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Tarsal tunnel syndrome produces pain, numbness, tingling or burning sensations on the bottom of the foot, often around the heel. It occurs when a prominent nerve (the posterior tibial nerve) is compressed when it passes through a dedicated space near the inside of the ankle called the tarsal tunnel, named after the tarsal bones of the foot where the tunnel is located.

The symptoms of tarsal tunnel syndrome are produced when there is pressure on the nerve. This pressure can be caused by a multitude of things, including:

  • A flat foot posture which can lead to the nerve being stretched or compressed over time
  • Soft tissue masses in the area of the tunnel such as cysts, fibromas, ganglions or lipomas, which then press on and compress the nerve
  • The development of small varicose veins around the nerve that can cause compression
  • A foot or ankle injury that leads to swelling in the area that compresses the nerve
  • Sports and sports-related injuries that place high demands on the foot and ankle and can lead to damage and swelling
  • Inflammatory conditions

 

Diagnosing Tarsal Tunnel Syndrome

Diagnosing tarsal tunnel syndrome starts with your medical history, injury history and a clinical exam to understand which movements compress the nerve and produce your symptoms. For those whose symptoms are a result of their foot posture, we often find the symptoms are easily reproduced by moving the foot outwards which stretches the nerve, and the symptoms resolve when we turn the foot to face it inwards, which creates more of an ‘arched’ foot shape. Where the cause is unable to be determined clinically, we may refer you for an x-ray or ultrasound to look for any masses like cysts that may be present in or near the tunnel.

 

Treatment

Treating tarsal tunnel syndrome must be directed at the cause of the impingement. Before you’re able to get in to see your podiatrist, avoid any movements that bring on your painful symptoms as these can lead to further irritation and swelling, which may worsen your symptoms. It’s a good idea to take notes of exactly which movements and positions produce symptoms, as this will give valuable information to your podiatrist to use in their assessment.

If your foot posture is the cause of your symptoms, whether that’s from flat feet or other movement dysfunction, we may recommend treatments like custom foot orthotics to adjust the alignment of your feet and your foot biomechanics, or foot mobilisation therapy to help free up the joints in your feet to move without restriction (and therefore ease the potential strain on the tarsal tunnel).

If your nerve impingement is caused by a mass in the tarsal tunnel, we’ll assess this on a case-by-case basis, examining what the mass is and how best to help manage it and any specialists to involve in your care. 

 

Frequently Asked Questions

Can tarsal tunnel syndrome lead to long-term complications?

Yes – unfortunately without proper treatment, tarsal tunnel syndrome can result in chronic pain, muscle weakness, and sensory changes in the affected foot.

Is tarsal tunnel syndrome more common in athletes?

Tarsal tunnel syndrome affects people of all ranges of activity levels, not just athletes. With that said, as repetitive movements and overuse can contribute to its development, we definitely see a fair few cases of tarsal tunnel in those that like to stay physically active – including just taking long evening or weekend walks.

Can tarsal tunnel syndrome occur on both feet simultaneously?

Yes, tarsal tunnel syndrome can affect one or both feet, depending on the underlying causes and contributing factors. With that said, we usually only see one foot affected at a time. 

Is tarsal tunnel syndrome more common in certain age groups?

Tarsal tunnel syndrome can occur in individuals of all age groups, but it is more common in adults and older individuals, especially those with underlying health conditions that affect nerve health.

 

 

What people say…

Receptionists. So lovely. Welcoming smiles, and very approachable. Very comfortable chairs, easy to sit and stand up. Great for people with mobility issues. My appointment time was spot on. A very professional podiatrist. Brian Hudson. I was embarrassed with my feet condition. Brian listened and put me at ease. My appointment time went fast..but so much was achieved in greatly getting rid of my feet pain. Arriving in pain 9/10 and to be reduced to a pain level 3 on leaving the clinic. The next morning my pain level is 1. It Feels so good to be nearly complete pain free after such a very long period of time.

First time visiting a podiatrist and I was so impressed by the friendly, welcoming staff! Jess was so professional, kind and clearly knows a lot about feet! She explained my treatment plan really clearly so I knew exactly what to expect. Lovely Ali at reception was gorgeous too – super helpful and friendly. I’m very happy to drive over from Palmy for my future appointments. I don’t usually write reviews but really wanted to support such a great business!

Adam has a very friendly and professional manner. The procedure on my son’s toe was well explained whilst making him feel at ease. We were seen at short notice which was very much appreciated also. Adam has given us a thorough treatment plan and followed this up with email including photos.

Adam was brilliant and is a superb listener. I walked out with hope in my heart. The receptionist was lovely and easy to talk to. Thanks!

We traveled from Taranaki several times to visit Adam and his team for treatment of toe nail fungus. They are diligent, considerate and dedicated people. Highly recommend.

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