Does custom orthotics treat tarsal tunnel syndrome?

Tarsal tunnel syndrome involves irritation or compression of the posterior tibial nerve as it passes behind the inner ankle. Symptoms may include burning, tingling, numbness or aching in the sole and toes. A custom orthotic can influence how the foot loads during standing and walking, potentially reducing strain on tissues around the nerve. It cannot remove every possible source of compression, and symptoms may instead come from the back, a general nerve problem or another foot condition. A physical examination helps distinguish these possibilities and checks strength and sensation.

Book an assessment if symptoms recur or interfere with walking. Until then, choose comfortable footwear with enough room, avoid activities that clearly trigger tingling, and do not place prolonged pressure on the inner ankle. If orthotics are recommended, use the prescribed fit and allow a gradual adjustment period. Treatment may also involve activity modification, exercises, or other options chosen after the cause and severity of nerve irritation are clear.

Seek prompt medical advice for increasing numbness, new weakness, loss of balance or difficulty lifting the foot. Urgent care is appropriate for sudden severe symptoms after an injury, a cold or discoloured foot, or rapidly increasing swelling. Ongoing burning or altered sensation should be assessed rather than masked with a device, because persistent nerve compression can need a different treatment plan.

Ask: Is the tibial nerve being compressed at the ankle, or could symptoms come from elsewhere? Would an orthotic change my foot loading? What footwear and activities should I avoid? How quickly should numbness or tingling be reviewed? What findings would make another treatment more suitable?