Nerve Tunnels And Ankle Pain


By Matthew H. Paden, DPM

Have you ever had someone look at your feet and ankles from the back? That’s one of the things we will do if you come in complaining of pain by the inside of your ankle. By seeing how your foot and ankle bones line up, we can tell if you overpronate, a risk factor for developing tarsal tunnel syndrome. Let’s look at some more facts about this condition.

What Is a Tarsal Tunnel, and What Has It Done to My Nerve?

Your posterior tibial nerve runs down the inside part of your leg and curves between the end of the tibia (shin bone) and the calcaneus (heel bone) before branching out into your foot. These two bones, along with a firm tissue band called the flexor retinaculum, form what’s called the tarsal tunnel.

The syndrome part of the term comes when something in the tunnel presses on the nerve and causes pain. You may be more familiar with a similar condition which can happen in your wrists (carpal tunnel syndrome). Pressure can come from:

  • Flat feet, because the tilting ankle joint can press on the nerve from one side
  • A tumor, cyst, bone spur or swollen tendon that fills up the tunnel space
  • Swelling from a disease like arthritis or an injury like an ankle sprain

Symptoms of a Compressed Nerve

Most nerve problems manifest in the same three ways: pain, often sharp and moving along the nerve; numbness or lack of sensation; and tingling or “pins and needles” feelings. With tarsal tunnel syndrome, the tenderness will be located just under your ankle bone, and radiate from there into other parts of your foot. It could also be felt up into the calf.

You may notice this all of a sudden, after you’ve strained your legs physically with long periods of standing, an unusually long walk, or a new exercise program. Some may mistake the condition for plantar fasciitis, which also causes heel and arch pain. However, pain localized under your inner ankle bone clues you in to this condition.

When to Seek Medical Help for Ankle Pain

As soon as you notice symptoms of this condition, it is a good idea to have your feet evaluated at our office. The problem can get worse without treatment and you may end up with permanent nerve damage. Dr. Matthew Paden, Dr. Brett D. Sachs, and Dr. Dustin Kruse are expert Denver area podiatrists who can diagnose exactly what is causing your foot pain and formulate a treatment plan tailored to your needs.

Many times conservative remedies will take care of nerve pain from this condition. They include things like rest and icing, to let the nerve damage heal, numb the pain, and reduce swelling that is pinching the nerve. Immobilization, ultrasound therapy, injections, physical therapy, bracing, or special shoes or orthotics may also be tried. As a last resort, we may advise surgery to relieve the pressure on the nerve.

With years of expertise and the latest technology, our office can handle all your foot care needs—including surgery to correct tarsal tunnel syndrome. Simply contact our office in Golden or Wheat Ridge, CO by dialing (303) 423-2520, or ask for an appointment via our website. Catch us on Twitter and Facebook for more info and to leave feedback on how we are doing.

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