Tarsal Tunnel Syndrome vs. Plantar Fasciitis

Plantar fasciitis and tarsal tunnel syndrome are two foot-related conditions that cause pain along the soles of your feet, but they’re two different problems with two different causes, so it’s important to get an accurate diagnosis before you start treatment.

At Chicagoland Foot and Ankle, our board-certified podiatrists diagnose and treat both plantar fasciitis and tarsal tunnel syndrome at our four offices in the Chicago, Illinois, area. 

Because many of our patients aren’t aware of the difference between the two conditions and what they can do to decrease their risks of developing both, we’ve taken this opportunity to give a blow by blow of causes, risks, and treatment.

Causes, risks, and treatment of plantar fasciitis

The plantar fascia is a thick ligament that connects the calcaneus bone at the back of your heel to your toes. As it passes under the sole, it stretches like a bowstring to help maintain your foot arch. It also acts as a shock absorber when you walk, run, or jump.

If the fascia is subjected to severe shocks over time, or too much pressure, it becomes irritated and inflamed or develops small tears. The result is plantar fasciitis, characterized by pain in the heel.

Because the tissue tightens while you sleep, your pain is usually worse in the morning, and you have to stretch it out when you get up. If your case is severe, though, the ligament may resist stretching, and you’ll experience pain and tenderness all day.

While repetitive strain is a major cause of plantar fasciitis, other contributing factors include trauma, poor foot alignment, and/or shoes that don’t fit well.

In addition, certain people have an increased risk of developing plantar fasciitis. You may be at risk if you:

• Are a woman
• Are overweight, obese, or pregnant
• Are 40-70 years old
• Have flat feet or very high arches
• Have tight Achilles tendons
• Inwardly pronate your foot (ankle turns inward as you walk)
• Often wear high heels
• Spend a lot of time on your feet
• Wear shoes with thin soles or no arch support

If left untreated, the problem can lead to knee, foot, hip, and/or back problems.

At Chicagoland Foot and Ankle, we start with conservative treatments, such as lifestyle changes and targeted pain relief solutions. 

Ice packs, oral anti-inflammatories, or steroid injections can help if the pain is severe. We might also recommend custom orthotics, night splints, and physical therapy to help with pain while encouraging healing. 

Causes, risks, and treatment of tarsal tunnel syndrome (TTS)

TTS is also an overuse or repetitive stress injury, and it presents with burning, tingling, and pain in the sole of your foot that worsens during or after physical activity. 

But it has a very different cause than plantar fasciitis. TTS occurs when you have a damaged or compressed tibial nerve, which is one of the nerves that runs through your ankle and its tarsal tunnel. The tarsal tunnel is a passageway made up of bones and ligaments.

Tarsal tunnel syndrome occurs when something damages your tibial nerve. Causes include:

• Flat feet or high arches
• Injuries, such as a ligament sprain or bone fracture
• Growths, such as ganglion cysts, bone spurs, or varicose veins
• Masses, such as lipomas or tumors, that form near the tibial nerve
• Underlying conditions, such as hypothyroidism, diabetes, and arthritis

More than 2 in 5 people with the tarsal tunnel syndrome have a history of injuries such as ankle sprains.

Interestingly, despite the different causes of TTS, treatments for it are much the same as for plantar fasciitis, including over-the-counter anti-inflammatories, ice packs, steroid injections, and well-fitting shoes, as well as custom orthotics and physical therapy.

We may also prescribe a brace to keep the nerve immobile until it heals.

If you have pain in the soles of your feet, you could have either plantar fasciitis or tarsal tunnel syndrome. To get an accurate diagnosis and appropriate treatment, give us a call at any of our locations, or book your appointment online today.

Our offices are in the Mount Greenwood and Portage Park areas of Chicago, as well as Orland Park and New Lenox, Illinois.