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Tarsal tunnel syndrome

Tibial nerve dysfunction; Posterior tibial neuralgia; Neuropathy - posterior tibial nerve; Peripheral neuropathy - tibial nerve; Tibial nerve entrapment

Tarsal tunnel syndrome is a condition in which the tibial nerve is being compressed. This is the nerve in the ankle that allows feeling and movement to parts of the foot. Tarsal tunnel syndrome can lead to numbness, tingling, weakness, or muscle damage mainly in the bottom of the foot.

Causes

Tarsal tunnel syndrome is an unusual form of peripheral neuropathy. It occurs when there is damage to the tibial nerve.

The area in the foot where the nerve enters the back of the inner side of the ankle is called the tarsal tunnel. This tunnel is normally narrow. When the tibial nerve is compressed, it results in the symptoms of tarsal tunnel syndrome.

Pressure on the tibial nerve may be due to any of the following:

Damage to the tibial nerve may result from body-wide (systemic) diseases, such as diabetes, low thyroid function (hypothyroidism), arthritis, or hereditary nerve problems. In some cases, no cause can be found.

Symptoms

Symptoms may include any of the following:

In severe cases, the foot muscles are very weak, and the foot can be deformed.

Exams and Tests

Your health care provider will examine your foot and ask about your symptoms.

During the exam, your provider may find you have the following signs:

Tests that may be done include:

Other tests may include imaging tests, such as x-ray, ultrasound, or MRI.

Blood tests may be done to look for medical conditions that lead to nerve damage.

Treatment

Treatment depends on the cause of the symptoms.

Outlook (Prognosis)

A full recovery is possible if the cause of tarsal tunnel syndrome is found and successfully treated. Some people may have a partial or complete loss of movement or sensation. Nerve pain may be uncomfortable and last for a long time.

Possible Complications

Untreated, tarsal tunnel syndrome may lead to the following:

When to Contact a Medical Professional

Contact your provider if you have symptoms of tarsal tunnel syndrome. Early diagnosis and treatment increases the chance that symptoms can be controlled.


Related Information

Tibia
Peripheral neuropathy
Mononeuropathy
Systemic
Multiple mononeuropathy
Myelin
Diabetes
Polyarteritis nodosa

References

Katirji B. Disorders of peripheral nerves. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 106.

Smith G, Shy ME. Peripheral neuropathies. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 392.

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Review Date: 1/23/2023  

Reviewed By: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School of Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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