Tarsal Tunnel Syndrome

Pain in the Ankle, Bottom of the Heel and Sole of the Foot

What could be my problem?

Tarsal Tunnel Syndrome, also known as TTS or Posterior Tibial Neuralgia, is a compression neuropathy and painful foot condition in which the tibial nerve is compressed as it travels through the tarsal tunnel. Inside the tunnel, the nerve splits into three different segments.  One nerve (calcaneal) continues to the heel, the other two (medial and lateral plantar nerves) continues on to the bottom of the foot. This leads to foot pain at the base of the heel and/or the bottom of the foot.

What causes Tarsal Tunnel Syndrome?

  • Injury, disease or natural shaping of the foot
  • Flat feet or fallen arches which can produce strain or compression on the tibial nerve
  • Arthritis or diabetes which can cause swelling, resulting in nerve compression
  • An enlarged or abnormal structure, such as varicose vein, ganglion cyst, swollen tendon or a bone spur that might be compressing the nerve.

When to see a foot doctor about Tarsal Tunnel Syndrome:

  • If you have numbness in the foot radiating to the big toe and the first three toes
  • Experience pain, burning, electrical sensations and tingling over the base of the foot and heel
  • If you have ankle pain and a burning sensation, numbness and tingling on the bottom of the heel and on the sole of the foot If you have radiating pain along the sole of the foot, sometimes up into the calf

What are my treatment options?

Non-Surgical TTS Treatment Options

The following options may be recommended by your foot doctor to relieve the foot pain caused by Tarsal Tunnel Syndrome:

  • Rest
  • Ice
  • Non-steroidal, anti-inflammatory drugs
  • Physical therapy
  • Corticosteroid injection therapy
  • Custom orthotics
  • Bracing

Surgical Options for TTS 

When non-operative treatment fails to relieve the foot pain caused by Tarsal Tunnel Syndrome, surgical release of the tarsal tunnel may be recommended.

  • Tarsal Tunnel Release
    A foot surgeon will make an incision behind the ankle extending down to the arch of the foot. The ligament over the tibial nerve in the region of the tarsal tunnel is released. The nerve is followed in the foot and the tunnels for the medial and lateral plantar nerves are also released.
    • Post surgical, it is required that you are non-weight bearing with splint and crutches for four weeks.