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Tarsal tunnel syndrome

Tarsal tunnel syndrome is the compression of the posterior tibial nerve in a narrow tunnel under the connective tissue just below the protrusion on the inner side of the heel. It is the standing form of hand carpal tunnel syndrome. The tarsal tunnel passes just below the inner bony prominence of the heel. The posterior tibial nerve passes through the tarsal tunnel, as well as the tendons of the muscles that make the big toe and fingers bend.


Post-fracture deformities in the bones, plastering, thickening of the muscles and ligaments, and rheumatic inflammation of the ligaments narrow this tunnel and compress the nerve.


Patients often experience burning pain in the toes, heel and sole of the feet. The pain can wake you up at night and hit the calves. If the inner heel protrusion is pressed into the dimple behind it, severe pain occurs. There may be weakness in the movement of the big toe and other fingers.


Definitive diagnosis is made by EMG. Nerve conduction velocity is decreased in EMG. In its treatment, corticosteroid injection is applied to the lesion site, but most patients require surgical release of the nerve and removal of pressure.

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