Everything You Need to Know About Tarsal Tunnel Syndrome

While tarsal tunnel syndrome is a relatively rare and often undiagnosed foot condition, it may sound familiar, because it’s closely related to carpal tunnel syndrome, a condition that affects the wrist. In carpal tunnel syndrome, numbness occurs when there is pressure on the median nerve in the carpal tunnel, the passageway that encases the nerve. Similarly, tarsal tunnel syndrome results from compression of the posterior tibial nerve as it travels through the tarsal tunnel, the passageway that surrounds this nerve.

The tarsal tunnel is a narrow space that is positioned on the inside of your ankle next to your ankle bones. It is covered with a thick ligament that protects and maintains the structures contained within the tunnel, which include veins, arteries, nerves, and tendons. One of these structures is the posterior tibial nerve, the nerve that runs along the back of your calf, from the inside of your ankle to your foot.

Getting relief from tarsal tunnel syndrome begins with an accurate diagnosis. Marshall L. Lukoff, DPM, FAAFS, of Foot Care Specialists, PC, in Quincy and Dedham, Massachusetts, expertly evaluates patients affected by tarsal tunnel syndrome. After a physical examination and review of X-rays or other imaging studies, Dr. Lukoff can determine the cause of your pain. Dr. Lukoff has the knowledge and experience necessary to create a treatment plan to relieve your symptoms, so you can return to normal activity without pain.

Read on to find out everything you need to know about tarsal tunnel syndrome and whether you may be experiencing symptoms related to it.


Tarsal tunnel syndrome develops as a result of compression on the posterior tibial nerve. Many conditions can cause this to occur. For example, having flat feet can increase your risk for developing tarsal tunnel syndrome, because fallen arches can produce an outward tilt of your heel and thus position the nerve so that it’s vulnerable to compression. 

Furthermore, varicose veins, swollen tendons, tumors, bone spurs, and other abnormalities that may occupy extra space in the tunnel can also make the posterior tibial nerve vulnerable to compression. And ankle sprains and other injuries that produce swelling and inflammation in or near the tarsal tunnel can compress the nerve as well. Tarsal tunnel syndrome can also result from systemic diseases, such as arthritis or diabetes, which typically cause swelling.


Most people who develop tarsal tunnel syndrome experience pain, tingling, or numbness that feels like one of the following sensations:

  • Sharp, shooting pain
  • An electric shock
  • Burning 
  • Pins and needles

You’re most likely to experience pain from tarsal tunnel syndrome on the inside of your ankle, on the bottom of your foot, or both. Some people experience pain in just one area, while it may radiate to the heel, arch, toes, and calf in others. 

The pain is often more intense during long periods of standing, walking, or any type of activity. It can be so severe that it may make you limp.


Getting an accurate medical diagnosis for tarsal tunnel syndrome is important, because the symptoms can resemble other conditions. Tarsal tunnel syndrome can be confused with plantar fasciitis, a condition that results from inflammation of the thick band of connective tissue — called the plantar fascia — that extends from your heel to your toes under your foot. Plantar fasciitis often causes sharp heel pain.

Other common causes of foot or ankle pain include diabetic neuropathy, stress fractures, and posterior tibial tendonitis. Disorders that affect the nerves outside of the nervous system, called peripheral neuropathy, can also cause similar symptoms. 

Dr. Lukoff diagnoses tarsal tunnel syndrome after a thorough clinical evaluation, a detailed medical history, and diagnostic tests. Electromyography (EMG), a nerve conduction study, or imaging, such as X-rays, an MRI, or CT scan, may also be used. 


There are many options for treating tarsal tunnel syndrome. Without treatment, the condition can result in permanent nerve damage. 

Conservative, nonsurgical treatments include custom orthotic devices, such as braces or splints, which are fitted to reduce pressure or limit movement that can cause compression on the nerve. Anti-inflammatory medications and cortisone injections may also be appropriate.

You may also benefit from one of the cutting-edge treatments offered by Foot Care Specialists, PC. Multi Radiance Medical’s MR4™, a super pulsed cold-laser treatment, is a highly focused light energy that can reduce the inflammation exerting pressure on the posterior tibial nerve. Another option is AmnioFix® Sports Med Regenerative Injectables, which contain growth factors to help the affected area repair itself.

Severe cases of tarsal tunnel syndrome may require surgical treatment to address the compression on the nerve.

You don’t have to suffer from foot pain. Tarsal tunnel syndrome is treatable when properly diagnosed. To find out more, book an appointment online or over the phone with Foot Care Specialists, PC today.

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