Tarsal Tunnel Syndrome

• Burning or tingling on the bottom of the foot
• Numbness in the toes or arch
• Pain that worsens with activity or prolonged standing
• Weakness or cramping in the foot
• Symptoms that may mimic Morton’s neuroma

The most common cause is overpronation or flattening of the foot arch, which stretches and compresses the nerve over time. Additional causes include:

• Flat feet due to subtalar joint instability
• Ganglions, fibromas, or lipomas pressing on the nerve
• Varicose veins within the tarsal tunnel
• Scar tissue from previous trauma
• Diabetes or systemic inflammation

Tarsal Tunnel Syndrome is most common in adults over the age of 30 and tends to progress slowly if not treated.

Diagnosis is based on:

• Thorough physical examination and patient history
• Tinel’s sign testing (tapping over the nerve)
• Observation of flatfoot deformity or swelling near the ankle
• In-office digital X-rays to assess foot structure
• Ultrasound or MRI (to evaluate soft tissue masses)
• Nerve conduction studies (for advanced or uncertain cases)

Other conditions that can cause similar symptoms include diabetic neuropathy, lumbar nerve compression, and poor circulation. Accurate diagnosis is critical to effective treatment.

Conservative Therapies

• Custom Foot Orthotics: Realign the foot to reduce nerve strain caused by overpronation
• Calf Muscle Stretching: Reduces strain on the nerve and ankle joint
• Anti-inflammatory Medications or Vitamin B supplements to reduce irritation
• Night splints or bracing for offloading pressure
• Nerve pain medications (as prescribed for nighttime burning sensations)

Advanced Options

• Shockwave Therapy: Non-invasive regenerative therapy that stimulates healing and reduces nerve entrapment
• Steroid Injections: Temporary relief from inflammation in the tarsal tunnel
• Surgical Decompression: Reserved for severe or structural causes like soft tissue masses. Surgery may relieve nerve pressure but does not correct flatfoot, so orthotics are still required afterward
• Galvanic Nerve Stimulation or magnetic insoles as adjunct therapies
• Referral to a pain specialist for persistent nerve symptoms

Note: If nerve damage has progressed, full recovery may not be possible, but targeted treatment can significantly reduce symptoms and improve quality of life.

• Located conveniently near Cedars-Sinai Medical Towers in Santa Monica
• Specialists in nerve-related foot conditions and biomechanical correction
• In-office diagnostics (ultrasound, X-ray, gait analysis)
• Customized orthotic therapy and modern regenerative care options
• Compassionate, personalized approach from a board-certified podiatrist

Tarsal Tunnel Syndrome rarely gets better on its own — and delayed treatment can lead to permanent nerve damage. If you’re experiencing burning, tingling, or numbness in your foot or ankle, schedule an appointment with SoCal Foot and Ankle Doctors today. We’ll help you get back on your feet — comfortably.