Tarsal tunnel syndrome

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Tarsal tunnel syndrome is a sore condition of the foot due to pressure on the posterior tibial nerve as it passes through the tarsal tunnel. This tunnel is positioned beneath the bony region on the interior of the ankle which results to burning pain in the foot along with pins and needles as well as discomfort radiating in the arch of the foot.

What are the symptoms?

  • Pain that is burning which radiates to the foot arch, heel and sometimes the toe.
  • Numbness or pins and needles sensation in the sole of the foot
  • Pain is aggravated by running or after standing for long periods of time and often worse at night time.
  • Area beneath the medial malleolus on the interior side of the ankle might be tender to the touch
    Tarsal tunnel syndrome
    Pain that is burning which radiates to the foot arch, heel and sometimes the toe.

What are the causes of tarsal tunnel syndrome?

Tarsal tunnel syndrome develops if the posterior tibial nerve that passes beneath the interior of the ankle is trapped or compressed.

If the individual overpronates in which the foot rolls in when walking or running, this adds up to the nerve compression. Since overpronation is a factor, it is common for the issue to affect both feet at the same time.

The condition might occur spontaneously for no evident reason or linked with injury such as the following:

  • Diabetes
  • Osteoarthritis
  • Tenosynovitis
  • Rheumatoid arthritis
  • Cyst or ganglion in the tarsal tunnel
  • Talonavicular coalition


Adequate rest from any strenuous activities and the application of ice in the acute phase is necessary if the foot or ankle is inflamed and painful. Anti-inflammatory medications can also help reduce the inflammation and pain.

Once the initial pain and inflammation has settled, a full rehabilitation program can be started which includes stretching and strengthening exercises for the foot.

In case the conservative measures are not effective, a corticosteroid shot might be given. For persistent cases, surgical intervention might be required to decompress the nerve. This involves decompressing the nerve by releasing the soft tissue structures in the area to provide more space for the nerve.

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