What is tarsal tunnel syndrome?

Ever heard of carpal tunnel syndrome? Well, tarsal tunnel syndrome is its lesser-known cousin, but it's just as important, especially for those experiencing foot discomfort. While carpal tunnel syndrome targets the wrist, tarsal tunnel syndrome takes aim at the foot, specifically the area near the inner ankle, where the tibial nerve and other vital structures reside within a tight space known as the tarsal tunnel.

Causes of tarsal tunnel syndrome

The causes for tarsal tunnel syndrome can be divided into intrinsic or extrinsic.

In the first group we can find hypertrophic tenosynovitis or most commonly space-occupying lesions such as ganglion cysts, lipomas or varicose veins. Extrinsic causes can include anything that can compress the tunnel from the outside: post-trauma or post-surgery scarring, and poorly fitting shoes. Contrary to its wrist counterpart, this is a very rare condition but it can often be undiagnosed. It can be seen at any age and it is more common in females.

What are the most common symptoms?

  • Heel pain localized beneath the inner ankle, often radiating to the arch of the foot.
  • Shooting pain with tingling or numbness in the sole of the foot.
  • Muscle weakness in the affected foot, especially in advanced cases.

Treatment options

Treatment for tarsal tunnel syndrome is composed of a combination of strategies that initially include physiotherapy and orthotics to decrease the pressure at the tarsal tunnel

Depending on the underlying cause of the disease, treatment may include:

  • Ganglion Cyst Aspiration: A procedure to reduce the size of cysts and alleviate symptoms, often guided by ultrasound.
  • Surgical Intervention: When conservative measures fail, surgery may be necessary to release the constricting band over the tunnel and decompress any nerve-impinging lesions.

Early intervention is crucial to prevent long-term nerve damage and alleviate symptoms effectively. Delayed treatment may result in persistent weakness, numbness, or incomplete relief.


Recognising the signs and symptoms of these conditions is crucial for seeking timely medical attention. Mr Francesc Malagelada is dedicated to diagnosing and treating various foot and ankle conditions, providing personalised treatment plans to address your specific needs and help you get back on your feet comfortably. Contact us and book an appointment today!

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This article is for information purposes only and is not a substitute for professional medical advice. Consult your physician for personalised guidance. In case of a medical emergency, contact your doctor or emergency services.