Tarsal Tunnel Syndrome

Tarsal tunnel syndrome is caused by anything that produces compression on the posterior tibial nerve, which is the nerve that provides sensation to the bottom of the foot. Having flat feet or severe swelling from an ankle injury can create this compression.

The tarsal tunnel refers to the canal formed between the ankle bone and the band of ligaments that stretches across the foot. Inside the tarsal tunnel are the nerves, arteries, and tendons that provide movement and flexibility to the foot. One of the nerves in the tarsal tunnel is the tibial nerve, which provides sensation to the bottom of the foot. When this nerve is compressed, the resulting condition is called posterior tibial neuralgia, or tarsal tunnel syndrome.


Tarsal tunnel syndrome may be caused by an injury, disease, or due to the natural shaping of the foot. Possible causes may include:

  • Having flat feet or fallen arches
  • Swelling caused by an ankle sprain
  • Diseases such as arthritis or diabetes
  • An enlarged or abnormal structure, such as a varicose vein, ganglion cyst, swollen tendon, or bone spur

Symptoms of tarsal tunnel syndrome may include:

  • Shooting pain in the foot
  • Numbness
  • Tingling or burning sensation

Diagnosis is necessary to determine the severity of the condition, so the appropriate treatment plan can be administered. Proper diagnosis of tarsal tunnel syndrome requires the expert attention of experienced neurologists and nerve specialists.

Diagnosis will typically include:

  • A comprehensive clinical exam
  • Complete medical history
  • Electrical testing
  • Imaging (X-rays, CT, or MRI scans)

In less severe cases, non-surgical treatment is recommended by using steroid injections or anti-inflammatory medications to relieve pressure and swelling. Braces, splints, and other orthotic devices can be used to limit movement and reduce pressure on the foot that can cause compression to the tibial nerve. In more severe cases, a surgical procedure called a tarsal tunnel release may be performed to decrease pressure on the nerve from the overlying ligament.


As an alternative to surgery, stem cell technology may help regenerate damaged tissue by injecting stem cells from the patient’s own fat cells or bone marrow directly into the injured tissue.