Tarsal Tunnel Syndrome:

Nerves Under Pressure

Tarsal Tunnel


Nerves Under


Nerves don’t like being pressed. If it happens too often or for too long, they will let you know in a variety of ways. At Parker Foot & Ankle and the Neuropathy Care Center of Houston, Dr. Parker has treated nerve compression in thousands of patients since training in nerve surgery in 2001, and one condition is often to blame—tarsal tunnel syndrome, a condition similar to carpal tunnel syndrome in the wrist. We want you to understand what’s happening to your nerves so you recognize when it is time to seek medical treatment to keep your feet healthy.

What’s Stressing Your Nerves?

The condition is located on the inside and back of the ankle and involves pressure on the posterior tibial nerve that runs alongside your inner ankle bone (which is actually the enlarged end of your larger leg bone, the tibia). This nerve is responsible for sensation through your calf and down into the bottom of your foot.

The nerve runs through the tarsal tunnel, which is the open area between the tibia and a ligament sheath (flexor retinaculum) that connects it to the tarsal bones in your feet. Arteries and tendons also lie along this same route, so when something happens to narrow the space, it can get a little crowded in there—and as we said, your nerves don’t take kindly to that.

Why You Have Tarsal Tunnel Syndrome

Sometimes the problem is related to genetics, as in a flat foot structure that causes your ankle to roll inward and force the retinaculum closer to the bone. You can develop fallen arches as you age or in as a result of certain diseases as well, with the same results.

Swelling is another cause for compression of the nerve. This can result from an injury like a sprain or from diseases like diabetes or prediabetes (metabolic syndrome) that cause the nerves in the foot and lower extremity to swell. Other tissues can also press on the nerve, such as varicose veins, a bone spur, an enlarged tendon, or a ganglion cyst. 

You can’t see these things happening inside your foot, so it is really important to get a proper diagnosis by a foot specialist who specializes in nerve conditions to determine why your nerve is under pressure.

Signs of Nerve Compression in Your Feet and What to Do

You will likely have one or more of the following symptoms with this condition: numbness, tingling, prickly sensation in your feet, sharp pains that come and go, or a feeling that your foot is hot or burning. These are your damaged nerves telling you something is wrong, and they are also the reason for a call to our office for an evaluation.

Besides considering your medical history and examining the foot, we may do Motor Nerve Conduction Studies (EMG) well as Sensory Nerve Conduction Studies (NCS) to analyze how they are performing, or imaging tests to confirm or rule out other possibilities like bone spurs or tumors. Once we have an accurate diagnosis, we can discuss possible treatment options with you.

Ways to Treat Tarsal Tunnel Syndrome

We will try non-invasive measures first, such as rest and icing, pain medications, injections, braces or splints, orthotic supports, or laser therapy.  Many times these will either remove the pressure from the nerves or dull the pain enough so you can function normally. If you are pre-diabetic, we will counsel you on how to change your lifestyle to reverse the processes creating the nerve inflammation in the first place.

In some cases, however, this type of treatment may not bring the relief you need, and then there is the surgical option. Dr. Parker is a Johns Hopkins’ Dellon-trained nerve surgeon and, as a member and past president of the Association of Extremity Nerve Surgeons, has taught hundreds of board certified surgeons; including podiatric, orthopedic, general, plastic surgeons how to use these techniques. We will always discuss the issue with your thoroughly before you make a decision to have a procedure done.

Finding Nerve Pain Help in Houston, TX

Nerve problems are one of our specialties at Parker Foot & Ankle, and want to help your foot feel better.  If you have foot pain or numb toes and feet, don’t ignore the problem and let it get worse. Call our office at (281) 497-2850 for an appointment and start the road to recovery. If you prefer, you can schedule your appointment with Dr. Robert Parker online.

Houston Office

14441 Memorial Drive, Suite #16

Houston, TX 77079

Phone: 281-497-2850

Office Hours: Monday-Friday 8:00AM to 3:00PM