Have you ever felt that sharp, burning pain near your ankle that just won’t quit?
If you’ve been struggling with foot pain, numbness, or tingling sensations around the inner side of your ankle, you might be dealing with something called tarsal tunnel syndrome. I see many patients experiencing these exact symptoms, and often, they come in unsure of what’s going on.
Understanding tarsal tunnel syndrome
Tarsal tunnel syndrome occurs when the posterior tibial nerve—which runs along the inside of your ankle and into your foot—gets compressed or pinched. Imagine stepping on a garden hose and seeing the water flow slow down. It’s pretty much the same concept, except it’s your nerve that’s compressed, causing pain or numbness.
This nerve compression can be triggered by many factors, like flat feet, injuries, swelling from ankle sprains, or even arthritis. Some people might experience it after repetitive activity or strenuous exercise.
In fact, I’ve noticed this happens frequently among runners and athletes. That’s why I often recommend patients consider getting a running assessment to identify potential issues early.
What symptoms should you watch out for?
Many patients come into the clinic describing a burning sensation or numbness in the bottom of their feet. Others mention sharp, shooting pains radiating into their toes or even up their leg. Some have described a tingling feeling, almost like pins and needles.
I remember a patient who had two surgeries on their foot and still felt pain around the ankle. They were frustrated because treatments like cortisone injections and local anaesthetics were only giving temporary relief. This isn’t uncommon. Often, tarsal tunnel syndrome can be tricky to pinpoint without the right diagnosis.
Some people also notice their toes starting to curl or claw, leading to additional problems like claw toes. This happens because nerve dysfunction can affect the muscles in your foot, changing how your toes and feet move.
Why diagnosis can be a challenge
Diagnosing tarsal tunnel syndrome isn’t always straightforward. Standard tests like MRIs or nerve conduction studies might sometimes miss it. I’ve observed this personally with several patients who’ve had clear test results but were clearly symptomatic.
That’s why having a thorough assessment from an experienced podiatrist is crucial. In our clinic, a detailed gait analysis or functional testing can make all the difference.
What can you do about it?
If diagnosed early, tarsal tunnel syndrome often responds well to conservative treatments. I regularly recommend starting with non-surgical approaches. Customised treatments like custom orthotics can significantly relieve symptoms by correcting the foot position and reducing nerve pressure.
Sometimes, I also suggest therapies like radial shockwave therapy or foot mobilisation and manipulation, both of which have shown positive results in alleviating nerve pain.
There’s compelling evidence from Cleveland Clinic and Johns Hopkins Medicine supporting these conservative treatments, especially when started early.
When is surgery an option?
Occasionally, conservative treatments aren’t enough. If symptoms persist or worsen despite non-surgical approaches, surgery might be necessary. The surgical procedure, known as tarsal tunnel release, involves relieving the pressure on your nerve.
Recovery from surgery typically involves careful rehabilitation. One important thing I’ve learnt from patients who’ve undergone surgery is the immense value of post-operative care. Regular scar tissue massage, as shared by those who’ve gone through the procedure, can significantly speed up nerve healing, which can sometimes take several months to fully recover.
Taking the first step towards relief
If you’re experiencing persistent foot or ankle pain and suspect it might be tarsal tunnel syndrome, getting an accurate diagnosis early is crucial. Addressing the issue promptly can stop it from progressing into more serious foot problems.
At my clinics in Port Melbourne, Elsternwick, and Williamstown, we take the time to carefully assess your symptoms and create a customised treatment plan.
If you’re concerned about your symptoms, or just want some clarity on what might be happening with your feet, I’d encourage you t0 book an appointment today. It’s always better to be proactive rather than reactive when dealing with your foot health.
Your feet carry you everywhere—it’s only fair to give them the care they deserve.