Posterior Tibial Nerve Entrapment and Compression

Posterior Tibial Nerve Entrapment and Compression can lead to a painful nerve condition known as peripheral mononeuropathy; also known as neuralgia. This is temporary damage to the nerve could potential become permanent if left untreated. The posterior tibial nerve can become entrapped or compressed in a variety of different areas. The common spots are all around the inside of the heel and ankle. But the pain can radiating into the foot and up the leg.



A Quick Check for Posterior Tibial Nerve Entrapment and Compression:

Do a quick test by pressing with your thumb between your inside ankle and the heel. If the pain radiates this is almost definitely what you have. But if it does not, it still does not rule out Posterior Tibial Nerve Entrapment and Compression.



Symptoms of Posterior Tibial Nerve Compression

Nerve pain is distinguished from muscle, tendon and bone pain by the type of pain it causes. Non-nerve pain usually produces more of a throbbing and aching soreness, while nerve pain causes numbness burning and tingling. Other symptoms of posterior tibial nerve compression and entrapment include:

  • Numbness burning and tingling around the ankles and possibly even the toes.
  • Swelling of the feet.
  • A shocking electrical sensation.
  • Pain radiating towards the foot, towards the leg or both.
  • Changes in temperature- Hot or cold.
  • Pain along the inside of the ankle.
  • “Pins and needle” pricking like sensation.
  • Postive Tinel or Valleix Sign.


The Posterior Tibial Nerve can experience entrapment and compression in two common sites:

1) Tarsal Tunnel Syndrome

  • The most common site of posterior tibial nerve entrapment and compression is in the tarsal tunnel. This is where the posterior tibial nerve travels between the calcaneus and the flexor retinaculum ligament. It travels along with the posterior tibial artery, the posterior tibialis muscle, the flexor digitorium longus muscle and the flexor hallucis longus muscle. This is a prime site for constriction of both the medial and lateral plantar nerves that are the terminal divisions of the posterior tibial nerve. The constriction can occur before, in the middle and after the tarsal tunnel in equal 1/3rd proportions.

2) Medial Calcaneal Nerve Impingement

  • The medial calcaneal nerve is a nerve that comes off the posterior tibial nerve punctures through the flexor retinaculum (a ligament that holds the neurovasculature protected against the inside of the ankle) on the inside of the ankle. The site where the medial calcaneal nerve pierces through the ligament is a primary site of constriction; this can mimic pain in a region close to the site of plantar fasciitis.


For More on a Painful Arch and Bottom of the Foot:

The Complete Painful Arch and Bottom of the Foot Treatment Guide.