What are the treatment options for tarsal tunnel syndrome?

Tarsal tunnel syndrome is compression or irritation of the posterior tibial nerve as it passes behind the inner ankle. It can cause burning, tingling, numbness or aching in the ankle and sole. Treatment is tailored to whether foot shape, swelling, injury, diabetes or another issue is increasing pressure in the tunnel.

Assessment may include sensation, muscle strength, ankle movement and walking pattern. The plan aims to reduce nerve irritation while preserving movement and preventing weakness from progressing.

Physiotherapy may address ankle mobility, calf flexibility, nerve movement, balance and strength, while also changing activities that provoke symptoms. Custom orthotics can alter foot loading when alignment or arch movement contributes to nerve pressure. Footwear with enough space and cushioning may also reduce local irritation.

A cortisone injection may be discussed when symptoms remain troublesome and the clinician believes an injection is appropriate. It is not suitable for everyone and should be explained in relation to nearby nerves, tendons and other risks. If weakness, a clear structural cause or persistent symptoms remains, a specialist may discuss surgical decompression.

Arrange an assessment for recurring tingling or numbness in the sole, burning behind the inner ankle, or symptoms that affect balance and walking. Seek prompt care for new or worsening foot weakness, inability to lift or move the foot normally, rapidly spreading numbness, or severe swelling after an injury.

Ask what may be compressing the nerve, whether your foot mechanics need orthotics, and which exercises are suitable. Ask what an injection would target, how nerve function will be monitored, and when a surgical opinion is needed.