Tarsal Tunnel Syndrome

Tarsal Tunnel Syndrome

What is the tarsal tunnel?

This consists of the compression of the posterior tibial nerve or its terminal branches at the level of the internal malleolus (inner ankle), causing paresthesias in the sole and pain in the heel (back of the foot) which make walking difficult.

At Clínica San Román, a conservative treatment is initially performed to solve this syndrome. In resistant cases, at Clínica San Román, a surgical treatment with minimal incision techniques is performed for the decompression of the posterior tibial nerve.

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Causes and Symptoms


There may be compression of the tarsal tunnel of traumatic origin (single or repeated), vascular, inflammatory or infectious origin, as well as osteoarticular degenerative processes. This produces paresthesia (tingling, numbness, etc.) and pain along the path of this nerve and its branches, making ambulation difficult.

What does the treatment consist of?

Conservative treatment includes rest and immobilisation of the ankle joint in discreet plantar flexion, ultrasound and anti-inflammatory drugs (NSAIDs) as well as the application of local cold.

The use of plantar supports (insoles) may also be indicated to correct excessive pronation and thus reduce the stress exerted on the inside of the ankle. On certain occasions, corticosteroid infiltration may be indicated.

Surgery is indicated when there is no response to conservative treatment. In these cases, the San Román clinic uses minimally invasive surgery to decompress the posterior tibial nerve.

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