Does physiotherapy treat tarsal tunnel syndrome?

Tarsal tunnel syndrome involves pressure or irritation affecting the posterior tibial nerve as it passes behind the inner ankle. Symptoms can include burning, tingling, numbness or aching in the sole and may extend into the toes. A physiotherapist can assess ankle movement, calf flexibility, foot strength, walking pattern and activities that increase symptoms. Treatment may include gentle mobility work, calf and foot strengthening, balance exercises, advice on footwear and changes to aggravating activity. Nerve-gliding exercises may be considered when appropriate. Physiotherapy cannot remove every possible cause of nerve compression, so the plan depends on the examination and the suspected source.

Arrange an assessment if symptoms persist, recur or interfere with walking, work or sleep. Follow the exercise dose provided rather than pushing through increasing tingling. Use comfortable footwear, vary standing and walking demands, and record which positions or activities bring symptoms on. A clinician may coordinate physiotherapy with other care if weakness, a structural problem or another nerve condition is suspected.

Seek prompt medical advice for new or worsening foot weakness, loss of balance, rapidly spreading numbness, severe pain after an injury, or a foot that becomes unusually cold or changes colour. Persistent numbness also deserves assessment because prolonged nerve irritation can affect sensation and muscle control.

Ask what is irritating the nerve, which activities should be modified, how exercises should feel, and what findings would require imaging, nerve testing or a different treatment.