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Tarsal Tunnel Syndrome

While tarsal tunnel syndrome is due to a nerve entrapment in the ankle/foot area, this is similar to a carpal tunnel syndrome in the wrist area.

With this in mind, it is the posterior tibial nerve that passes through the tarsal tunnel, which is a tunnel-like structure below the medial ankle. It can be compressed owing to various reasons and cause pain on the inside of the ankle. In other words, various conditions can bring this on such as first, abnormal foot motions, second, arthritis of the ankle and third, flexor tendinitis or venous insufficiency with associated swelling (edema).

Tarsal tunnel release

Notably, ankle pain gets worse with walking and standing, and by and large radiates into the toes. For the most part, there is worsening of the pain with tapping below the medial ankle (called “Tinel sign“). In any event, electromyography shows exactly the location of the blockage. Obviously, the surgeon orders this electrophysiological procedure before any planned surgery.  Ultimately, if nerve entrapment is proven by EMG studies, no time should be wasted to have a surgeon do a surgical release. In this case, the nerve does not get damaged permanently through nerve atrophy. This surgery is called tarsal tunnel release.


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Last modified: June 21, 2019

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.