Tarsal Tunnel Syndrome, also known as posterior tibial neuralgia, is a painful condition in which the tibial nerve is compressed as it travels through the tarsal tunnel in the ankle.

The tarsal tunnel is a dense band of fibrous tissue which holds the tibial nerve and arteries, running along the inner leg and behind the bump on the inside of the ankle.

What causes Tarsal Tunnel Syndrome?

There is no one specific cause for tarsal tunnel syndrome, but inflammation is the most recognized reason for TTS. Since the tibial nerve is encased in the tarsal tunnel, anything that takes up extra room, like inflammation, causes swelling in the tissues and puts pressure on the nerve. When the nerve becomes "pinched", it sends a pain signal, which may be felt anywhere from the toes through the lower leg, depending on where the nerve is under pressure. Inflammation can be caused by varicose veins, a noncancerous tumor on the nerve, trauma, edema, arthritis, ankle sprain, flat feet, bone spur, ganglion cyst, or any number of conditions.

Symptoms of Tarsal Tunnel Syndrome may include :
(symptoms vary depending on where the nerve is compressed)

• Numbness in foot radiating to the big toe and the first 3 toes
• Pain, burning, tingling, electrical sensations over the base of the foot, lower leg, heel, ankle, and sometimes the toes. Pain worsens with activity
• Burning sensation in the bottom of the foot which radiates up into the knee
• Hot and cold sensations in the foot
• Unusual swelling in the foot
• Cramping feeling in the foot
• Affected skin feels numb
• Affected muscles weaken

Treatment for Tarsal Tunnel Syndrome
Treatment depends on the reason for the pressure on the nerve, but may include :

• Prescription anti inflammatory medication to reduce inflammation and swelling in the tissues around the tibial nerve
• Rest
• Immobilization of affected foot
• Physical therapy
• Custom orthotic shoe inserts to take pressure off of the nerve
• Cortisone injections
• If conservative treatments fail, surgery may be indicated