Dr. M.J. Bazos, MD. Patient Handout

About Your Diagnosis
Tarsal tunnel syndrome is a relatively rare condition that produces burning pain along the medial (inside) aspect of the ankle and down into the bottom of the foot. It is generally caused by compression on a nerve that travels in this area (Fig 1). Although the name is similar to carpal tunnel syndrome, it is much less common, and the physician considers this diagnosis only after other potential causes of pain in these areas are excluded. A physical examination is all that is usually needed to confirm or exclude the diagnosis. However, electrical testing, such as electromyography (EMG) can sometimes be helpful. You can be treated for tarsal tunnel syndrome after it has been appropriately diagnosed. Surgical decompression may be necessary.

Living With Your Diagnosis
Signs and symptoms of tarsal tunnel syndrome include pain along the inside of the ankle that extends down into the bottom of the foot. Numbness or tingling also may occur in this distribution. Compression on the nerve can sometimes lead to decreased function of the nerve but does not usually cause any permanent paralysis of the foot. This is usually a painful condition and eventually begins to limit your ability to walk or stand for prolonged periods. The symptoms usually come and go and are usually related to activity level.

When the diagnosis of tarsal tunnel syndrome has been confirmed, treatment can include rest, elevating the extremity, and, sometimes, injections in an effort to decrease the inflammation that can occur around the nerve. Anti-inflammatory medications can sometimes be helpful. No vitamins, diets, or exercises have been proved to decrease the pressure on the nerve once it occurs. An attempt to determine the cause of the symptoms, including critical evaluation of shoes and activities, may be of benefit. Surgical release of the nerve can be considered when the other forms of treatment fail. There can be risks with surgical treatment, including failure to relieve the pain. Pain sometimes can be relieved initially with surgical treatment, but the symptoms quickly recur. Scarring around the nerve after an operation is common and can lead to longterm difficulties.

The DOs
• Take your medications as prescribed.
• Rest and elevate the leg.

The DON’Ts
•Ê Do not perform aggressive exercise usually worsens the condition.

When to Call Your Doctor
•Ê Should your symptoms change from intermittent to constant, then a physician should be sought out who has a fair amount of experience dealing with this relatively rare diagnosis.