The tarsal tunnel is the space behind the bump on the inside of your ankle. The tibial nerve lives in this tunnel along with some tendons. Tarsal tunnel syndrome means that the tibial nerve is being irritated within the tunnel. This results in pain, numbness or tingling into your heel and the arch of your foot.

The tibial nerve may be irritated by compression (from trauma , arthritic spurs, or swelling of other tissues within the tunnel), or more commonly by constant stretch (from flat feet). Research has shown that tarsal tunnel pressure increases almost 30 fold in people with flat feet.
Tarsal tunnel is slightly more common in women, and high heels are suspect. The condition often affects both feet. Conditions like diabetes and thyroid disorders may aggravate nerve problems like tarsal tunnel. Plantar fasciitis commonly accompanies tarsal tunnel syndrome.

The discomfort is often described as “burning”. Symptoms may increase with long periods of standing, running or exercise. Almost half of patients report increased symptoms at night.

Your doctor will make the diagnosis of tarsal tunnel syndrome based on your history and an exam. Your doctor may take an x-ray to rule out other problems like arthritic spurs or a stress fracture. In severe cases, more sophisticated nerve testing may be necessary.

The first goal of treatment is to allow you to return to pain-free activity as soon as possible. The second goal is to correct the mechanical problem that allowed this condition to begin with.