How long do custom orthotics take to work for tarsal tunnel syndrome?

Tarsal tunnel syndrome involves irritation or compression of the posterior tibial nerve around the inside of the ankle. A custom orthotic may support the foot and change loading through the ankle, which can reduce a mechanical contributor for some people. It does not directly repair an irritated nerve, and improvement is not measured only by pain: tingling, burning, altered sensation, and foot strength matter too. A new device should feel supportive rather than sharply restrictive.

Use the wearing schedule from your podiatrist, physiotherapist, or orthotist and increase time gradually. Check your skin after wearing them, especially if sensation is reduced. Wear shoes that hold the heel securely and do not squeeze the toes or inner ankle. Temporarily reduce activities that reproduce burning or tingling, then follow the strengthening and mobility plan you were given. Keep track of whether symptoms are becoming less frequent, less intense, or easier to trigger; this helps the clinician judge whether the device is useful. A fit review is appropriate if symptoms increase or the orthotic causes pressure.

Arrange medical review promptly if numbness spreads, foot weakness develops, you begin tripping, or symptoms interfere with walking. Seek urgent assessment after a sudden loss of strength or rapidly increasing swelling. Ongoing burning or tingling despite a sensible trial should prompt reassessment of the nerve, ankle, footwear, and possible alternative causes rather than simply wearing the orthotics for longer.

Ask what improvement to track, how long your planned trial should last, whether nerve testing or imaging is needed, and how to adjust activity while symptoms are active. Ask which changes should lead you to stop wearing the device and return sooner.