By Lucas Elias
Foot pain is one of the most common complaints among adults, and while many people attribute it to something simple like overuse, poor footwear, or a minor strain, the real cause can sometimes be much more complex. One lesser-known but potentially serious condition is Tarsal Tunnel Syndrome—a nerve disorder that affects the foot and ankle and can lead to chronic pain, numbness, and even long-term mobility issues if left untreated.
At a glance, Tarsal Tunnel Syndrome may resemble other foot problems. The symptoms can be subtle at first, often coming and going or being mistaken for more common conditions like plantar fasciitis or simple nerve irritation. But understanding what this condition is and how it affects the body is key to getting the right treatment and preventing further complications. Clinics like Gelbmann Podiatry specialize in diagnosing and treating complex foot issues like this, helping patients return to an active, pain-free lifestyle.
What Is Tarsal Tunnel Syndrome?
Tarsal Tunnel Syndrome occurs when the posterior tibial nerve, which runs along the inside of the ankle and into the foot, becomes compressed or squeezed. This nerve passes through a narrow space called the tarsal tunnel, located near the ankle bone and covered by a thick band of tissue. When pressure builds in this tunnel—whether from swelling, injury, or an underlying condition—it can irritate the nerve, leading to pain and other neurological symptoms.
This condition is often compared to carpal tunnel syndrome in the wrist, as both involve nerve compression in a tight anatomical space. However, tarsal tunnel syndrome is less widely recognized, and because of that, it can go undiagnosed for long periods.
What Causes Tarsal Tunnel Syndrome?
There are several possible causes of tarsal tunnel syndrome, and often more than one factor contributes to the development of the condition. One of the most common causes is overpronation, or flat feet. When the foot rolls inward too much while walking or standing, it can stretch and put pressure on the tibial nerve.
Other causes include injuries such as ankle sprains, which can lead to swelling or scar tissue that compresses the nerve. Conditions like arthritis, varicose veins, or cysts near the ankle can also crowd the tarsal tunnel and irritate the nerve. People with diabetes are at higher risk as well, due to nerve inflammation or damage that makes the nerve more sensitive to pressure.
Tarsal tunnel syndrome doesn’t always come on suddenly. In some cases, it develops gradually, starting with occasional tingling or burning in the foot. Over time, the symptoms can worsen and become more consistent, eventually leading to weakness, numbness, or shooting pains that affect daily activities.
Recognizing the Symptoms
The symptoms of tarsal tunnel syndrome can vary widely depending on the severity of the nerve compression and the individual’s health. For many people, the first sign is a burning or tingling sensation on the bottom of the foot, around the arch, heel, or toes. This may be accompanied by sharp, shooting pain or a feeling of “pins and needles.”
Some people experience numbness or a dull ache in the foot and ankle, which can extend up the leg in more advanced cases. These symptoms often worsen during prolonged standing, walking, or after physical activity. In some instances, pain can even be triggered by simply touching or tapping along the inside of the ankle, a clinical sign known as Tinel’s sign.
Because these symptoms can mimic other foot and ankle problems, proper diagnosis is crucial. Without it, patients may waste time and money treating the wrong issue while their condition worsens.
Getting a Diagnosis
Diagnosis of tarsal tunnel syndrome typically begins with a thorough physical exam and medical history. A podiatrist will look for tenderness, swelling, or nerve sensitivity in the ankle and foot. They may perform certain tests to see if pressure on the nerve reproduces symptoms.
Advanced imaging studies, such as ultrasound or MRI, may be used to detect any structural issues like masses, cysts, or scar tissue compressing the nerve. In some cases, a nerve conduction study or electromyography (EMG) may be performed to measure how well the tibial nerve is functioning and confirm the diagnosis.
Clinics like Gelbmann Podiatry use a combination of high-resolution imaging and hands-on diagnostic techniques to pinpoint the source of the problem and create a targeted treatment plan for each patient.
Treatment Options
The good news is that many cases of tarsal tunnel syndrome can be managed with non-surgical treatments, especially when caught early. One of the first steps is reducing pressure on the nerve through rest, proper footwear, and custom orthotics designed to support the foot and correct flat-footedness or overpronation.
Anti-inflammatory medications or corticosteroid injections may be used to reduce swelling around the nerve. Physical therapy can also play a role in improving flexibility, strengthening surrounding muscles, and relieving tension on the tibial nerve.
For persistent or severe cases, more advanced therapies may be considered. Some clinics offer laser treatments to reduce inflammation and promote healing. If all conservative options fail and the nerve remains compressed, surgical decompression of the tarsal tunnel may be necessary. This procedure involves carefully releasing the ligament or removing any mass that is putting pressure on the nerve, allowing it to function normally again.
Recovery from surgery varies but is often successful when performed by an experienced specialist. Most patients report significant relief from symptoms and are able to return to normal activities with proper follow-up care.
Why Early Treatment Matters
Like many nerve-related conditions, early diagnosis and treatment are essential. When nerve compression continues for a long time without relief, it can lead to permanent damage. That’s why anyone experiencing unusual foot pain, burning, or numbness should seek evaluation sooner rather than later.
Even mild symptoms shouldn’t be ignored, especially if they are persistent or interfere with daily life. The sooner the underlying cause is addressed, the better the chances of avoiding surgery and long-term nerve problems.
A Step Toward Relief
Tarsal Tunnel Syndrome can be frustrating and painful, but it doesn’t have to be a life sentence. With the right care and attention, most people can find relief and return to the activities they love. Specialized clinics like Gelbmann Podiatry are equipped to diagnose and treat complex foot conditions with modern tools and patient-focused care.
Understanding that foot pain isn’t always simple—and recognizing when it might be a nerve issue—is the first step toward healing. Whether the solution involves lifestyle changes, therapy, or advanced treatment options, there is real hope for recovery when the right diagnosis is made. For those dealing with unexplained foot or ankle pain, exploring the possibility of tarsal tunnel syndrome could be the key to finally finding lasting relief.
