Atypical Presentation of Tibial Nerve Entrapment Coexisting with Flexible Flat Foot

Introduction: tarsal tunnel syndrome presents with typical pain and paresthesia around the ankle and medial aspect of the foot. Flexible flatfoot results from posterior tibial tendon insufficiency can also present with above symptoms. The deformity in the early stages of flatfoot, may be overlooked due to its mild nature. Here we present a case of 45-year-old lady, presented with symptoms of tarsal tunnel syndrome associated with flexible flat foot. We highlight the importance of the good clinical acumen to gauge the tarsal tunnel syndrome coexisting with flexible flatfoot by the appropriate investigations and custom made management. It is essential to consider the co-existing deformities in the foot, when a patient comes with the tarsal tunnel syndrome like presentation and vice versa. It is also important to know the aetiology of each component along with the clinical assessment and appropriate investigations, before planning a management protocol. A custom made approach may be the answer, considering the patient’s clinical, occupational, social conditions and radiological observations.