Tarsal tunnel syndrome is a condition caused by compression, or squeezing of the posterior tibial nerve, causing damage and resulting in inflammation inside the ankle. Tarsal tunnel syndrome is similar to more common carpal tunnel syndrome, which occurs in the wrist, as both disorders arise from the compression of a nerve in a confined space. 

The tarsal tunnel is a narrow space inside the ankle next to the ankle bones and is covered with thick ligament that protects the structures of the Posterior tibial nerve. 


Tarsal tunnel syndrome occurs when the Posterior tibial nerve becomes compressed, damaged and inflamed due to overuse and constant pressure on the foot, mostly with strenuous activities or prolonged walking, running, standing and exercising. 

Common causes for Tarsal tunnel syndrome are:

  • Flat feet, resulting in strain and compression due to outward tilted heels and fallen arches
  • Abnormal structures that occupy the space within the tunnel, such as varicose veins, ganglion cysts, swollen tendons or arthritic bone spurs
  • Injury


People with Tarsal tunnel syndrome experience: 

  • Tingling, burning or a sensation similar to an electrical shock
  • Numbness
  • Pain

These symptoms are felt in the inside of the ankle and the bottom of the foot. Sometimes they may appear suddenly or be brought on by overuse of the foot with activities such as standing, walking or exercising.  


Early treatment is very important if any of the symptoms occur, because if left untreated, the condition may progress and result in permanent nerve damage. The symptoms of Tarsal tunnel syndrome can be confused with other conditions and proper analysis and diagnosis must be made before starting treatment. 

Many treatment options are often used in combination and include: 

  • Rest
  • Ice
  • Nonsteroidal anti-inflammatory drugs 
  • Immobilization
  • Physical therapy
  • Ultrasound therapy
  • Steroid injections 
  • Orthotic devices
  • Supportive shoes
  • Bracing