Numbness in the Heel?
This article was medically reviewed by Dr. Kimberly Langdon, M.D.
Tarsal Tunnel Syndrome is the most common cause of numbness in the heels.
Often confused with plantar fasciitis, tarsal tunnel sufferers experience numbness, tingling, or the feeling of “pins and needles” rather than sharp, stabbing, or throbbing pain that is found with plantar fasciitis.
Why Does Tarsal Tunnel Cause Numbness in the Heels and Feet?
The tarsal tunnel is a canal linking part of the ankle bone, called the medial malleolus, to a set of ligaments, called the flexor retinaculum, which spans the foot.
The tendons, nerves and arteries that enable your foot to be flexible and mobile are located inside of this canal. Tarsal tunnel syndrome results from the tibial nerve (arising from the calf muscle) becoming compressed inside the tarsal tunnel. The tibial nerve is what enables you to experience sensations along the bottom of your foot, and works with the muscle of your calf to make flexing the foot and toes possible. The tarsal tunnel and tibial nerve play a vital role in your ability to stand, walk and run.
A hallmark symptom of Tarsal Tunnel Syndrome is numbness in the heel or in other areas of the foot. Symptoms may also include shooting pain and tingling sensations. Tarsal tunnel syndrome is like carpal tunnel syndrome which occurs in the hands as a result of a compressed nerve in the canal in the wrist.
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Who Is At Risk For Tarsal Tunnel Syndrome?
Tarsal Tunnel Syndrome can occur at any age, but specific factors may make you more prone to developing this condition. Check this list to see if any of the risk factors apply to you:
- The presence of any disease, including arthritis, that causes swelling. Swelling can result in the tibial nerve becoming compressed in the foot.
- A physical anomaly, such as a swollen tendon, a heel spur, a ganglion cyst or a varicose vein. These physical abnormalities can result in nerve compression.
- Conditions such as fallen arches or flat feet can trigger compression of the tibial nerve.
- An irregular gait that puts undue pressure on the tarsal tunnel.
- Participation in high-impact sports such as running and basketball.
- An injury to the ankle bone, such as a sprain, which results in nerve compression.
If you are experiencing prolonged numbness in one or both heels and have noticed that any of the above factors apply to you, you should seek medical attention to receive an expert diagnosis. Your General Practitioner may refer you to a neurologist who will conduct a variety of tests, including an EMG, X-ray, CT or MRI in order to reach a diagnosis. Depending on the medical findings, you will then be able to explore a variety of treatment options.
Treatment Options For Tarsal Tunnel Syndrome
Whenever possible, conservative, non-invasive treatment methods should be utilized to resolve the cause and symptoms of Tarsal Tunnel Syndrome. While extreme cases may require surgery, many Tarsal Tunnel Syndrome sufferers can recover with a combination of the following aides:
- Resting the foot; abstaining from activities that put pressure on the tarsal tunnel (ankle and foot)
- Icing the foot to reduce inflammation and provide temporary relief from symptoms
- The use of anti-inflammatory medicines, as prescribed by a doctor
- The use of steroid injections, under the care of a physician
- The use of orthotics, such as braces, splints or inserts, at the recommendation of a doctor
If none of the above non-invasive modalities result in resolution of heel numbness and pain, your doctor may suggest surgery.
What is Tarsal Tunnel Surgery?
Tarsal tunnel release surgery is typically an out-patient procedure requiring general anesthesia or possibly a combination of local, IV sedation, and epidural. The surgeon makes a small incision behind the inner ankle bone, opens the tarsal tunnel and releases the tibial nerve at all compression points. The incision is then sutured closed and the sutures are typically removed after about ten days.
An ace bandage will be wrapped around the treated area of the foot and should be worn at all times for the time period specified by the surgeon. The goal of tarsal tunnel release surgery is complete healing from symptoms, and most, but not all patients will enjoy a successful outcome from the procedure. Before undergoing surgery of any kind, please discuss the risks and benefits of the procedure with your doctor.