diagnosis

Last reviewed 01/2018

  • mainly a clinical diagnosis
    • palpation along the course of the nerve in the tarsal tunnel may elicit discomfort either locally or distally
      • tarsal tunnel is on the medial aspect of the ankle passing from just behind the tibial malleolus towards the distal aspect of the calcaneus/navicular region
      • tibial nerve splits into three (medial calcaneal, medial plantar and lateral plantar nerves), often with several branches in the region
    • symptoms may be accentuated by passive pronation of the foot
    • percussion of the nerve may cause symptoms distally (Tinel's sign) or proximally (Valleix phenomenon)
    • X-rays, ultrasound and MRI scans are all helpful in diagnosing pathology that may cause nerve irritation
      • nerve conduction studies are often reported for diagnosis - however it is not uncommon for these to be normal despite clinical symptoms (1)

Reference:

  1. ARC. Common foot disorders. Hands On 2006;10:1-6.