Section 5. Bone, Joint, and Muscle Disorders

Chapter 72. Foot Problems

Topics: Introduction | Foot Pain | Ankle Sprain | Tarsal Tunnel Syndrome | Plantar Fasciitis | Achilles Tendon Bursitis | Ingrown Toenail | Onychomycosis | Onychia | Corns and Calluses | Onychauxis and Onychogryphosis | Hallux Valgus and Bunion | Hammer Toe | Sesamoiditis

Tarsal Tunnel Syndrome

Tarsal tunnel syndrome (posterior tibial neuralgia) is pain in the ankle, foot, and toes caused by compression of or damage to the nerve supplying the heel and sole (posterior tibial nerve).

The posterior tibial nerve runs along the back of the calf, through a fibrous canal near the heel, and into the sole of the foot. When tissues around this nerve become inflamed, they can press on the nerve, causing pain.

Pain, the most common symptom of tarsal tunnel syndrome, usually has a burning or tingling quality. It may occur when a person stands, walks, or wears a particular type of shoe. Pain located around the ankle and extending to the toes usually worsens during walking and is relieved by rest. Occasionally, pain also occurs during rest.

To diagnose this condition, a doctor manipulates the affected foot during a physical examination. For example, tapping the injured or compressed area often causes tingling, which may extend to the heel, arch, or toes. Extensive tests may be needed to determine the cause of the injury, especially if foot surgery is being considered.

Injections of a mixture of corticosteroids and local anesthetics into the area may relieve pain. Other treatments include wrapping the foot and placing specially constructed orthotic devices in the shoe to reduce pressure on the nerve. When other treatments do not relieve the pain, surgery to relieve pressure on the nerve may be necessary.