Tarsal Tunnel Syndrome
Tarsal Tunnel Syndrome is a condition involving compression or irritation of the tibial nerve as it passes through a narrow area on the inside of the ankle called the tarsal tunnel.
It can cause burning, tingling, numbness, shooting or electric-shock-like pain in the foot. Symptoms can sometimes be felt around the inside of the ankle, heel or along the sole of the foot.
Because some of these symptoms can overlap with other causes of foot and heel pain, it is important to understand what may be contributing to your symptoms rather than assuming that every case of burning or tingling foot pain is Tarsal Tunnel Syndrome.
What is the tarsal tunnel?
The tarsal tunnel is a narrow passageway on the inside of the ankle. The tibial nerve passes through this area before dividing into nerves that supply parts of the foot.
If the nerve becomes compressed or irritated within or around this passageway, it can produce symptoms such as pain, tingling or altered sensation in the foot.
What does Tarsal Tunnel Syndrome feel like?
Symptoms can vary between individuals, but may include:
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Burning pain in the foot
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Tingling or pins and needles
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Numbness
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Shooting or electric-shock-like sensations
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Pain around the inside of the ankle
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Pain or altered sensation underneath the heel or sole of the foot
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Symptoms that become more noticeable with prolonged standing or walking
Some people may experience symptoms mainly in the foot, while others may notice them extending from around the ankle into the sole.
What causes Tarsal Tunnel Syndrome?
There is not necessarily one single cause of Tarsal Tunnel Syndrome.
Symptoms can occur when the tibial nerve becomes compressed or irritated. There may be a number of factors involved, and understanding the individual's symptoms, foot function and lower-limb mechanics can be important when assessing the problem.
Foot and ankle movement can influence how forces are distributed through the lower limb. However, foot posture alone does not establish that it is the cause of someone's symptoms.
This is why an individual assessment is important.
Tarsal Tunnel Syndrome or Plantar Fasciitis?
Tarsal Tunnel Syndrome can sometimes produce symptoms that overlap with other causes of heel or foot pain, including plantar heel pain.
Plantar Fasciitis and Tarsal Tunnel Syndrome are different conditions, even though some symptoms may feel similar.
Burning, tingling, numbness or electric-shock-like sensations may suggest nerve involvement rather than a straightforward mechanical heel pain problem.
If you are unsure what is causing your symptoms, an appropriate clinical assessment can help determine what may be contributing to your pain.
Can foot mechanics contribute to Tarsal Tunnel Syndrome?
The way your feet and lower limbs move can influence how forces are distributed through the ankle and foot.
For some people, particular movement patterns or foot mechanics may be relevant to their symptoms. However, there is no single foot shape or movement pattern that explains every case of Tarsal Tunnel Syndrome.
At MK Orthotics, we therefore look at the whole lower-limb movement pattern rather than assuming that your foot shape is the cause of your symptoms.
We may consider:
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Foot posture
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Foot and ankle movement
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Lower-limb alignment
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Walking mechanics
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Running mechanics where appropriate
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Previous injuries
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Footwear
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The location and behaviour of your symptoms
The aim is to understand whether your individual mechanics may be relevant to your symptoms.
Can orthotics help Tarsal Tunnel Syndrome?
An orthotic is not automatically required simply because you have Tarsal Tunnel Syndrome.
In some circumstances, an orthotic may be considered if an assessment identifies a foot or lower-limb loading pattern that could be contributing to your symptoms.
An orthotic may be designed to influence how forces are distributed through the foot and lower limb. Whether this is appropriate depends on your individual symptoms, mechanics and overall assessment.
The important question is not simply whether you have Tarsal Tunnel Syndrome, but whether an orthotic intervention is likely to be useful for you.
If we do not think orthotics are appropriate, we will tell you.
What happens during an MK Orthotics assessment?
At MK Orthotics, we don't prescribe orthotics simply because you have been given a particular diagnosis.
We first look at the relationship between your symptoms, foot mechanics and lower-limb function.
Your approximately 90-minute assessment may include:
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A detailed discussion of your symptoms
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Review of your activities and lifestyle
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Assessment of foot posture
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Assessment of foot and ankle movement
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Lower-limb alignment
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Functional movement assessment
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Assessment of walking mechanics
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Video gait analysis where appropriate
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Review of your footwear
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Assessment of any existing orthotics or insoles
We then consider whether an orthotic intervention could reasonably contribute to your management.
What if I've already tried orthotics?
If you have already tried insoles or orthotics and your symptoms have continued, bring your previous devices with you if possible.
It can be useful to consider:
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What the previous orthotic was designed to change
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Whether it altered your foot or lower-limb mechanics
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Whether it was comfortable
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What footwear you used with it
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Whether your symptoms changed
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What was identified during your original assessment
A previous unsuccessful orthotic does not necessarily mean that an orthotic can never be useful. However, it is important to understand why the previous approach did not help before considering another device.
When should Tarsal Tunnel symptoms be assessed?
Consider having persistent foot symptoms assessed if you experience:
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Ongoing burning or tingling
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Persistent numbness
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Repeated shooting or electric-shock-like sensations
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Foot or ankle pain that is affecting walking or everyday activities
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Symptoms that continue despite modifying aggravating activities
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Symptoms that keep returning when you increase your activity
Because burning, tingling and numbness can have a number of possible causes, appropriate clinical assessment is important if symptoms persist or are worsening.
Tarsal Tunnel Syndrome and foot pain in Milton Keynes
If you are experiencing persistent burning, tingling, numbness or shooting pain in your foot and want to understand whether your foot and lower-limb mechanics could be contributing, MK Orthotics can assess you in Milton Keynes.
Our approach is not simply to prescribe an orthotic because you have a particular diagnosis.
We assess the relationship between your symptoms, foot mechanics and lower-limb function and consider whether an orthotic could form a useful part of your management.
Related conditions
Tarsal Tunnel Syndrome can share symptoms with other foot and lower-limb conditions.
You may also find these pages useful:
Foot pain, burning or tingling causing you problems?
If persistent foot pain, burning, tingling or numbness is affecting your walking, exercise or everyday activities, an assessment can help identify factors that may be contributing.
Book a 90-minute biomechanical assessment with MK Orthotics in Milton Keynes.
MK Orthotics is based in Blakelands, Milton Keynes.