How effective is physiotherapy for tarsal tunnel syndrome?

Tarsal tunnel syndrome involves irritation or compression of the tibial nerve as it passes behind the inner ankle. A physiotherapist may examine ankle and foot movement, calf flexibility, strength, walking pattern and activities that increase pressure. Treatment can include gentle mobility, nerve movement techniques, calf and foot strengthening, balance work, footwear advice and changes to standing or walking loads. These measures may help function, but they cannot remove every structural cause of compression.

Have the diagnosis and possible cause assessed before starting exercises, especially if symptoms include burning, electric sensations or altered feeling in the sole. Follow the prescribed dosage and increase activity gradually. Supportive footwear and temporary changes to hills, prolonged standing or high-impact exercise may reduce irritation. Tell the therapist if tingling spreads, sensation changes or the foot feels weaker after treatment.

Arrange prompt medical review for progressive weakness, worsening numbness, frequent tripping, loss of balance or difficulty lifting or controlling the foot. Seek urgent care for sudden severe weakness, major injury, a cold or discoloured foot, or rapidly increasing swelling. Persistent symptoms despite a tailored programme may require further nerve or structural assessment.

Ask what may be compressing the nerve, which activities or shoes to modify, how sensation and strength will be monitored, and when specialist review should be considered.