Many people are all too familiar with carpal tunnel syndrome, a common condition involving nerve entrapment at the wrist which leads to burning and pain in the hand and fingers.  A very similar, but less recognized condition commonly can lead to pain in the foot and ankle. This is known as tarsal tunnel syndrome.

The tarsal tunnel is an area on the inner portion of the ankle where several important soft tissue structures pass behind the ankle bone and travel to the bottom of the foot.  One of these structures is a large nerve that supplies sensation to the bottom of the foot and toes. This nerve can become compressed or squeezed where it wraps around the ankle, leading to pain in the ankle, foot and/or toes. These painful symptoms usually include burning, pins and needles and tingling sensations. Many factors may be involved in the development of tarsal tunnel syndrome, but the problem is more common in patients with flatfeet and those who are extremely active.

Tarsal tunnel syndrome may lead to nerve damage if left untreated, so establishing the diagnosis as soon as possible is essential.  An examination by a foot and ankle specialist may be followed by a nerve conduction study to test for tarsal tunnel syndrome.  It is important to differentiate tarsal tunnel syndrome from other problems, such as nerve pain which is caused by a pinch nerve in the lower back.

The initial treatment of tarsal tunnel syndrome can involve several conservative measures. This will frequently involve shoe inserts to stabilize foot motion, oral anti-inflammatory medication, injection therapy and physical therapy. Patients who do not respond well to conservative treatments may required surgery to release the nerve.

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