The tarsal tunnel syndrome is a neuropathy similar to the carpal tunnel syndrome with entrapment of the posterior tibial nerve at the level of the ankle.
When to suspect the tarsal tunnel syndrome:
(1) pain in the bottom of the feet when standing or walking
(2) dysethesias in the distribution of the medial and lateral plantar nerves, including burning sensation
(3) paresthesias over the bottom of the foot with nerve compression
(4) positive Tinel's sign behind the medial malleolus
(5) tenderness of the nerve along its course (Valleix phenomenon)
(6) presence of varus heel with a pronated, splayed forefoot
Findings supporting the diagnosis:
(1) normal pulses
(2) normal reflexes
(3) normal muscle strength
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