Tarsal Tunnel Syndrome


 

The posterior tibial nerve runs down along the inside of the ankle, down to the foot. It passes between the inside of the ankle, and under a thick band of tissue. If the nerve gets compressed, or squeezed, then it will not work properly.

 

Common Causes

May be due to direct trauma, or following an ankle injury. Swelling or inflammation of the other tendons inside the tarsal tunnel besides the nerve also increase pressure on the nerve.

 

Symptoms

Usually a vague burning or tingling running down along the inside and sole of the foot. Usually aggravated by activity, and relieved by rest.

 

Physical Findings

Tenderness along the course of the nerve, with reproduction of symptoms by pressure on the nerve.

 

Workup

History, physical examination, and possibly nerve conduction studies. X-rays are generally negative.

 

Non-operative Treatment

Rest, avoiding aggravating activity, orthotics, anti-inflammatory medication, and a trial of a corticosteroid injection may all be helpful in reducing symptoms.

 

Surgical Treatment

Decompression of the nerve by releasing the compressing structures, through a small incision, is generally curative.

 

Injury Comment

This is an uncommon injury, and is frequently confused with other foot conditions.