You might know the feeling: a sharp, shooting pain in your ankle, numbness on the bottom of your foot, or a burning sensation that just won’t go away. It can feel like you’re always walking on a pebble, or an electrical shock zipping through your heel. For many people feeling them for the first time, these symptoms are confusing. Is it a sprain? Plantar fasciitis?
Often, these symptoms point to tarsal tunnel syndrome (TTS), a condition that can be tricky to identify because its symptoms sometimes overlap with other foot problems. While plantar fasciitis involves the inflammation of the tissue band on the bottom of the foot, TTS happens when the posterior tibial nerve in your foot becomes compressed or pinched. This nerve runs through a narrow passage of tissue inside your ankle known as the tarsal tunnel, which can press on the nerve under certain conditions.
Getting a diagnosis is a huge relief, but it often leads to more questions. You might wonder how it happened in the first place, or worry that it might keep coming back even after it heals initially. Understanding and treating the root cause of your pain is the first step toward finding a solution that lasts, no matter what your lifestyle looks like now or in the future.
Potential causes of tarsal tunnel syndrome
To understand how to treat this condition, it helps to understand exactly what is happening inside your ankle. The tarsal tunnel is a small space where arteries, veins, tendons, and nerves pass through the bottom of your foot. Think of it like a highway tunnel. If anything takes up too much space—like swelling or a cyst—or if the tunnel narrows due to the position of your foot, traffic gets jammed. In the case of tarsal tunnel syndrome, the "traffic jam" compresses the tibial nerve.
When the nerve is squeezed, pain and other symptoms follow. They can occur in just one foot or both feet, which usually helps a medical professional diagnose the underlying cause.
There are several causes and aggravating factors that can induce tarsal tunnel symptoms:
- Flat feet or fallen arches: When your arch collapses, your heel tilts outward, which can pull the structures around the tarsal tunnel tight, compressing the nerve.
- Swelling and inflammation: An ankle sprain, arthritis, or even concurrent condition like diabetes can cause swelling of the tarsal tunnel itself that presses on the nerve.
- Overuse: Standing for long periods, especially on hard surfaces, can fatigue your leg muscles and lead to inflammation.
- Unsupportive footwear: Shoes that don't support your arch or that are too tight can force your foot into unnatural positions.
Because the causes vary so much, what works for one person may not work for you. A runner with flat feet needs a different approach than a factory worker standing on cement all day, even if they both have the same diagnosis.
How to help tarsal tunnel syndrome symptoms
If you are currently in pain, your immediate goal is often finding a way out of it. There are several conservative treatments that can help calm the inflammation and give the nerve some breathing room.
- Rest and ice: It sounds simple, but staying off your feet allows the inflammation to subside. Icing the inner ankle can also reduce swelling that might be pressing on the nerve.
- Anti-inflammatories: Non-steroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and swelling temporarily.
- Footwear changes: Switching to shoes with better arch support or a wider toe box might relieve pressure through your foot that worsens symptoms.
- Bracing: A specialized tarsal tunnel syndrome brace can help immobilize the foot to prevent movements that stretch or compress the nerve, particularly while you sleep or during heavy activity.
However, a word of caution: if you are self-diagnosing and trying these methods without success, you may not be dealing with tarsal tunnel syndrome. Other conditions, such as lumbar spine issues, inflammatory conditions, or neuropathies, can present similar symptoms.
If home remedies aren't working, or if the pain is becoming severe, please seek out a physical therapist or your primary care provider for a formal diagnosis.
Address tarsal tunnel compression through aligned biomechanics
For many people, the treatments listed above provide temporary relief, but the pain returns once they resume their normal activities. This is often because the underlying issue is not simple overuse or a one-time injury, but rather your biomechanics.
Biomechanics refers to how your bones, muscles, and tendons work together when you move. If your biomechanics are misaligned, your body compensates, often in suboptimal ways that can cause pain over time. In the case of TTS, the most common culprit is overpronation (when your foot rolls inward excessively). This rolling motion twists the tarsal tunnel and pinches the nerve tightly.
Whether you are an elite athlete pushing your limits or someone simply navigating daily life, correcting these imbalances is possible. This is where custom solutions make a significant difference.
The role of custom orthotics
For those with biomechanical imbalances, custom orthotics for tarsal tunnel syndrome is a highly effective way to address the root mechanical cause of the pain. Unlike generic shoe inserts you might buy at a pharmacy, custom orthotics are tailored to your unique anatomy.
Generic inserts often focus on just cushioning or providing a generic "bump" for arch support. While cushioning might feel nice at first, it doesn't necessarily correct the angle of your heel or the rotation of your ankle.
Custom orthotics are designed to:
- Realign the foot: By supporting the arch and heel in the correct neutral position, orthotics prevent the foot from rolling inward. This opens up the tarsal tunnel, relieving pressure on the tibial nerve.
- Distribute pressure: Orthotics help spread your weight evenly across your foot, reducing strain on specific areas that might be inflamed.
- Provide tailored support: With TTS, there is such a thing as "too much" support. If an arch support is too high or too rigid, it can actually over-correct and cause supination, which can also pinch the tarsal tunnel. A custom orthotic is designed to ensure the support is applied exactly where you need it—and nowhere you don't.
By correcting the mechanics of how you walk and stand, custom orthotics don't just treat the symptom; they help prevent the condition from recurring.
Your custom orthotics at Biocorrect
Living with foot pain can feel limiting, but you don't have to sideline your active lifestyle forever. At Biocorrect, we understand that every foot, every lifestyle, and every experience of foot pain is different.
Our team creates custom orthotics designed to address your specific biomechanical deficits. Whether you need to offload pressure from a sensitive nerve or correct a collapsing arch, we build a solution that fits your life.
Request your appointment at our West Michigan fabrication lab or start the virtual appointment process by contacting our team today.
