How is tarsal tunnel syndrome treated?

Tarsal tunnel syndrome involves pressure or irritation of the posterior tibial nerve as it passes behind the inner ankle. It can cause burning, tingling, numbness, or pain into the heel and sole. The symptoms may change with standing, walking, ankle position, or pressure on the tunnel.

Assessment includes foot and ankle movement, sensation, strength, alignment, and a search for swelling or another source of nerve symptoms. Nerve tests or imaging may be used when the diagnosis is uncertain or symptoms are persistent.

Start by reducing activities that trigger symptoms and choosing footwear that does not compress the inner ankle. Custom orthotics may help redistribute pressure when foot shape or movement contributes. Physiotherapy can address ankle mobility, calf flexibility, strength, balance, and gradual loading.

Pain relief may be discussed according to your health history. A cortisone injection can sometimes be used around the irritated area, but it is not suitable for everyone and should be performed by an experienced clinician. Surgery to release the tunnel is reserved for selected cases with persistent symptoms or a clear compressive cause.

Arrange a review for ongoing heel pain, leg numbness and tingling, altered walking, or weakness in the foot. Seek prompt care if numbness is rapidly spreading, the foot becomes markedly weak, or a swollen, red, hot area is accompanied by fever or severe pain.

Ask what is pressing on the nerve, whether footwear or orthotics could help, and which exercises are safe. If an injection or operation is suggested, ask what result it targets and how nerve function will be monitored.