Tarsal tunnel syndrome is similar to the more common carpal tunnel syndrome in the wrist. They are both caused by compression of a nerve. In the case of tarsal tunnel syndrome, the posterior tibial nerve is involved. The nerve is located in the inside of the ankle just below the ankle bone. As is passes from this area into the foot, it is surrounded by bone and soft tissue with can cause compression on it in certain situations.
Compression of the posterior tibial nerve can cause pain, burning, tingling, and/or numbness. These symptoms may involve the heel, the inside of the ankle, the bottom of the foot, and/or the toes.
Tarsal tunnel syndrome is usually caused by one of two things. Either a mechanical problem with the way the foot works or a growth or mass near the nerve. A condition such as a flat foot can cause compression on the nerve and thereby cause tarsal tunnel syndrome. Soft tissue masses such as ganglion cysts, lipomas, and fibromas which develop near the posterior tibial nerve can cause tarsal tunnel syndrome. The posterior tibial nerve runs adjacent to a vein. An enlargement of this vein or a varicose vein can cause compression on the nerve causing tarsal tunnel syndrome. Lastly, the nerve also runs adjacent to tendons. If the tendons become thickened or inflamed, this can cause compression of the nerve as well.
The treatment of tarsal tunnel syndrome is somewhat dependent of the underlying cause. Custom made orthotics are often prescribed to correct the abnormal mechanics of the foot that contributed to the tarsal tunnel syndrome. Cortisone injections and oral medication are often used as well. At times, immobilization or physical therapy may be necessary.
If conservative treatment is unsuccessful, surgery may be necessary, especially if a mass or other growth is present. Surgery involves releasing the compression around the nerve and removing any abnormal growths that are present.