Tarsal tunnel syndrome occurs when the tibial nerve is compressed or damaged. The causes of tarsal tunnel syndrome can be divided into two main categories: intrinsic factors, originating from the internal structures of the foot, and extrinsic factors, influenced by the external environment.

Intrinsic factors (intrinsic causes) stem from the foot's own anatomy or internal conditions. These factors include flat feet or high arches, ganglion cysts, tendon problems, varicose veins, bone spurs due to calcification, lipomas (fatty lumps) on the sole of the foot, tumors, systemic diseases such as hypothyroidism, diabetes, or arthritis, and constrictions originating from the nerve sheath.

Extrinsic factors, on the other hand, arise from external environmental influences or traumas. The primary extrinsic causes include inappropriate shoe choice, foot traumas or impacts, post-surgical scar tissue formation, and abnormalities in foot anatomy.