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Tarsal Tunnel

You have probably heard of carpal tunnel syndrome – which is an entrapment of a nerve in your wrist that causes numbness, tingling and pain in the hand. Tarsal tunnel syndrome is a similar condition but affects the foot. It is caused by irritation of the tarsal nerve that travels on the inside of the ankle, behind the ankle bone. Most often the irritation is caused by excessive stretch on the nerve and is often associated with flat feet.

Tarsal tunnel syndrome can cause many types of foot pain including burning pain, shooting pain, sharp pain, tingling numbness and aching. It can cause heel pain, ankle pain, bottom of the foot pain and even toe pain. .

We feel strongly that the initial treatment of tarsal tunnel syndrome should be conservative. Surgery should only be a last resort. Custom orthotics are often our first line of treatment but to be effective in relieving symptoms of tarsal tunnel syndrome a very specific orthotic prescription should be used. Several research studies over the past 8 years have indicated exactly how an orthotic should be prescribed to best alleviate tension and compression on the tarsal nerve.1, 2, 3

Other treatments for tarsal tunnel syndrome include anti-inflammatory measures, injection, shoe changes and, if all conservative treatment fails, surgical decompression of the tarsal nerve.

Diagnosis of tarsal tunnel syndrome is usually made via physical and biomechanical examination. Advanced diagnostic testing including x-ray, MRI, and nerve conduction studies can help us determine the cause for specific cases of tarsal tunnel syndrome.

If you think you might have tarsal tunnel syndrome, make an appointment to see us as soon as possible in our Seattle office. This problem will usually get worse over time, so get treated early.

1. Trepman E: Effect of Foot and Ankle Pronation on Tarsal Tunnel Compartment Pressure. Foot Ankle Int. 2000
2. Labib, SA, Gould JS: Heel Pain Triad. Foot Ankle Int. 2002
3. Kinoshita M, et. al.: A New Test for Tarsal Tunnel Syndrome: J Bone Joint Surg Am 2002


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Douglas Hale, DPM & Lawrence Huppin, DPM
Foot and Ankle Center of Washington, Seattle
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