Tarsal tunnel is the gap that is formed between the underlying bones of the foot and the overlying tough fibrous tissue. Tarsal tunnel syndrome refers to a condition where the posterior tibial nerve that lies within the tarsal tunnel is compressed. The condition occurs when the tibial nerve is pinched.
Exact cause of the condition is not known but certain conditions such as fractures, bone spurs, ganglions, benign tumors, muscle impingement, or foot deformities are known to increase the risk of developing tarsal tunnel syndrome. Other medical conditions such arthritis can cause swelling of the joints that may compress the nerve. Scar tissue formed after an ankle injury and growth of abnormal blood vessels can press against the nerve resulting in compression.
Most children with tarsal tunnel syndrome complain of pain, numbness, and burning or tingling sensation at the bottom of the foot and heel.
Tarsal tunnel syndrome can be diagnosed by Tinel's test. Tinel's test is performed by tapping the posterior tibial nerve lightly which produces pain and other symptoms indicating tarsal tunnel syndrome.
Tarsal tunnel syndrome may be treated with conservative approaches which include:
- Nonsteroidal anti-inflammatory medications to relieve pain and reduce swelling
- Corticosteroid injection that are injected into the area around the nerve to decrease the swelling
- Use orthotics, such as specially designed shoe inserts or change in foot wears will help to support the arch of the foot and take the tension off the tibial nerve
Surgery is often considered a last resort only when conservative treatments fail to resolve the condition and provide symptomatic relief. Your doctor may perform tarsal tunnel release surgery to treat the condition. During this surgery an incision is made in the tarsal tunnel and the pressure on the tibial nerve is released.