Tarsal Tunnel Syndrome  

Tarsal tunnel syndrome is compression of the posterior tibial nerve at the level of the ankle. The
postorier tibial nerve, 3 tendons, 2 veins and 1 artery occupy a tight space called the tarsal tunnel. As
they course through this fibro-osseous tunnel bounded by a thick band of tissue called the flexor
retinaculum into the bottom of the foot, pressure on the nerve by swelling and inflammation of
tendons, veins or a space occupying lesion may cause symptoms ranging from numbness and
tingling to severe pain to the entire foot. It is similar to Carpel Tunnel Syndrome in the hands and
wrist. Diagnosis of this condition may require nerve studies and imaging such as EMG, NCV and

There are four conservative steps to relieve symptoms of this condition. The first line of conservative
treatment is directed toward reducing inflammation. The use of anti-inflammatory medication and
cortisone injections may be used to reduce inflammation around the nerve tissue. Other
conservative measures may involve physical therapy providing deep massage to break up scar
tissue within the tunnel and to assist in mobilization of the constricted nerve. An orthotic may also be
utilized to support the foot to take tension away from the nerve. If conservative treatment fails to
relieve the symptoms, surgical decompression of the nerve may be required.