Tarsal tunnel syndrome results when the posterior tibial nerve is compressed within the tarsal tunnel. This condition is very similar, in mechanism, to carpal tunnel syndrome in the wrist. Both of these conditions result when a nerve in pinched within a confined space.
The tarsal tunnel, as mentioned previously, has little room to give. When the space becomes tight, the tibial nerve is pinched. Venous insufficiency and the attendant increase in venous pressure in the veins of the leg and ankle area may cause excess fluid accumulation in the tarsal tunnel and is one of the recognized causes of tarsal tunnel syndrome.
Venous ultrasound evaluation can definitively establish the diagnosis and stratify the severity of venous disease. A positive response to a conservative trial of elevation and compression hose is a good predictor of response to treatment of the underlying venous insufficiency.
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