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Tarsal Tunnel Syndrome


Tarsal tunnel syndrome, or TTS, is a condition that affects the posterior tibial nerve located in the foot. TTS is an uncommon condition that can often be overlooked as a diagnosis for pain in the ankle and foot, so it is important to speak with a specialist regarding the pain and symptoms you feel to get the best diagnosis for your foot pain.

What Is TTS?

Tarsal tunnel syndrome is, essentially, carpal tunnel in the foot. Classified as a nerve disorder, TTS occurs when the posterior tibial nerve experiences repeated pressure and becomes compressed. The posterior tibial nerve is connected to your sciatic nerve and runs from your ankle through the tarsal tunnel to the rest of your foot. Left untreated, TTS can result in damage to the posterior tibial nerve.

What Are the Symptoms of TTS?

Leg pain of senior woman at home, healthcare problem of senior concept

While symptoms of tarsal tunnel syndrome may be different for each person, the following are general symptoms of TTS:

  • A feeling of pins and needles
  • Numbness
  • Burning
  • Shooting pain in the foot
  • A feeling of electric shock

A person with TTS may feel these symptoms at any point along the posterior tibial nerve, which runs through the inside of the ankle and the sole of the affected foot. Symptoms can either arise suddenly or gradually increase in intensity, depending on the damage to your nerves.

What Are the Causes of TTS?

Because so many things can result in compression of the posterior tibial nerve, tarsal tunnel syndrome causes will vary widely. Some causes include:

  • The structure of the foot – The more flat-footed a person is, the more the tibial nerve can be strained and compressed.
  • Inflammation and swelling from trauma or injury – Fractures and sprains cause inflammation that can lead to tibial nerve compression and TTS.
  • Certain diseases – Conditions like diabetes and arthritis can cause TTS. Diabetes increases the vulnerability of the tibial nerve to compression, while arthritis can produce inflammation in the tibial nerve.
  • Masses, lesions, and growths – Lipomas, tumors, or bony growths located near the tibial nerve or in the tarsal tunnel can place additional strain on these areas.
  • Varicose veins – Additional compression on the tibial nerve can be caused by varicose veins located in the membrane that surrounds it.

How Is TTS Treated?

The treatment for tarsal tunnel syndrome depends on the cause and location of tibial nerve pain, as well as the severity of symptoms you are experiencing. It is important to see a foot specialist, or a podiatrist, in order to receive specialized treatment to alleviate your TTS symptoms. Your podiatrist may suggest both non-surgical and surgical methods to treat tarsal tunnel syndrome:

Non-Surgical TTS Treatments

  • Restriction of movement – Short-term immobilizing the foot with a cast can help the tibial nerve and the tissue around it to heal.
  • Frequent application of ice packs – Ice should be applied to affected areas for 20 minutes at a time, with a 40-minute break between applications.
  • Rest – Allowing the affected foot to rest will support tibial nerve healing and prevent reinjury.
  • Pain medications – Ibuprofen and other NSAIDs can help reduce both inflammation and pain in affected areas.
  • Injection or physical therapy – Pain and inflammation can be treated with corticosteroid or local anesthetic injections.
  • Brace – This may be an option for those with severe tibial nerve damage and intense symptoms, as bracing relieves the pressure placed on the foot.
  • Supportive shoes or orthotics – Specially constructed shoes or shoe inserts can help to limit the motion of the foot and maintain the arch, which can relieve pressure on the tibial nerve and reduce symptoms.

Tarsal Tunnel Syndrome Surgery

Some cases of TTS are best treated with tarsal tunnel release surgery, which releases the ligament that runs behind the ankle to the arch. Another surgery involves stretching the ligament using small instruments.

When Should You See a Podiatrist?

The best time to see a podiatrist about foot or ankle pain is as soon as possible. Tarsal tunnel syndrome, as well as many other conditions affecting the foot and ankle can cause permanent damage of the posterior tibial nerve, which may be irreversible if left untreated.

Should the posterior tibial nerve sustain permanent damage, you may find it difficult or painful to walk. You may also have problems when trying to resume certain previously enjoyed physical activities.

Getting treatment can relieve pain and other symptoms, restore flexibility in the posterior tibial nerve, and prevent reinjury over the long term.

Complex Foot and Ankle Care

Podiatrist treating feet during procedure

Tarsal tunnel syndrome can be a very painful condition that limits mobility and prevents you from being active. However TTS, along with several other foot and ankle problems, is completely treatable.

The board-certified podiatrists at Crystal Run Healthcare specialize in the diagnosis and treatment of TTS, as well as other foot conditions that include heel pain, hammer toe, bunions, and arthritis.

Treating patients ranging from infants to seniors, our expert team’s focus is on conservative options for treating foot problems. However, where this is not possible, Crystal Run Healthcare foot and ankle surgery specialists provide the latest surgical techniques that are as minimally invasive as possible.

The full suite of comprehensive treatments available at Crystal Run Healthcare include sports podiatry for professional and casual athletes.

Our podiatrists are available at several locations in New York, including West Nyack, Rock Hill, and Middletown. To schedule your appointment with aCrystal Run podiatrist, visit our website or call 845-703-6999.