Musculoskeletal Condition · Glastonbury, CT

Tarsal Tunnel Syndrome

Tarsal tunnel syndrome can cause burning or numbness in the sole of the foot. Learn about evaluation and non-surgical options with Dr. Paul Tortland, DO.

Written and clinically reviewed by

Paul D. Tortland, DO, FAOASM, CAQSM, RMSK

Dr. Paul Tortland, DO is a non-surgical orthopedic & sports medicine physician specializing in regenerative orthopedics and surgical alternative treatment. He is dual board-certified in Sports Medicine & Osteopathic Manipulative Medicine (OMM) and Regenerative Medicine, Fellowship-trained in Sports Medicine. He became the first physician in the world to earn board certification in Regenerative Medicine in 2015. Diplomate, American Board of Regenerative Medicine (ABRM), 2015. Registered in Musculoskeletal Ultrasound (RMSK).

Condition

What is tarsal tunnel syndrome?

Tarsal tunnel syndrome is a squeezed nerve at the inside of your ankle, causing burning, tingling or numbness in the sole of the foot and toes. It is often worse with standing or activity. Footwear, activity changes and rehab come first. Dr. Paul Tortland, DO, uses ultrasound to see where the nerve is being squeezed and may use hydrodissection (fluid placed around the nerve to free it) if symptoms stay. Evidence for hydrodissection is still early.

Explore related conditions: Browse the Foot and ankle condition hub for related diagnoses and treatment options.

CARE OPTIONS

How is tarsal tunnel syndrome treated?

Dr. Tortland’s potential treatment options: Dr. Tortland may evaluate the tibial nerve and nearby structures with examination and ultrasound. If a specific peripheral nerve entrapment is confirmed, ultrasound-guided nerve hydrodissection may be discussed for selected cases; evidence is limited and treatment depends on the cause of compression.

Physical therapy and traditional care: Traditional care can include footwear changes, arch support or orthotics, activity modification, and physical therapy for foot and ankle mechanics. Treating swelling or an underlying condition may also be important.

When other care may be needed: Progressive numbness, intrinsic foot weakness, or symptoms that do not improve need further evaluation to distinguish tarsal tunnel syndrome from neuropathy or a nerve problem originating in the back.

Common questions

Questions about tarsal tunnel syndrome

What causes tarsal tunnel syndrome?

Tarsal tunnel syndrome is compression of the tibial nerve as it passes behind the inner ankle. Contributing factors can include flat feet, prior ankle injury, swelling, cysts or tight surrounding tissue. A clinician may assess the ankle, nerve symptoms and other possible causes of foot numbness.

What are the symptoms of tarsal tunnel syndrome?

Symptoms include burning, tingling or numbness in the sole or heel, sometimes with pain that spreads up the inner ankle and worsens after standing or walking. The pattern can resemble plantar fasciitis or neuropathy, so an examination helps distinguish the cause.

What are the non-surgical treatment options for tarsal tunnel syndrome?

Treatment may include supportive footwear or orthotics, activity modification, physical therapy and targeted injections in selected cases. Nerve testing or imaging may help identify the cause of compression. Persistent numbness, weakness or symptoms despite conservative care warrant specialist assessment.

What regenerative options may help tarsal tunnel syndrome?

Ultrasound-guided hydrodissection may be discussed for selected cases to separate the tibial nerve from surrounding tissue. Evidence remains limited, and it is not appropriate for every cause of heel or foot pain. Evaluation should rule out other problems before treatment is chosen.