Perhaps your first question is what is the tarsal tunnel? At Paul S. DeMarco, DPM, we find that many patients are not familiar with this part of their foot until it has an issue. The tarsal tunnel is a narrow space on the inside of your ankle near the ankle bone that contains arteries, veins, tendons and nerves. The posterior tibial nerve is one of these nerves. When the tarsal tunnel is compressed it squeezes the posterior tibial nerve causing symptoms of pain, tingling and burning along the nerve’s pathway from the inside of the ankle into the foot. Tarsal tunnel syndrome is similar to carpal tunnel syndrome, which happens in the wrist.
There are a wide variety of reasons why compression of the posterior tibial nerve may be occurring:
- An abnormal or enlarged structure is inside the tarsal tunnel which means less room and in turn a high likelihood of compression. Possibilities include a ganglion cyst, swollen tendon, varicose vein or even a bone spur.
- Flat feet may cause the heel to turn outward which can produce strain and squeezing of the nerve.
- Ankle injuries may lead to inflammation and swelling near or even inside the tunnel which will put pressure on the posterior tibial nerve.
- Certain systemic diseases can have the same inflammation/swelling effect. Two of the more common ones are diabetes and arthritis.
Diagnosis and Treatment
Our foot and ankle surgeon, Dr. Paul S. DeMarco, will need to examine your feet and ankles and see if there is any loss of sensation. The foot doctor will check for any unusual masses and also try to position the foot in such a way as to reproduce the symptoms you’re experiencing. Advanced imaging studies and nerve conduction studies may also be ordered.
Once the foot doctor determines the cause of the tarsal tunnel syndrome the proper treatment can be prescribed. There are many conservative methods available including bracing, physical therapy, injections and custom orthotics. In some cases, surgery may be the best option. If you are experiencing unusual symptoms on the inside of your foot near the ankle, contact our Somers Point office for an appointment by calling: (609) 927-4894.