About Tarsal Tunnel Syndrome (TTS)
TTS is rare, with unknown exact population incidence (under 1% of foot/ankle complaints); higher in women, athletes (runners), ages 30-50, diabetics, or post-trauma; 20-40% idiopathic. TTS is compression of the posterior tibial nerve or its branches (medial/lateral plantar nerves) within the tarsal tunnel behind the medial ankle malleolus, beneath the flexor retinaculum, akin to carpal tunnel but in the foot. Pseudo-tarsal tunnel syndrome (PTTS) mimics TTS symptoms but arises from proximal issues like L5-S1 radiculopathy, peripheral neuropathy, or plantar fasciitis without true ankle entrapment—confirmed by normal ankle Electrodiagnostic Studies but abnormal lumbar/nerve diagnostic studies.
Symptoms
TTS: Burning/tingling/numbness/pain in medial ankle, sole, toes (plantar distribution), worse with standing/walking; Tinel’s sign at malleolus, positive dorsiflexion-eversion test; possible intrinsic foot weakness/atrophy. PTTS: Similar paresthesias but no ankle tenderness, symptoms with lumbar motion/back pain, normal tarsal tests.
Known Causes
- Primary: Intrinsic: Ganglion cysts, varicosities, tenosynovitis, osteophytes; extrinsic: Trauma/ankle sprain, flat feet/coalition, or tight shoes.
- Secondary: Diabetes, rheumatoid arthritis, hypothyroidism, post-surgical scarring, edema; PTTS from spinal instability or stenosis, or polyneuropathy.
Schedule a $69 New Patient Appointment at McPherson Chiropractic Center
Schedule a $69 New Patient Appointment at McPherson Chiropractic Center
