Tarsal tunnel syndrome is a condition that is caused by the entrapment of the tibial nerve on the inside of the ankle.

There are some very tight structures in this area, so there is very little room for expansion if any of these structures becomes inflamed or enlarged. This inflammation or enlargement of the nerve in this area causes the entrapment.

When this entrapment compresses the nerve, it can cause pain, burning sensations, and tingling on the sole of the foot. This usually worsens as the day progresses and is usually relieved by rest, elevation, or rubbing the area. The diagnsis of tarsal tunnel syndrome is sometimes made using nerve conduction tests.

Cause of tarsal tunnel syndrome:

A number of factors are involed in the cause if tarsal tunnel syndrome:

• the nerve ‘bends’ around behind the inner ankle bone (medial malleolus) – this bend in the nerve does make it more prone to damage in this area.
• structures that are adjacent to the nerve can compress the nerve if they become swollen (eg tendon)
• people with very flat or pronated feet are more prone to develop tarsal tunnel syndrome.
• a cyst or other lesion may develop in the area
• some systemic diseases, such as rheumatoid arthritis can cause a swelling in joints that may compress on the nerve.
• trauma or fractures causing a malalignment or the development of scar tissue can also affect how the nerve functions and the pressures on it.

Treatment of tarsal tunnel syndrome:

Conservative treatment generally consists of the use of some sort of foot support, which can often help, especially if the feet are very flat. Anti-inflammatory drugs may be used. Sometimes steroid injections can be effective. Surgical treatment may be necessary if these conservative measures are ineffective. An incision is made into the tisses to allow room for expansion of the nerve or for remoeal of a cyst or other structure that is compressing the nerve.