms of the condition. Since there are many causes of foot pain, it’s best to have an examination by a doctor or physical therapist to determine if your pain is TTS. Several other conditions may cause the same type of foot and ankle pain, including Morton’s Neuroma.

What Causes Tarsal Tunnel Syndrome?

Several factors can cause your posterior tibial nerve to become compressed and tarsal tunnel syndrome to occur. Here are some of the most common.

  • Trauma, or injury, to your foot or ankle, can cause your foot’s tissues to become inflamed. Injury can also occur from improper stretching or muscle strain.
  • Flat feet or fallen arches can cause a strain on the posterior tibial nerve. People with naturally flat feet are at risk for developing tarsal tunnel syndrome.
  • Some medical conditions can cause inflammation in the feet, such as rheumatoid arthritis, diabetes, and gout.
  • Obesity can cause pressure on the posterior tibial nerve due to excess weight.
  • Wearing shoes that are too small or that pinch the back of your ankle may lead to nerve pressure and pain.
  • In rare instances, a tumor on the tibial nerve can cause it to become compressed.


How Do You Treat Tarsal Tunnel Syndrome?

When possible, it’s best to treat tarsal tunnel syndrome without surgery. The American College of Foot and Ankle Surgeons recommends several non-surgical options for treating tarsal tunnel syndrome. These include methods for reducing inflammation, such as ice, rest, and anti-inflammatory drugs. Many people who suffer from tarsal tunnel syndrome find relief in physical therapy. Custom orthotics or braces may also be prescribed to prevent inflammation on the posterior tibial nerve.


For more severe cases of TTS, doctors may prescribe an injected corticosteroid. In rare cases, surgery may be required.

If you’re experiencing pain in the back of your ankle and the bottom of your foot, don’t hesitate to have it looked at right away. Cawley Physical Therapy and Rehab can help you get back to feeling your best. Call us at (570)208-2787 or email us at cawleyptfrank@gmail.com.

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