What Is Tarsal Tunnel Syndrome (TTS)?


Tarsal Tunnel Syndrome (TTS) is the result of posterior tibial nerve damage. It causes pain, numbness and weakness in the toes or foot. The tarsal tunnel is a narrow passageway that is formed by ankle bones and ligaments that stretch across the foot. It is located on the inside of the ankle. The tibial nerve branches from the sciatic nerve and travels to the ankle and through the tarsal tunnel. The tibial nerve, along with tendons and arteries, provide flexibility and movement of the foot. Compression of the posterior tibial nerve due to repeated pressure can cause nerve damage, resulting in TTS.


Nerve pain inside the ankle or on the bottom of the foot is a common symptom of tarsal tunnel syndrome. Symptoms may worsen at night or while standing. They include, but are not limited to, the following:

  • Sharp, dull or shooting pain in the toes or foot
  • Burning, numbness or tingling in the toes
  • Weakness of the foot muscle
  • An electric shocking feeling in the ankle or bottom of the foot
  • Loss of feeling in the foot or toes
  • Foot cramps
  • Trouble moving the foot or toes


The cause of tarsal tunnel syndrome is compression of the tibial nerve, which can result from the following:

  • Ankle sprain or fracture
  • Arthritis
  • Bone spur
  • Diabetes
  • Flat feet or fallen arches
  • Ganglion cyst
  • Hypothyroidism
  • Lipoma or tumor near the tibial nerve
  • Overuse
  • Swollen tendon
  • Varicose veins


Various factors increase the risk of developing tarsal tunnel syndrome. They include, but are not limited to, the following:

  • Ankle or foot injury
  • Repetitive activity with forceful foot movement, such as dancing
  • Existing mass in the foot area
  • Pregnancy
  • Bony overgrowth in the ankle
  • Obesity
  • Wearing tight shoes
  • Misalignment of the foot
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