Tarsal coalition

A tarsal coalition is an abnormal connection that develops between two bones in the back of the foot (the tarsal bones). This abnormal connection, which can be composed of bone, cartilage, or fibrous tissue, may lead to limited motion and pain in one or both feet.

Usually, tarsal coalition occurs before birth, resulting in the individual bones not forming properly. Other causes, though relatively rare, include infection, arthritis, or a previous injury to the area.


While many people who have a tarsal coalition are born with this condition, the symptoms generally do not appear until the bones begin to mature, usually around ages 9 to 16. Sometimes, there are no symptoms during childhood. However, pain and symptoms may develop later in life. These symptoms can include:

  • Pain (mild to severe) when walking or standing
  • Tired or fatigued legs
  • Muscle spasms in the leg, causing the foot to turn outward when walking
  • Flatfoot (in one or both feet)
  • Walking with a limp
  • Stiffness of the foot and ankle


Depending on the severity of the condition, any of the following may be used:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be helpful in reducing the pain and inflammation.
  • Physical therapy, including massage, range-of-motion exercises, and ultrasound therapy.
  • Steroid injections (cortisone). Sometimes more than one injection is necessary.
  • Orthotic devices – these can be beneficial in distributing weight away from the joint.
  • Immobilisation. The foot is placed in a cast or cast boot, and crutches are used to avoid placing weight on the foot.
  • Injection of an anaesthetic agent may relax spasms and is often given before immobilisation.

If the patient's symptoms are not adequately relieved with nonsurgical treatment, surgery is an option.