The tarsal tunnel refers to the space formed between the inside of the ankle and the ligaments behind the heel. Inside the tarsal tunnel are the nerves and tendons that provide movement and flexibility to the foot. One of the nerves in the tarsal tunnel is the tibial nerve, which provides sensibility to the bottom of the foot. When this nerve is compressed, this condition is called tarsal tunnel syndrome. Symptoms of tarsal tunnel syndrome may include pain in the bottom of the foot, numbness, or a tingling or burning sensation that is bothersome to patients.
Tarsal tunnel syndrome may be caused by systemic conditions, trauma to the ankle, or the natural shaping of the foot. Causes may include trauma to the ankle (including ankle sprains), diabetes that can cause swelling, or an enlarged ganglion cyst or bone spur that compresses the nerve. Proper diagnosis of a tarsal tunnel syndrome requires experience with the condition and a complete history and examination.
Occasionally, diagnostic treating may include electrical testing such as a lower extremity EMG or nerve conduction study. Possible treatment options may include anti-inflammatory medications or steroid injections into the nerves in the tarsal tunnel to relieve pressure and swelling. Orthotics may be recommended to reduce pressure on the foot and limit movement that could cause compression on the nerve. Depending on the severity of the condition, one of many surgical options may be recommended, including tarsal tunnel release (decompression of the nerve surgically).