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Tarsal Tunnel Syndrome - Causes, Symptoms, Diagnosis and Treatment

Published on May 23, 2022   -  4 min read


Tarsal tunnel syndrome is the squeezing of the tibial nerve (nerve of the leg and foot muscle), which causes painful feet. The below article explains the condition in detail.



The term tarsal in Latin means pertaining to the ankle. A narrow passage found between the bones and the soft tissue inside the ankle is called the tarsal tunnel. This tunnel is present near the bony bump on the inner side of the ankle. Few tendons, blood vessels, and tibial nerves pass through this tunnel to reach the foot. Damage to the tibial nerves is rare and is often caused by the entrapment or compression caused inside the tunnel.

What Is Tarsal Tunnel Syndrome?

The tarsal tunnel syndrome is a painful foot condition caused by compressive neuropathy of the tibial nerve. The syndrome is common in the active adults, with a higher incidence in women. Sports activities involving more of the lower limb like playing football, skating, snowboarding, and track and field events have a higher risk of developing tarsal tunnel syndrome. This syndrome can occur in one foot or both feet.

What Causes Tarsal Tunnel Syndrome?

Tarsal tunnel syndrome can be idiopathic (without any underlying diseases) or secondary to any factor that compresses the tibial nerve. The common causes are

What Are the Symptoms of Tarsal Tunnel Syndrome?

How to Diagnose Tarsal Tunnel Syndrome?

1. Physical Examination: Evaluating the patient’s history and physical examination are the first steps in the diagnosis of tarsal tunnel syndrome. Physicians may perform a simple, non-invasive test to check for nerve problems which are called the Tinel’s sign.

2. Imaging Techniques:

3. Nerve Conduction Test:

The nerve conduction test is the gold standard in diagnosing secondary tarsal tunnel syndrome.

4. Electromyography (EMG):

Electromyography records and evaluates the electrical activity of skeletal muscles and the nerve cells that control them. Any abnormal result may indicate a suspected tarsal tunnel syndrome.

How to Treat Tarsal Tunnel Syndrome?

The treatment of the tarsal tunnel syndrome depends on the severity of the condition and the intensity of pain elicited during activities.



Tarsal Tunnel Syndrome

A result with a total score of ten points was judged as excellent, eight to nine points as good, six to seven points as fair, and below five as poor.


Tarsal tunnel syndrome is similar to carpal tunnel syndrome. However, the prevalence of tarsal tunnel syndrome is rare. Tarsal tunnel syndrome is a chronic condition of foot pain that may progress and result in nerve damage. It is very important to treat the symptoms at the earliest. Many patients have good treatment outcomes. If left untreated, tarsal tunnel syndrome can greatly impact the patient’s quality of life. Depending on the severity, proper pain management, counseling, and even surgery are considered.


Frequently Asked Questions


What Happens if the Tarsal Tunnel Is Left Untreated?

The treatment for tarsal tunnel syndrome depends on the severity of the condition. Most of the patients feel better with rest and home remedies. But If it is left untreated, it can further worsen the nerve damage and could be more painful, making it difficult to walk and do regular activities.


How Long Can Tarsal Tunnel Syndrome Last?

If the underlying cause is found and treated accordingly, the tarsal tunnel syndrome symptoms will fade within a few weeks. The recovery time also depends on the severity of nerve compression. Post-treatment rehabilitation will help further with pain reduction and regaining the range of motion.


Can You Walk With Tarsal Tunnel Syndrome?

Tarsal tunnel syndrome produces pain that refrains one from walking or doing other physical activities involving the leg. Painkillers and supporting devices can help temporarily, but mild stretching and strengthening exercises must be practiced regularly to achieve muscle resistance.


How Do You Fix Tarsal Tunnel Syndrome?

Rest, medications like painkillers and anti-inflammatories, and supporting devices are the conservative method of managing tarsal tunnel syndrome. Steroid shots can also be used to reduce inflammation. Surgery may be needed if there is any presence of cysts or tumors compressing the tibial nerve.


What Does the Tarsal Tunnel Feel Like?

