An Overview of Tarsal Tunnel Syndrome (TTS) and Treatment Options

An Overview of Tarsal Tunnel Syndrome (TTS) and Treatment Options

Jun 02 , 2021

Erandika Mohanathasan

Tags - Overview of Tarsal Tunnel Syndrome (TTS) and Treatment Options


The Tarsal Tunnel is a narrow space that lies inside the ankle next to the bones.

And, it is covered with a ligament that protects the ankles structure within this tunnel, including the arteries, veins and nerves.

Consequently, when these nerves are squeezed or compressed, it leads to Tarsal Tunnel Syndrome (TTS).

Typically, this occurs due to the ankle being overused or bears more stress than it can take, thus the nerves get damaged and leads to inflammation.

Unfortunately, people with flat feet are more at risk of developing TTS, because their heels tilt outwards and fallen arches add extra strain on the nerves in the ankle.

However, it can be caused by injuries such as ankle sprains too and even spontaneously without no clear reason. 

With that in mind, anyone can develop TTS at any age, although there are some factors that increase the likelihood of developing the condition, which includes:

  • Arthritis: rheumatoid and osteoarthritis
  • Diabetes
  • Poorly fitted shoes
  • Cysts near the foot and ankle area
  • Varicose veins
  • Overweight 

TTS causes pain near the ankles and bottoms of the feet; Common symptoms of TTS include:

  • Shooting pains
  • Numbness
  • Tingly feeling
  • Burning sensations 
  • Inability to flex, bend and fan out the toes
  • Loss of feeling in the toes and bottom of feet

Sometimes, these symptoms will appear suddenly when the foot and ankle becomes aggravated, and it’s important to seek early treatment.

Because, if TTS is not treated on time it could lead to longer nerve impairment or permanent nerve damage

Moreover, these symptoms are often confused with different conditions and so proper evaluation is needed for correct diagnosis and appropiate treatment.

As such, treatments for TTS include:


1. RICE (Rest, Ice, Compression and Elevation) and Immbolisation

Resting well is vital to healing, so during this time you should stay off the foot to prevent further injury.

Secondly, you should apply ice to the affected area for 20 minutes with 40 minute intervals.

In some cases, it may be necessary to wear a cast to limit foot movement, which can boost healing in the nerves and surrounding tissues.

Ultimately, immbolisation of the foot can help sprained tissue to heal and compression of the nerve to settle.


2. Anti-Inflammatory Drugs

Anti-inflammatory drugs, such as ibuprofen, can help to reduce swelling and pain.

Typically, anti-inflammatory drugs will help reduce inflammation, especially when TTS is associated with arthritis.


3. Physiotherapy

Physiotherapy is an important element in the treatment of TTS.

Following diagnosis, you’ll be advised physiotherapy treatment, which can include a wide range of movment exercises, electrotherapy, hydrotherapy and soft tissue treatment. 


4. Orthotics

The main goal of using orthotics to treat TTS is to control the heels movement and provide arch support.

As such, orthotics should have a deep heel cup, wide width through the arch to increase surface area and a small heel lift to encourage ankle joints to flex to a neutral position and control the pain.


5. Appropriate Shoes

Wearing appropriate, comfortable shoes are essential when suffering from TTS, as you want to be able to reduce tension and support the foot’s arch as much as possible.

With that in mind, your shoes should be stable and prevent the heel from rolling in as well as considering durability of the shoe, as the nerve needs extra protection.

Lastly, shoes should be lightweight when suffering from TTS as this can help the tarsal tunnel to relax when wearing shoes - anything heavy applies extra force and strain, leading to more pain.


6. Surgery

If all else fails, then surgery may be beneficial as a tempt to reduce tension and pressure on the tarsal nerve.

However, your doctor will advise if this is the appropriate treatment, based on the cause of your condition.

Final Remarks

Small cases of TTS can significantly improve within a few days of RICE and over the counter medications.

However, leave untreated and it could cause permanent nerve damage.

As such, when symptoms occur, always consult with your doctor for the correct treatment for you.

Ultimately, to prevent TTS from ever occurring, it is advised to wear properly fitted shoes, leaving breathable space to avoid adding pressure on the nerve.

If you’d like to know more, contact us today.


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