The tarsal tunnel is a gap that is formed between the underlying bones of the foot and the overlying tough fibrous tissue. Tarsal tunnel syndrome refers to a condition where the posterior tibial nerve that lies within the tarsal tunnel is compressed. The condition occurs when the tibial nerve is pinched.
The exact cause of the condition is not known, but certain conditions, such as fractures, bone spurs, ganglions, benign tumours, muscle impingement or foot deformities, are known to increase the risk of developing tarsal tunnel syndrome. Other medical conditions such arthritis can cause swelling of the joints that may compress the nerve. Scar tissue formed after an ankle injury and growth of abnormal blood vessels can press against the nerve, resulting in compression.
Most children with tarsal tunnel syndrome complain of pain, numbness, and burning or tingling sensation at the bottom of the foot and heel.
Tarsal tunnel syndrome can be diagnosed by Tinel’s test. Tinel’s test is performed by tapping the posterior tibial nerve lightly to test for pain and other symptoms that would indicate tarsal tunnel syndrome.
Tarsal tunnel syndrome may be treated with conservative approaches, which include:
- Non-steroidal anti-inflammatory medications to relieve pain and reduce swelling
- Corticosteroid injections that are injected into the area around the nerve to decrease the swelling
- Orthotics, such as specially designed shoe inserts or change in footwear, to support the arch of the foot and take the tension off the tibial nerve
Surgery is often considered a last resort only when conservative treatments fail to resolve the condition and provide symptomatic relief. Your doctor may perform tarsal tunnel release surgery to treat the condition. During this surgery, an incision is made in the tarsal tunnel and the pressure on the tibial nerve is released.