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Tarsal Tunnel Syndrome

What is the Tarsal Tunnel?

The tarsal tunnel is an area of the foot located just behind your inside (medial) ankle bone. It is an area that is particularly important. There are a number of arteries, veins, tendons, and nerves that run their course through it that are responsible for innervating the bottom of the foot.

One nerve in particular is the posterior tibial nerve. which runs through the tarsal tunnel and then continues on to the bottom of the foot, splitting into branches of nerves that are responsible for providing sensation and movement from the bottom of the foot right up to the toes.

Tarsal tunnel syndrome

TTS is similar to carpal tunnel syndrome that is seen in the wrist in that it is a condition that is attributed to unnatural compression of a nerve.

Tarsal tunnel syndrome is a condition that causes painful, burning, or numb sensations throughout the inside aspect and bottom of the foot. Often it will be exacerbated with increased activity and settled with rest. In some circumstances, it may be worse at night, or when the foot is resting.

Because the area of the tarsal tunnel is so busy, there are many structures that can cause impingement of the nerve and can interrupt the proper nerve signal. One common cause is excessive pronation, or feet that have a tendency to roll in. The alignment of the bones can cause pressure against the nerve, altering the signal. An injury to the area can have a similar effect. A cystic or tumour growth in the area, varicose veins, muscle and tissue tightness, or inflammation of a tendon in the area can also be the cause.


The treatment for tarsal tunnel syndrome will depend on the cause. Orthotics are a great way to realign the foot and prevent any excessive rolling in. Anti-inflammatories, rest, and ice may be helpful treatments if the sensation is due to an inflamed structure. Surgery is reserved for causes that create a physical compression of the nerve, such as cyst growths.