Tarsal tunnel is a narrow space that is located on the inside of your ankle. It is next to the ankle bones and covered with a thick ligament. This ligament, flexor retinaculum, protects and maintains the structures inside of the tunnel- like arteries, veins, tendons, and nerves. Among these structures is the posterior tibial nerve, which is the focus of tarsal tunnel syndrome.
Tarsal tunnel syndrome is when the posterior tibial nerve is compressed or squeezed at any point along the nerve. This syndrome may sound similar, because of its similarities to carpal tunnel syndrome, occurring in the wrist. Both disorders originate from compression of a nerve in the confined space.
Tarsal tunnel syndrome is caused by anything that can produce compression, or pressure on the posterior tibial nerve.
Symptoms are usually felt on the inside of the ankle and/or bottom of the foot. Sometimes, the symptoms can be isolated to one location and recur only in that same spot, or they can extend to the heel, arch, toes, and even the calf. Here are the most common symptoms:
Symptoms usually appear suddenly, brought on or aggravated by overuse of the foot (standing, walking, exercising, or beginning to exercise). It is important to seek early treatment if you notice these symptoms. The symptoms of tarsal tunnel can be confused with other health conditions. The evaluation of these symptoms by a podiatrist is essential so a correct diagnosis/correct treatment begins.
Diagnosis is done through an in-depth examination by a podiatrist/foot and ankle surgeon. At the time, the surgeon positions your foot and tap on the nerve to see if the symptoms can be reproduced. They will also apply pressure to the area to determine if an abnormal growth/mass is present in this area.
At times, the doctor may suggest more imaging studies if a mass is suspected or if the initial treatment does not reduce the symptoms. Some studies can evaluate nerve problems- electromyography, EMG/NCV to measure nerve conduction velocity if the condition shows little improvement without surgery.
There are a variety of nonsurgical treatments, such as rest, icing, immobilization.
Surgical treatment is sometimes the best option for treating tarsal tunnel syndrome. A foot and ankle surgeon will determine if surgical treatment is necessary. Your doctor will select an appropriate procedure(s) depending on the origin of tarsal tunnel syndrome