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Dallas Podiatry Works

Tarsal Tunnel Syndrome: Trapping Nervous Tissue

Diagram of tarsal tunnel syndromeHave you ever banged your “funny bone” on a corner and felt that painful tingling all down your arm? An injury to a nerve, even a relatively minor one that is resolved quickly, can cause a lot of discomfort. Nervous tissue is sensitive by design—it needs to be so that it can pass accurate messages to your brain. However, this also makes it vulnerable. Conditions like tarsal tunnel syndrome in your feet cause numbness, shooting pain, and burning sensations, making it harder to function normally.

Trapped in the Tunnel

You have long nerves that travel down your legs and into your feet. One of these is the posterior tibial nerve. As it enters the foot, it passes through a structure called the tarsal tunnel. This narrow passage is just behind the bump on the inside of your ankle and contains a variety of structures that enter and attach to the foot. A thick band of connective tissue called the flexor reticulum keeps the tendons, blood vessels, and nerves in place in the cavity. Sometimes, however, the posterior tibial nerve can become compressed as it passes through this tunnel, leading to shooting pain, numbness, tingling, and burning sensations. Often these symptoms worsen at night or through prolonged use of the foot during the day. The discomfort can radiate into the foot and up the calf muscles as well.

Anything that pinches the nerve in this narrow space can lead to tarsal tunnel syndrome. The flexor reticulum doesn’t stretch very much, so any swelling in the passage has a risk of compressing the nerve against inflexible tissues. Cysts, tumors, and inflammation all trap the nerve in the tunnel. Flat feet tilt the ankle inward and can also create a problem with pinching. Ankle sprains, arthritis, and any other injuries or conditions that lead to swelling can narrow the tarsal tunnel and put the posterior tibial nerve at risk. If the problem isn’t addressed, eventually the damage may become permanent.

Releasing the Nerve

You’ll need to have your lower limbs thoroughly examined to determine the source of your pain and rule out other conditions. Dr. Joel W. Brook and Dr. David R. Northcutt will perform different tests to evaluate your discomfort and discover any underlying problem that is pinching the nerve. They may request diagnostic images to check for structural issues within the foot and ankle that could result in the condition as well. Once they have identified the problem and any contributing factors, you can move forward with targeted treatment.

You’ll need to rest your foot to avoid continued aggravation of the nerve and allow your body to repair the damage. This may require immobilization in a brace or cast to keep your foot still enough to heal. Any swelling and inflammation around the tarsal tunnel will need to be addressed. Icing the ankle and elevating the foot can help. Our expert staff may also recommend anti-inflammatory medications. Any structural issues, like flatfoot, will also need to be treated. Orthotics and shoe changes to cushion the foot and manage your biomechanics can help. Occasionally physical therapy can address preexisting conditions as well. If conservative treatment is unsuccessful, though, you may need surgery to release the tissues compressing the nerve and relieve the discomfort of burning and numbness.

Tarsal tunnel syndrome can be so uncomfortable that you find it hard to walk and continue normal daily activities. Fortunately, though, foot pain doesn’t have to keep you sitting down. With prompt care, you can avoid permanent damage and restore your lower limbs to full strength. Contact the specialists here at Dallas Podiatry Works. We can help you regain your foot and ankle health. Call either of our two office locations—for the Dallas office, call (972) 566-7474; for the Plano location, call (972) 943-3323—or use the online contact page to reach us.


Photo Credit: OrthoPediatrics Corp