Tarsal tunnel syndrome is most common in active adults. The burning or tingling sensation it causes is a result of the compressed tibial nerve. Other symptoms may include numbness and shooting pain along the bottom of the foot or the inside of the ankle that may extend to the heel, arch, toes and even the calf. These symptoms are often brought on or aggravated by overuse of the foot including prolonged standing, walking, exercising for extended periods of time, or beginning a new exercise program. Early detection and treatment is very important in order to avoid permanent nerve damage. In athletes, this condition is usually the result of an ankle sprain and can also be brought on by a ganglion cyst, an arthritic bone spur, or a fallen arch. Conservative treatment such as arch supports and wider shoes may successfully relieve the discomfort of tarsal tunnel syndrome along with anti-inflammatory drugs. Steroid injections also may prove effective, and if the problem is caused by flat feet, custom orthotics can help restore the foot’s natural arch. If surgical treatment is necessary, your podiatric surgeon will make an incision behind and below the inside of the ankle and will cut the laciniate ligament, providing room for expansion of the nerve. If a cyst is impinging on the nerve, it can be removed to provide enough space to prevent the nerve from being compressed.