Similar in complaint to Carpal Tunnel, Tarsal Tunnel Syndrome is due to compression of a nerve called the Posterior Tibial Nerve. Dr. Marc Blatstein, a Podiatric Surgeon, explained that Tarsal Tunnel Syndrome occurs over time as the nerve becomes inflamed resulting in symptoms such as burning, electric shocks, tingling, as well as a shooting type of pain. Other factors that Dr. Marc Blatstein, has found that contribute to Tarsal Tunnel Syndrome come from either an overly pronated foot which puts a stretch on the nerve, pressure on the nerve from soft tissue masses such as ganglions, fibromas, or lipomas that physically compress the nerve, as well as other insults to the nerve.
The diagnosis is usually quickly made by physical exam as well as the patient’s history of their complaint. Observation may reveal a slight swelling just on the inside of the ankle joint. As part of the physical exam, Dr. Marc Blatstein finds that gently taping the inside of the ankle joint in the acute phase will result in a tingling sensation that may shoot, both up the leg and/or into the foot. Nerve conduction studies are another tool that will reveal if there is damage to the nerve.
Treatment of Tarsal Tunnel involves many different components, some of which are: correcting the abnormal pronation of the foot [which is accomplished with prescription functional foot orthotics]. Along with this, oral anti-inflammatory medications, vitamin B supplements, &/or steroids may provide some benefit, but are rarely curative. Should there be a soft tissue mass compressing the nerve, then surgical removal of the mass may be necessary. Surgical correction of Tarsal Tunnel Syndrome has a good chance of success, at the same time the over-pronation of the foot still needs to be followed with functional foot orthotics.