The tarsal tunnel is an anatomic passageway on the inside area of the ankle. It is a space where nerves, blood vessels and tendons travel from the lower leg into the foot. It is encased in a thick fibrous band of tissue called the flexor retinaculum. This structure maintains the content of the tunnel and allows for little expansion of the soft tissue. Tarsal tunnel syndrome occurs when the tibial nerve becomes compressed in the tunnel. This causes symptoms of pain, burning, tingling and numbness to the foot and ankle. A common complaint associated with this condition is heel pain, which can be mistaken for plantar fasciitis.
Symptoms associated with tibial nerve compression can be addressed with several methods. Topical compounded pain relief medications, oral medications, steroid injections, and physical therapy based modalities can sometimes be useful in treatment. Surgery is typically indicated for more symptomatic patients with advanced symptoms.