Neuropathy - posterior tibial nerve; Tarsal tunnel syndrome
Tibial nerve dysfunction is a loss of movement or sensation in the foot from damage to the
Tibial nerve dysfunction is an unusual form of peripheral neuropathy. It occurs when there is damage to the tibial nerve. This nerve is one of the lower branches of the sciatic nerve of the leg. It supplies movement and sensation to the calf and foot muscles.
A problem in function with a single nerve group, such as the tibial nerve, is called mononeuropathy. The usual causes are:
Entrapment creates pressure on the nerve when it passes through a narrow structure.
The damage may destroy the myelin sheath that protects and insulates the nerve, or part of the nerve cell (the axon). This damage reduces or prevents the movement of signals through the nerve.
The tibial nerve is often injured by pressure from a ligament on the inner part of the ankle. Injury or disease of structures near the knee may also damage the tibial nerve. The tibial nerve may also be affected by diseases, such as diabetes, which damage many nerves.
In some cases, no cause can be found.
Symptoms may include any of the following:
In severe cases, the foot muscles are very weak and the foot can be deformed.
Your health care provider will examine your legs and ask about your symptoms.
During the exam, your provider may find you have the following signs:
Tests for tibial nerve dysfunction may include:
Treatment is aimed at restoring feeling and strength to the foot and toes. In some cases, no treatment is needed, and people will recover on their own. Severe loss of sensation may lead to toe or foot sores (ulcers) and infections.
Surgery to enlarge the tarsal tunnel or transfer the nerve helps reduce pressure on the tibial nerve. This may help some people.
Over-the-counter pain medicines may relieve mild pain. Other medicines may be prescribed to help control severe pain.
Physical therapy may help some people maintain muscle strength.
A change in job or retraining may be recommended.
Untreated, tibial nerve dysfunction may lead to the following:
Call your health care provider if symptoms of tibial nerve dysfunction are present. Early diagnosis and treatment increases the chance that symptoms can be controlled.
Prevention varies depending on the cause of the nerve damage.
Katitji B, Koontz D. Disorders of the peripheral nerves. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC. Bradley's Neurology in Clinical Practice. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 76.
Shy ME. Peripheral neuropathies. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 420.
Last reviewed on: 2/3/2015
Reviewed by: Amit M. Shelat, DO, FACP, Attending Neurologist and Assistant Professor of Clinical Neurology, SUNY Stony Brook, School of Medicine, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.