Tarsal Tunnel Syndrome (Posterior Tibial Neuralgia)

Tarsal tunnel syndrome (TTS)—also referred to as posterior tibial neuralgia—occurs when the tibial nerve in the ankle is compressed or injured. Patients with fallen arches, diabetes, poor circulation, lower back issues, and those who stand or walk for long periods are at an increased risk of developing tarsal tunnel syndrome.

What You Need To Know About Tarsal Tunnel Syndrome

What is Tarsal Tunnel Syndrome?

Tarsal tunnel syndrome involves the posterior tibial nerve. The tibial nerve is a branch of the sciatic nerve that runs down the leg to the foot and passes through the tarsal tunnel inside the ankle. The tarsal tunnel comprises bones and ligaments that cross the foot.

Like carpal tunnel syndrome in the wrist, any pressure, irritation, or damage to the tibial nerve can cause tingling or pain in the feet. TTS is also slightly more common in women than men.

Alleviating symptoms of tarsal tunnel syndrome starts with a visit to Resurgens Foot & Ankle Center. Schedule an appointment at one of our Metro Atlanta locations now!

What Causes Tarsal Tunnel Syndrome?

Irritation to the tibial nerve at this location can result from the following:

Extrinsic compression: Varicose veins, swollen tendons, cysts, or bone spurs in the ankle can put pressure on the tibial nerve.

Tension factors: Flat feet, fallen arches, or other foot-shape issues can damage the nerve.

Intrinsic factors: Arthritic conditions and diabetes can cause swelling and damage the nerve's cellular structure.

Tarsal Tunnel Syndrome is often related to overuse. This condition is often seen in patients who frequently stand or walk for long periods, exercise at high levels, or have a history of ankle sprains.

Tarsal Tunnel Syndrome Symptoms

Tarsal Tunnel Syndrome is a nerve condition that causes pain in the ankle, the bottom of the feet, toes, heel, and lower leg.

Symptoms of tarsal tunnel syndrome include:

  • Anterior or posterior tibial nerve pain
  • Cramping
  • Tingling or burning sensations
  • Numbness
  • Weakness in the foot muscles
  • Patients often report that symptoms of tarsal tunnel syndrome worsen at night and after physical activity. Symptoms may be sporadic at first but can occur consistently if the condition is not treated.

    How is Tarsal Tunnel Syndrome Diagnosed?

    The Resurgens foot and ankle physicians diagnose tarsal tunnel syndrome by gathering your complete medical history and conducting a comprehensive exam. The exam can include Tinel's test, where your physician taps the tibial nerve and asks if you feel TTS symptoms. Resurgens physicians also use advanced imaging technology to diagnose nerve damage, including:

    • EMG (electromyograph)
    • X-ray
    • MRI (magnetic resonance imaging)
    • CT scan (computed tomography)

    The data from these diagnostic scans will help your physician plan your tarsal tunnel treatment and rule out any other causes of posterior tibial nerve pain.

    Tarsal Tunnel Syndrome Treatment

    The underlying cause of the tibial nerve's irritation will determine the treatment. Some cases caused by swelling can improve with medication, and other more severe injuries may require surgery.

    Non-Surgical Tarsal Tunnel Treatment

    Non-surgical tarsal tunnel treatment options include:

    Resting: Avoiding activities that irritate the nerve can prevent further damage and promote healing.

    Ice: Icing the injured area for 20 minutes at a time can reduce swelling.

    Medication: Nonsteroidal anti-inflammatory drugs, including ibuprofen and naproxen, can reduce pain and inflammation.

    Supports: Immobilizing the ankle with a boot, brace, or cast can allow the nerve or damaged tissue to heal.

    Physical therapy: Rehabilitation exercises and other therapies can rebuild strength in the injured area.

    Shoes and shoe inserts: Custom-made shoes or shoe inserts can support feet arches and relieve pressure on the nerve.

    Surgical Tarsal Tunnel Treatment

    Physicians may recommend surgery for patients with cases caused by extrinsic compression. TTS procedures are often successful with low complication rates.

    Surgical procedures include:

    • Removing any cause of extrinsic compression, including bone spurs or cysts.
    • Releasing the tissue around the nerve.

    Your journey to finding the best tarsal tunnel syndrome treatment starts with visiting Resurgens Orthopaedics. Schedule your appointment at one of our Metro Atlanta locations now!




    Virtual After-Hours Access

    Resurgens Orthopaedics has partnered with the HURT! app to offer FREE virtual after-hours access to orthopedic specialists right when you need it.

    Download the app to receive immediate guidance on your injury.