Tarsal Tunnel Syndrome

Tarsal tunnel syndrome is a foot condition caused by pressure on the posterior tibial nerve as it passes through the tarsal tunnel on the inside of the ankle. This nerve compression can lead to burning pain, tingling, numbness, or discomfort that radiates into the sole and arch of the foot.

The tarsal tunnel is a narrow space formed by bone and soft tissue near the medial malleolus (the bony bump on the inside of the ankle). Because several tendons, blood vessels, and the posterior tibial nerve pass through this confined area, swelling or structural changes can easily place pressure on the nerve.

Tarsal tunnel syndrome can affect one or both feet and may gradually worsen if the underlying cause is not addressed.

Common Signs and Symptoms

Pain that is burning which radiates to the foot arch, heel and sometimes the toe.

Symptoms can vary in intensity and may come and go, especially during early stages. Common indications include:

Burning pain in the foot that may radiate into the arch, heel, or toes
Numbness or a pins-and-needles sensation on the sole of the foot
Pain that worsens after standing, walking, or running for long periods
Discomfort that is often more noticeable at night
Tenderness beneath the medial malleolus on the inside of the ankle

In some individuals, symptoms increase during activities that place stress on the ankle or foot and may ease with rest.

Possible Causes

Tarsal tunnel syndrome develops when the posterior tibial nerve becomes compressed. This pressure may result from:

Overpronation, where the foot rolls inward excessively during walking or running
Swelling following an ankle injury or sprain
Inflammatory conditions such as arthritis or tenosynovitis
Diabetes-related nerve changes
Cysts, ganglions, or abnormal growths within the tarsal tunnel
Structural differences in the foot or ankle

Because overpronation can affect both feet, symptoms may sometimes appear on both sides.

General Management and Care

Early care focuses on reducing strain and inflammation around the ankle and foot. General approaches may include:

Rest from activities that aggravate symptoms
Applying cold packs during periods of pain or swelling
Using supportive footwear to reduce stress on the foot
Gradual stretching and strengthening exercises once pain improves

If symptoms persist, worsen, or interfere with daily activities, medical assessment is recommended to rule out other causes of foot pain and nerve compression.

First Aid and Training Note

Foot pain, numbness, or burning sensations can affect balance and mobility, increasing the risk of slips, trips, and falls — particularly in workplaces, sports, and active environments across Canada.

Learning to recognize early warning signs of musculoskeletal and nerve-related injuries is an important component of first aid and safety training.

Disclaimer

The information on this page is for educational purposes only and is not a substitute for medical advice. To learn how to recognize and respond to lower limb injuries and mobility-related concerns, consider enrolling in a first aid and CPR course with a certified Canadian training provider.