Tarsal tunnel syndrome

Tarsal tunnel syndrome

Description, Causes and Risk Factors:

Abbreviation: TTS.

Tarsal tunnel syndrome refers to the condition when the posterior tibial nerve is entrapped in the tarsal tunnel - that space between the bones of the feet and corresponding tissue. It is compared to carpal tunnel syndrome (which happens on the wrist) because they are both triggered by the same cause - a nerve is pinched in a cramped area. The tarsal tunnel is very confined. Once it tightens, it pinches the tibial nerve.

The cause of tarsal tunnel syndrome is unknown in most cases, but can be the result of fractures, bone spurs, ganglions and other benign tumors, muscle impingement, or foot deformities. It can also occur with diabetes, back pain, arthritis, injury to the ankle, abnormal blood vessels, scar tissue that press against the nerve.

Tarsal Tunnel Syndrome and Reflex Sympathetic Dystrophy (RSD) have long been linked. Reflex Sympathetic Dystrophy (RSD), which refers to recurring pain in the sympathetic nerve system because of triggers like trauma, injury, surgery, or infection, can occur alongside tarsal tunnel syndrome. In RSD, the trigger starts an irregular succession of pain (often intractable) and eventually set off total disability. Tarsal tunnel syndrome can be a coexisting condition together with peripheral neuropathies, thoracic outlet syndrome, and neuromas.


Most patients feel pain on the sole of the foot, often described as a burning or tingling sensation, because the nerves are compressed by entrapment. The pain is usually progressive. It becomes more severe during day.


Diagnosis of this condition is especially confusing because the pain instigated is similar to other conditions. Electrodiagnostic studies seem to help with the diagnosis, especially in cases when there is reason for uncertainty.Magnetic resonance imaging (MRI) and the dorsiflexion-eversion test can confirm the diagnosis.


There are two kinds of treatment options for tarsal tunnel syndrome - conservative treatment (involving orthotics) and invasive (surgery). Rest or elevation (sometimes even a massage) can help provide temporary relief.Treatment begins with anti-inflammatory medications, and possibly an injection of cortisone into the area around the nerve. Orthotics and changes in footwear may also help to relieve the symptoms. If none of these measures helps, then a procedure called a tarsal tunnel release may be necessary. Tarsal tunnel syndrome caused by known conditions, such as tumors or cysts, may respond better to surgery than tarsal tunnel syndrome of unknown cause. It can take months after this surgery for a person to recover and resume normal activities. Only experienced surgeons should perform tarsal tunnel syndrome surgery.

Disclaimer: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.


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