Nerve Entrapment at Foot Foundation
Tarsal Tunnel Syndrome is a painful nerve condition caused by compression of the posterior tibial nerve as it passes through a narrow tunnel on the inside of the ankle. This pressure irritates the nerve, leading to burning pain, tingling, numbness, or shooting sensations in the foot. If left untreated, it can progress to weakness and loss of muscle control.
Because its symptoms often mimic plantar fasciitis or neuropathy, accurate diagnosis is key. At Foot Foundation, we specialise in identifying the exact cause of nerve pain and providing tailored treatment to relieve pressure, restore comfort, and protect long-term foot function.
What is Tarsal Tunnel Syndrome?
Tarsal Tunnel Syndrome is a form of nerve entrapment neuropathy, similar to carpal tunnel in the wrist, but occurring in the ankle. It involves compression of the posterior tibial nerve (or its branches) as it passes through the tarsal tunnel, a narrow space on the inside of the ankle bounded by bone and a thick ligament.
When compressed, the nerve becomes irritated, causing burning pain, tingling, or numbness in the sole of the foot. If untreated, long-term nerve compression can lead to weakness and muscle wasting.
At Foot Foundation, we specialise in accurate diagnosis (distinguishing tarsal tunnel from plantar fasciitis, neuropathy, or referred pain) and provide comprehensive treatment to relieve pressure on the nerve and restore function.
Causes & Risk Factors
Flat feet or overpronation – stretching the tibial nerve in the tunnel
Swelling or inflammation – from ankle sprains or injury
Space-occupying lesions – ganglion cysts, lipomas, or varicose veins
Systemic conditions – diabetes or inflammatory arthritis
Poor footwear – overly tight or unsupportive shoes
Biomechanical overload – excessive standing, walking, or running
Scar tissue – following trauma or surgery
Treatment at Foot Foundation
Custom orthotics – correct overpronation and reduce nerve tension
Footwear modification – supportive, cushioned shoes with medial support
Manual therapy and mobilisation – improve ankle joint mechanics and reduce compressive forces
Shockwave therapy – may help with associated tendon pain but not nerve compression itself
Anti-inflammatory strategies – activity modification, strapping, and offloading
Strengthening and mobility programs – calf and intrinsic foot exercises to improve stability
Referral pathways – to orthopaedics or neurology if surgery or nerve testing is required, with surgical decompression considered in severe cases
Symptoms
Burning, tingling, or shooting pain in the sole of the foot
Numbness in the arch, heel, or toes
Symptoms that worsen with prolonged standing, walking, or at night
Pain radiating from the ankle into the foot
Weakness or loss of intrinsic foot muscle control in advanced cases
Symptoms often confused with plantar fasciitis
Diagnosis
At Foot Foundation, diagnosis includes:
Clinical history and symptom mapping to distinguish nerve pain from plantar fascia pain
Palpation and percussion using Tinel’s sign, where tapping the nerve at the tarsal tunnel reproduces symptoms
Biomechanical assessment for pronation, arch collapse, or ankle instability contributing to nerve irritation
Imaging:
Ultrasound or MRI – to rule out space-occupying lesions
Nerve conduction studies – in severe or persistent cases to confirm nerve compression
Tarsal Tunnel Syndrome – FAQs
It is compression of the tibial nerve inside the ankle, causing burning, tingling, or numbness in the sole of the foot.
Patients often describe burning, shooting, tingling, or numbness in the arch or toes. Pain may worsen at night or with standing/walking.
Common causes include flat feet, injury swelling, cysts, varicose veins, or arthritis that narrow the tunnel and compress the nerve.
Diagnosis is based on symptom pattern, clinical testing, and imaging. Tinel’s sign is a classic test, and nerve studies or MRI may confirm the diagnosis.
Yes. With early intervention, symptoms can often be managed conservatively using orthotics, footwear changes, and rehabilitation. Severe cases may require surgical decompression.
Plantar fasciitis causes heel and arch pain in the morning that improves with movement. Tarsal tunnel causes burning/tingling pain, often at rest or night, and may involve numbness or neurological symptoms.
Yes. Orthotics correct biomechanical overload (such as overpronation) and reduce traction forces on the tibial nerve, often relieving symptoms.
Flat feet, ankle injuries, arthritis, space-occupying lesions, and systemic conditions like diabetes increase risk.
If you experience burning, tingling, or numbness lasting more than two weeks, or if pain worsens at night, you should seek assessment. Early care prevents long-term nerve damage.
Why Choose Foot Foundation?
Foot Foundation provides specialist care for nerve entrapments, with detailed biomechanical assessment, orthotic prescription, and advanced rehabilitation. We focus on accurate diagnosis, targeted treatment, and collaboration with neurologists and orthopaedic surgeons where needed.
With clinics in Rosedale, Takapuna, Remuera, Botany, Hamilton, and Tauranga, expert nerve pain care is available across New Zealand.
