Tarsal Tunnel Syndrome (Posterior Tibial Neuralgia)
What is Tarsal Tunnel Syndrome?
Tarsal Tunnel Syndrome, also called TTS, affects the tibial nerve in the ankle. This nerve is a branch of the sciatic nerve. It passes from the back of the leg down and into the foot, just below the bony bump on the inner side of the ankle, through a small space called the tarsal tunnel. TTS is a compression of the nerve within this tunnel.
What are the causes and risk factors?
Anything that increases pressure on the tibial nerve in the tibial tunnel can cause TTS. Tarsal tunnel syndrome can be caused by a variety of factors, including:
- Flat feet or fallen arches or other changes in the shape of the foot can be a culprit.
- Swelling in the ankle after an injury can cause TTS.
- Abnormal growths such as ganglion cyst, varicose vein, bone spur in the tarsal tunnel region.
- Ankle sprains or fractures
- Systemic diseases, such as diabetes or arthritis, that can cause nerve damage or inflammation
- Repetitive stress or overuse of the foot and ankle, such as running or standing for extended periods.
- You may also have a higher risk of developing this condition if you have diabetes, lower back problems or poor circulation, or if you have a job that requires a lot of standing or walking.
The tibial nerve provides sensation to the bottom of the foot and controls the movement of the muscles in the foot. When the nerve is compressed or squeezed, it can cause pain, numbness, and tingling in the bottom of the foot and toes. In some cases, it can also cause weakness in the foot and ankle.
What are the symptoms of TSS?
Symptoms may include shooting pain, numbness, and tingling or burning sensations. These may be felt in the inner ankle, the bottom of the foot and the toes. You may feel cramping sensations in the arch or the toes. Symptoms are usually aggravated by activity. They are often worse in the evening. Your symptoms may come and go at first, but as the condition progresses they may last for longer periods of time.
What treatments are available for TSS?
Treatment varies depending on the cause of the condition. TTS that results from tissue swelling may be treated with options such as anti-inflammatory medications, steroid injections, physical therapy, custom orthotics or shoe inserts, and in some cases, surgery. A procedure called tarsal tunnel decompression can create more room for the nerve within the tarsal tunnel. This can allow it to resume proper function.