We often think of tunnels as a way to get from one place to another, but they also need to be strong enough to protect us from any outside forces that want to crush in from the outside. There are certain points in our bodies that create protective tunnels, one located in our ankle. The tarsal tunnel performs its job admirably most of the time, protecting the blood vessels and nerves that pass through it, but if room starts becoming tight, a painful condition known as tarsal tunnel syndrome can develop.
The tarsal tunnel is located between the medial malleolus (the part of the ankle bone that forms that bump on the inside of your ankle) and a band of ligaments. Both pieces provide protection for some sensitive material inside, but the one we’re most concerned about here is the posterior tibial nerve. This nerve provides feeling to the bottom of the foot, but will cause more sensations than it should if something happens to compress it.
Tarsal tunnel syndrome can have several different causes. People who have flat feet are more prone to developing the condition because the outward tilting of the heel can place stress on the area. The pressure can also arise from inside the tunnel if something swells or grows within, such as an inflamed tendon or a cyst. Certain injuries, such as sprains, or diseases like diabetes or arthritis can also cause swelling.
Symptoms of a compressed nerve can show up differently in patients, but those with a pressured posterior tibial nerve tend to feel a tingling, burning, or shocking sort of pain on the inside of the ankle or the bottom of the foot. There may also be numbness or tingling. These symptoms can appear suddenly or be triggered by prolonged standing or physical activity.
When a case of tarsal tunnel syndrome is suspected, we try to verify our suspicions and find out what might be causing the problem. This sometimes includes pressing on the foot and tapping on the nerve during an examination to see if the symptoms can be reproduced. We may also feel for any abnormal lumps or masses. In some cases, imaging studies or other tests may be ordered if symptoms persist.
Depending on what we find, certain treatments may be recommended. More conservative measures include rest, ice, immobilization, and the use of anti-inflammatory medications. More severe cases, however, might benefit from physical therapy, injections, or orthotics. If none of these measures succeed in providing relief, then surgery might then be considered as an option. Surgery may depend on the cause of the syndrome, but a tarsal tunnel release is a common procedure. Please note that conservative treatments will always be attempted as a first method, however, and surgery is never suggested unless it is believed to be necessary.
Don’t hesitate if tarsal tunnel syndrome might be putting the squeeze on a nerve. Dr. Kevin Powers can identify the source of the problem and tailor treatments to meet your specific needs. Schedule an appointment with our Bloomington office by calling (812) 333-4422 or use our online contact form.