What is the first treatment for tarsal tunnel syndrome?

Tarsal tunnel syndrome involves irritation or compression of the posterior tibial nerve as it passes behind the inner ankle. Burning, tingling, numbness, or aching may extend into the sole or heel. Initial care is selected after checking the foot, ankle, nerve function, footwear, and possible contributors such as swelling or altered foot alignment. The aim is to reduce repeated pressure and give irritated nerve tissue room to settle, while preserving comfortable movement.

Choose roomy, supportive footwear and reduce activities that repeatedly increase symptoms until you have a plan. Custom Orthotics may be considered when foot mechanics contribute to nerve loading. Physiotherapy can address ankle movement, calf flexibility, strength, balance, and graded activity. A Cortisone Injection may be discussed in selected cases after examination, but it is not suitable for everyone and does not replace finding the cause of compression. Avoid self-treating persistent numbness because reduced sensation can make pressure injuries easier to miss.

Arrange a clinical assessment for ongoing tingling, numbness, burning foot pain, or weakness. Seek urgent care if weakness develops quickly, the foot becomes cold or discoloured, sensation is suddenly lost, or symptoms follow a serious injury. A wound on a numb foot also deserves prompt review.

Ask whether your symptoms fit nerve compression, whether another condition needs to be excluded, and which footwear or activity changes are appropriate. Ask how nerve strength and sensation will be monitored and when injection or specialist review should be considered.