Medial tarsal tunnel syndrome: a review

The medial tarsal tunnel syndrome is a compression neuropathy involving the tibial nerve or its branches as they pass through the tarsal tunnel under the flexor retinaculum. Medial tarsal tunnel syndrome is not recognized as readily as its counterpart in the wrist. This syndrome can lead to a painful burning sensation in the medial border of the foot and into the great toe. In its fullest extent medial tarsal tunnel syndrome can involve sensory changes in the heel and the lateral part of the sole of the foot as well as the remaining toes. In addition, it may lead to weakness of the intrinsic muscles of the foot. This syndrome often goes unrecognized or misdiagnosed particularly in the athlete. While medial tarsal tunnel syndrome may respond initially to nonoperative techniques of ultrasound and modification of footwear, as it progresses surgical release of the nerve in the tunnel will be required for optimal results. This paper reviews the anatomy, etiology, pathology, clinical presentation, and treatment of the medial tarsal tunnel syndrome. In order to bring more attention to this condition, our clinical experience is presented.J Orthop Sports Phys Ther 1984;6(1):39-45.