Tarsal Tunnel Syndrome

On the inside of your ankle, under the skin and covered by some ligaments, lies a narrow space called the tarsal tunnel. Within that tunnel you’ll find some arteries, some veins, and the posterior tibial nerve.

Under a number of conditions, the posterior tibial nerve can become compressed, causing numbness, tingling, or pain in various parts of the foot. Some of those causes include:

All of these conditions can cause swelling in and around the tarsal tunnel, putting pressure on the posterior tibial nerve.

Not to Be Confused With Carpal Tunnel

You may be familiar with the more common “carpal tunnel syndrome,” which causes pain and numbness in the fingers. The word “carpal” refers to one’s wrist, while “tarsal” refers to the ankle, but the reason for pain is similar. In carpal tunnel syndrome, a nerve that runs through the carpal tunnel is being squeezed by some kind of inflammation.

Tarsal tunnel syndrome can cause symptoms in the toes, but numbness and tingling is often felt on the inside of the ankle, up into the calf, in the foot arch, or in the bottom of the foot. When our patients describe their symptoms, we might first suspect plantar fasciitis or heel spurs. Tingling and numbness could also indicate a different kind of nerve damage known as peripheral neuropathy.


Careful examination and testing, such as practiced by our expert podiatrists at Foot & Ankle Associates of Cleveland, will hone in on the posterior tibial nerve to determine if it’s being compressed, thereby eliminating other diagnostic possibilities. Dr. Craig B. Frey and Dr. Megan Oltmann might attempt to recreate your symptoms by tapping or pressing on the nerve. They may recommend a nerve conductivity test, which uses short electrical bursts to show how well signals are being transmitted through the nerve.


Patients should begin by eliminating whatever underlying condition is causing compression of the posterior tibial nerve. That might mean controlling your diabetes, evaluating and changing your medications, wearing shoe inserts to relieve pressure, or refraining from exercise for a time.

When these non-operative treatments don’t provide relief, surgery to remove the cause of pressure is an option. Discuss your symptoms and treatment options carefully with Dr. Frey or Dr. Oltmann at our comfortable office in the great community of Solon. You can contact us through our website or call us directly at (440) 903-1041. We welcome your inquiries.