Tarsal Tunnel Syndrome

Do you suffer from tingling or burning pain along the inside of your ankle and foot? Does it refer pain from the inside of your ankle all the way to your foot arches and toes? Does it vary from mild discomfort to a shooting sharp pain? Have your symptoms changed from being present intermittently to now being constant?

You may be suffering from Tarsal Tunnel Syndrome, a condition where a major nerve in your lower leg becomes increasing compressed as it makes its way from the knee to the toes. The nerve (tibial nerve) becomes trapped as it traverses a restricted narrow space similar to a tunnel hence the name. The more compressed and irritated the nerve becomes, the more severe the symptoms are felt. The tibial nerve originates from the sciatic nerve and innervates all the intrinsic muscle of the foot as well as the calf muscles.

Anything that can narrow the tunnel and compress the tibial nerve can cause of Tarsal Tunnel Syndrome. Common causes are:

• Poor foot mechanics and alignment that allows the foot to excessively roll inwards
• Flat feet 
• Trauma and acute injury to any of the structures that make up the walls of the tunnel (bone & soft tissue such as tendons)
• Irregular begin soft tissue growths such as ganglion cysts or lipomas
• Irregular begin bony growths such as bone spurs and arthritic changes
• Other medical conditions such as Diabetes

Successful treatment always relies on an accurate diagnosis and there is no rule that you can only suffer from one condition and any given time. It’s really important that all possible causes are considered and ruled out as its been our experience that often a combination of reasons exists.

When treating Tarsal Tunnel Syndrome, a number of treatment management options are utilised:

• Orthotics
• Footwear modifications & advice
• Rehabilitation exercises (strength & conditioning)
• Shock Wave Therapy
• Ultrasound Therapy
• Activity modification
• CAM walker prescription to completely rest and immobilise the lower leg
• Referral to an orthopaedic specialist should conservative measures fail

Although it is rare that permanent damage to the tibial nerve can eventuate you certainly don’t want to take your chances. The tibial nerve controls and regulates how your foot moves (motor) and provides skin sensations (sensory). Early intervention is always the best approach as the prognosis is usually excellent when treated in its early stages.

If you are concerned you may have Tarsal Tunnel Syndrome, contact the clinic and speak with our podiatrist Dr Ella Wright.