Tarsal tunnel syndrome symptoms & treatment

We know living with foot and ankle pain can keep you from enjoying the activities you love most. This can be especially true with tarsal tunnel syndrome (TTS), a condition that causes sharp pain, numbness and tingling in your ankle or foot.

TTS occurs when your tibial nerve – which runs along the inside of your ankle – is pinched or compressed. This important nerve carries motor and sensory messages from your brain to 21 different muscles in the lower part of your leg.

Symptoms of TTS may increase and worsen over time. That's why it’s important to seek treatment before the nerve damage worsens and symptoms are harder to manage.

What is tarsal tunnel syndrome?

Tarsal tunnel syndrome happens when an injury or other condition puts pressure and strain on your tibial nerve. Your tibial nerve starts at your knee and runs through your tarsal tunnel – a narrow passage of bones and ligaments in your ankle.

Also called tibial nerve dysfunction, TTS can make it difficult to walk or even stand. If left untreated, TTS may also lead to permanent nerve damage.

What causes tarsal tunnel syndrome?

Tarsal tunnel syndrome can happen to anyone. The condition is caused by a range of factors that damage your tibial nerve. Common causes of TTS include:

• Swelling from an ankle sprain or fracture
• Having flat feet or high arches
• Bone spurs
• Inflammation from a disease like arthritis
• Varicose veins
• Overuse injury
• Diabetic neuropathy, a complication of diabetes
• Tumors near your tibial nerve

Tarsal tunnel syndrome symptoms

It’s common to have pain or tingling in your foot if you have tarsal tunnel syndrome. These symptoms may get worse after you exercise or are on your feet. Symptoms may also worsen over time as your nerve damage increases.

Symptoms of TTS may include:

• Numbness or tingling in your foot
• Pain in your inner ankle, foot or toes
• A burning sensation, often on the bottom of your foot
• Weakness in your foot

Diagnosing tarsal tunnel syndrome

Your primary care provider will first review your symptoms, health history and perform a physical examination of your foot. If TTS is suspected, you’ll usually be referred to an orthopedic specialist.

While there’s no definitive tarsal tunnel syndrome test, other routine tests can help confirm a TTS diagnosis and find any underlying cause of your symptoms.

Tests may include:

• MRI: This test creates detailed images of your soft tissue and bones that look for injury or nerve damage.
• Tinel’s test: Your doctor will tap on the skin above the tibial nerve to indicate where you feel the tingling sensation (known as Tinel’s sign).
• Electromyography (EMG): An EMG measures nerve and muscle function.

How do you fix tarsal tunnel syndrome?

It’s possible to heal your nerve damage and recover from tarsal tunnel syndrome. A combination of nonsurgical and surgical treatments can be used to manage TTS, depending on the cause of your nerve compression and your health history.

Nonsurgical tarsal tunnel syndrome treatment

There’s a range of ways you can manage your tarsal tunnel syndrome symptoms at home and heal your nerve damage. Your doctor may recommend you try:

• Decreasing your physical activity or switching to low-impact activities
• Icing your foot for 10 to 20 minutes to reduce swelling and pain
• Resting and elevating your foot to help heal an injury and reduce swelling
• Using an over-the-counter anti-inflammatory medicine like ibuprofen to control pain
• Wrapping your foot in a compression bandage or brace
• Using arch supports, heel cushions or custom foot orthotics (inserts) in your shoes if you have flat feet or high arches

Sometimes, a cast or splint may be recommended to take pressure off your foot, allowing your nerve to heal. Steroid injections may also help with intense inflammation and pain.

Orthopedic rehab is also an important part of recovery. Physical therapy exercises help improve your strength and get you back to your normal range of motion.

Surgical tarsal tunnel syndrome treatment

If the above nonsurgical options haven’t worked for you, your doctor may recommend tarsal tunnel syndrome surgery. Certain surgery methods, such as the tarsal tunnel release, relieve the pressure on the tibial nerve.

If your TTS is caused by a tumor or bone growth, surgery may be recommended to treat your underlying condition.

Learn more about foot and ankle surgery at Aurora.

Does tarsal tunnel ever go away?

The faster you seek treatment, the better your outlook is for treating your tarsal tunnel syndrome. Following your orthopedic care plan will also help you recover and get back to feeling your best.