Sharp shooting pain is the primary symptom of tarsal tunnel syndrome. In addition, there may be numbness, burning, and tingling sensations in the toe, ankle, and leg region. The pain can be like a pricking sense with muscle weakness that makes it difficult to move the leg.


Is Tarsal Tunnel Syndrome Permanent?

Tarsal tunnel syndrome can be treated effectively, and leg activities can be resumed shortly after the treatment. But if the condition is not treated appropriately on time, the nerve can be damaged permanently, and the condition is irreversible restricting the movements of the foot during walking or other normal activities.


Where Does the Tarsal Tunnel Hurt?

The tarsal tunnel is a narrow passage located at the inner side of the ankle, providing space for many blood vessels, nerves, tendons, and ligaments to pass through to serve their purpose. Tarsal tunnel syndrome occurs when the tibial nerve is compressed or pinched inside the tarsal tunnel, and hence the pain is located at the bottom inner sides of the foot and toes.


How Do You Test for Tarsal Tunnel Syndrome?

Physical examination, imaging techniques, nerve conduction tests, and electromyography are used to diagnose tarsal tunnel syndrome. Tinel’s sign is a test done by tapping the nerve. When there is pain or tingling sensation in the area of tapping, it is a potential indicator of tibial nerve compression.


Can an MRI Show Tarsal Tunnel Syndrome?

Yes, MRI (magnetic resonance imaging) is a radiation technique that clearly visualizes the tarsal tunnel and its contents. MRI images are highly sensitive in demonstrating the soft tissue lesions, tumors (space-occupying), or any other condition causing nerve damage.


Do Compression Socks Help Tarsal Tunnel Syndrome?

Supporting devices help in decompressing the nerve and give better posture for the foot, thus relieving pain. Some of them are compression socks, specially designed shoes, and soles that can potentially reduce the pressure on the tibial nerve and are recommended in the treatment of tarsal tunnel syndrome.


Is Heat Good for Tarsal Tunnel Syndrome?

Alternative ice packs and heating pads during vigorous physical activity like sports can alleviate the pain and also can prevent nerve damage. Applying cold can reduce inflammation, thereby reducing swelling, and heat can improve circulation, thereby improving faster recovery.


Can the Tarsal Tunnel Go Away on Its Own?

Tarsal tunnel syndrome can be managed with simple home remedies if there is no underlying disease condition. But one has to check the reason for nerve compression. If the condition is left untreated, it may cause permanent nerve damage and can cause severe pain during walking.


Is Ice or Heat Better for Tarsal Tunnel Syndrome?

Both ice and heat are helpful in treating tarsal tunnel syndrome, hence it is recommended to use them alternatively. Ice can reduce swelling, and heat can reduce the pain, both giving relief from the symptoms of tarsal tunnel syndrome.


Can Plantar Fasciitis Cause Tarsal Tunnel Syndrome?

Plantar fasciitis usually occurs below the ankle region while the tarsal tunnel syndrome is because by the compression of the tibial nerve in the tarsal tunnel, which is present above the ankle region. Both the conditions share some common symptoms, but tarsal tunnel syndrome is rare, and the pain is severe.


Who Is at Risk for Tarsal Tunnel Syndrome?

Most of the time, the condition is caused by injury to the foot or ankle region. Otherwise, patients with flat feet, varicose veins, diabetes, arthritis, and disk hernia are at the risk of developing tarsal tunnel syndrome due to inflammation, swelling, and nerve compression.


How Can You Tell the Difference Between Tarsal Tunnel and Plantar Fasciitis?

The pain from plantar fasciitis is more in the mid-bottom foot region and gets worse while walking, running, and in the morning. But, in the case of tarsal tunnel syndrome, the pain is located at the sides of the foot and ankle region and gets worse while standing and at night.


What Tests Help Identify the People Suffering From Tarsal Tunnel Syndrome?

A Tinel test is performed to diagnose tarsal tunnel syndrome. The Tinel sign is the pain or tingling sensation perceived by tapping the injured or compressed nerve. A positive Tinel sign while percussing on the ankle region indicates tarsal tunnel syndrome.

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23 May 2022  -  4 min read




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