Tarsal tunnel syndrome is a condition affecting the foot and ankle, often compared to carpal tunnel syndrome in the wrist due to similar nerve compression. It occurs when the tibial nerve, which runs through a narrow passageway near the ankle bones called the tarsal tunnel, becomes squeezed or damaged. Individuals typically report symptoms such as pain, numbness, tingling, or burning sensations in the foot, which can worsen with activity.
Immediate At-Home Actions
Immediate at-home actions can help alleviate discomfort and reduce inflammation. Resting the affected foot by reducing or stopping activities that aggravate symptoms is a primary step. Apply ice to the affected area for 15 to 20 minutes, several times a day, using a thin cloth.
Elevating the foot above the heart whenever possible helps reduce fluid buildup and pressure on the nerve. Wearing supportive footwear with adequate arch support and cushioning reduces strain on the foot and ankle. Over-the-counter arch supports or shoe inserts can provide additional stability.
Activity modification involves avoiding prolonged standing, walking, or movements that worsen symptoms. Taking regular breaks to rest and stretch the foot is beneficial if activities cannot be entirely stopped. Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help manage pain and inflammation.
Professional Non-Surgical Treatments
If at-home measures do not adequately relieve symptoms, a healthcare professional may recommend various non-surgical treatments. Physical therapy plays an important role, with therapists prescribing specific exercises and stretches to improve flexibility, strengthen foot muscles, and reduce nerve compression. Nerve gliding exercises, for instance, are designed to help the tibial nerve move more smoothly within the tarsal tunnel.
Custom or over-the-counter orthotics can provide tailored support and correct foot mechanics, especially for individuals with flat feet or high arches, by helping to maintain a proper arch and limit excessive motion that compresses the nerve. Braces or splints may also be used to immobilize the foot and ankle, which helps encourage nerve healing by reducing stress on the tarsal tunnel.
Corticosteroid injections can be administered directly into the tarsal tunnel to reduce localized inflammation and pain around the nerve. This approach provides targeted relief. For persistent pain, a doctor might prescribe stronger oral medications, including prescription-strength anti-inflammatory drugs or nerve-pain medications like gabapentin. These medications aim to manage symptoms when other treatments are insufficient.
Surgical Options
Surgery is typically considered only after conservative treatments have failed or if there is evidence of progressive nerve damage. It is often a last resort for severe, persistent symptoms that significantly impact daily activities. The most common surgical procedure is tarsal tunnel release, which decompresses the tibial nerve.
During this procedure, an incision is made, often along the inner ankle, to access the tarsal tunnel. The surgeon then cuts the flexor retinaculum, a thick ligament that forms the roof of the tunnel, to relieve pressure on the tibial nerve and its branches. Any abnormal growths, such as bone spurs or cysts, contributing to nerve compression are also removed.
Recovery after tarsal tunnel release involves a period of immobilization and gradual weight-bearing. Full recovery typically takes several weeks to months. Physical therapy is recommended post-surgery to restore strength and mobility. While many patients experience significant relief, symptom subsidence time varies depending on the severity and duration of nerve compression.
Ongoing Care and Recurrence Prevention
Long-term management involves strategies to prevent recurrence and maintain foot health. Maintaining a healthy weight helps reduce stress and pressure on the feet and ankles, alleviating strain on the tibial nerve. Choosing appropriate footwear, including shoes that provide good support and cushioning for daily activities and exercise, is also important.
Regular, low-impact exercise that does not aggravate the foot helps maintain flexibility and strength without placing undue stress on the ankle. Specific stretches for the calf muscles and nerve gliding exercises can be incorporated into a routine to support nerve health and flexibility. Individuals should remain attentive to any returning symptoms and seek medical attention promptly if they reappear. Early intervention can prevent minor issues from escalating.
Adjusting workspaces or daily activities to minimize prolonged pressure on the feet and ankles is also beneficial, which might involve taking regular breaks from standing or using ergonomic supports. Adhering to a healthcare provider’s recommendations and attending all follow-up appointments are important for monitoring recovery and making any necessary adjustments to the treatment plan. This ensures ongoing support for foot health.