Tarsal Tunnel Syndrome (Posterior Tibial Neuralgia)

Overview

This condition, also called TTS, affects the tibial nerve in the ankle. This nerve is a branch of the sciatic nerve. It passes from the leg down to the foot. Just below the bony bump on the inner side of the ankle, it passes through a small space called the tarsal tunnel. TTS is a compression of the nerve within this tunnel.

Causes and Risk Factors

Anything that increases pressure on the tibial nerve in the tibial tunnel can cause TTS. Fallen arches or other changes in the shape of the foot can be a culprit. Swelling in the ankle after an injury can cause TTS. It can develop because of a varicose vein, bone spur or cyst in the tarsal tunnel region. You may have a higher risk of developing this condition if you have diabetes, lower back problems or poor circulation, or if you have a job that requires a lot of standing or walking.

Symptoms

Symptoms may include shooting pain, numbness, and tingling or burning sensations. These may be felt in the inner ankle, the bottom of the foot and the toes. You may feel cramping sensations in the arch or the toes. Symptoms are usually aggravated by activity. They are often worse in the evening. Your symptoms may come and go at first, but as the condition progresses they may last for longer periods of time.

Treatment

Treatment varies depending on the cause of the condition. TTS that results from tissue swelling may be treated with options such as anti-inflammatory medications, steroid injections and orthotic devices. Compression caused by other issues may require surgery. A procedure called tarsal tunnel decompression can create more room for the nerve within the tarsal tunnel. This can allow it to resume proper function.