Tarsal Tunnel Syndrome Tarsal tunnel syndrome describes a condition where the tibial nerve — which runs down the inside of the lower leg and passes through the tarsal tunnel — is compressed due to injury or inflammation. The tarsal tunnel is behind the bony bump on the inside of the ankle, and is made up of bone on the inside and a band of fibrous tissue on the outside. Symptoms of tarsal tunnel syndrome include burning and/or tingling sensation, numbness, and pain in the first three toes, the sole of the foot, the heel, and/or the ankle. Severe tarsal tunnel syndrome can cause muscle weakness and complete loss of movement or sensation in the foot. Diagnostic tests Treatment Treatment begins with modification of activities that may be contributing to the symptoms. A temporary cast may be prescribed to immobilize the ankle and allow the inflamed tissues to heal. Steroid injections in or near the tarsal tunnel may relieve symptoms. Non-steroidal anti-inflammatory medications may be prescribed. Surgery may be recommended for people that have progressive symptoms or weakness that does not respond to conservative treatment. An incision is made on the inside of the ankle, and the nerves and the tarsal tunnel are examined for abnormalities. Tissue that is compressing the nerve may be removed and the ankle is flexed and extended to ensure that the nerves and tendons that pass through the tarsal tunnel move freely. The incision will be closed with absorbable stitches.