Nerve Compression - Dr. Burke Orthopedics

Tarsal Tunnel Syndrome – Understanding Ankle Nerve Compression and Treatment Options

Tarsal Tunnel Syndrome (TTS) is a painful nerve compression condition that occurs when the tibial nerve—which runs along the inside of the ankle—becomes pinched or irritated as it passes through a narrow space called the tarsal tunnel.

Similar to carpal tunnel syndrome in the wrist, this condition can cause burning pain, tingling, and numbness that radiates into the foot. Left untreated, tarsal tunnel syndrome can lead to chronic pain, weakness, or loss of sensation in the foot and ankle.

At Dr. Burke Orthopedics, we specialize in diagnosing and treating nerve compression syndromes affecting the ankle and foot. Dr. Robert L. Burke, a board-certified orthopedic surgeon, provides advanced diagnostic imaging, personalized treatment plans, and both non-surgical and surgical care to help patients across Pearland, Houston, Friendswood, and Southeast Texas regain pain-free movement.

Understanding the Tarsal Tunnel

The tarsal tunnel is a small passageway inside the ankle formed by bone and a fibrous band called the flexor retinaculum. Inside this tunnel run tendons, blood vessels, and the tibial nerve, which provides sensation to the bottom of the foot and motor function to some foot muscles.

When the tunnel becomes inflamed or narrowed, pressure builds on the tibial nerve—leading to pain and nerve dysfunction.

Common causes and contributing factors include:

Repetitive stress or overuse injuries
Flatfoot deformity (causing excessive inward ankle rolling)
Trauma or ankle sprains that produce scar tissue
Cysts, varicose veins, or bone spurs pressing on the nerve
Systemic conditions like diabetes or arthritis that affect nerve health
Improper footwear or biomechanical imbalances

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Understanding the underlying cause allows for precise, long-term relief.

Symptoms of Tarsal Tunnel Syndrome

Tarsal tunnel symptoms often develop gradually and may worsen with activity or prolonged standing.

Tarsal tunnel symptoms often develop gradually and may worsen with activity or prolonged standing.

Typical symptoms include:

Burning, tingling, or numbness along the inside of the ankle or sole of the foot
Shooting or radiating pain that extends into the arch or toes
Weakness or cramping in the foot muscles
Pain that worsens after walking, running, or standing
Swelling or warmth near the inside ankle area

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In advanced cases, symptoms may persist even at rest or during the night, affecting sleep and daily comfort.

Diagnosis

Accurate diagnosis is essential since tarsal tunnel symptoms can resemble plantar fasciitis, arthritis, or neuropathy.

At Dr. Burke Orthopedics, diagnosis includes a thorough medical history, physical exam, and advanced imaging to confirm nerve compression.

Diagnostic steps may include:

Physical examination: Evaluating tenderness, tapping sensitivity (Tinel’s sign), and sensory response
Nerve conduction studies and electromyography (EMG): To assess nerve function and pinpoint compression sites
Ultrasound or MRI: To detect cysts, scar tissue, or inflammation around the tibial nerve
X-rays: To identify bony abnormalities or structural deformities

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This comprehensive approach ensures a treatment plan tailored to your individual condition.

Treatment Options at Dr. Burke Orthopedics

Non-Surgical Treatments

Mild to moderate tarsal tunnel syndrome often responds to conservative care aimed at relieving nerve pressure and reducing inflammation.

Non-surgical care includes:

Rest and activity modification to avoid repetitive ankle strain
Anti-inflammatory medications or topical treatments
Custom orthotics to correct foot alignment and reduce nerve compression
Bracing or supportive footwear for structural support
Corticosteroid or PRP injections — to reduce inflammation and promote natural healing

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Physical Therapy

Including stretching, strengthening, and nerve-gliding exercises

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With consistent therapy, many patients experience gradual relief and improved ankle function.

Surgical Treatments

When conservative treatment fails or compression is severe, surgical intervention may be necessary to release pressure on the tibial nerve.

Dr. Burke specializes in Tarsal Tunnel Release Surgery, which involves carefully opening the tunnel to decompress the nerve and remove any impinging tissue such as cysts, scar tissue, or bone spurs.

In more complex cases, Reconstructive Surgery may be performed to correct biomechanical alignment contributing to nerve stress.

Surgical benefits include:

Improved nerve function
Reduced pain and tingling
Restored mobility and stability

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Recovery and Prevention

Recovery depends on the severity of nerve compression and treatment approach:

Non-surgical care: Typically 4–6 weeks of rest, therapy, and gradual return to activity
Post-surgical recovery: Averages 8–12 weeks, followed by guided rehabilitation

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During recovery, physical therapy focuses on improving range of motion, strengthening supporting muscles, and ensuring proper gait mechanics.

Prevention strategies:

Wear supportive, cushioned shoes
Maintain healthy weight and posture
Avoid repetitive stress without rest intervals
Manage underlying conditions such as diabetes or arthritis
Manage underlying conditions such as diabetes or arthritis

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Early intervention is key to preventing permanent nerve damage and restoring full function.

When to Seek Medical Care

Contact an orthopedic specialist if you experience:

Persistent burning or tingling in the ankle or foot
Weakness or loss of sensation
Pain that radiates into the toes or arch
Difficulty walking or prolonged swelling

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Prompt diagnosis and care improve the likelihood of full recovery and prevent nerve deterioration.

Serving Our Community

At Dr. Burke Orthopedics, we proudly serve Pearland, Houston, Friendswood, and Southeast Texas, offering compassionate orthopedic care backed by medical expertise and advanced technology. Whether you’re recovering from nerve compression, joint inflammation, or chronic ankle pain, our mission is to help you move confidently again.

Restore Comfort and Mobility with Expert Nerve Care

If you’re experiencing ankle or foot pain from nerve compression, Dr. Burke Orthopedics offers proven solutions to restore comfort and mobility.

Call (713) 436-3488 or Request an Appointment Online to schedule your evaluation with Dr. Robert L. Burke, board-certified orthopedic surgeon serving Pearland, Houston, Friendswood, and Southeast Texas.

Our team provides comprehensive diagnostics, targeted treatment, and advanced surgical care to help you get back on your feet—pain-free.

Medical Disclaimer:

The information provided on this page is for educational purposes only and should not replace professional medical advice, diagnosis, or treatment. Always consult your physician or a qualified healthcare provider regarding any medical condition. If you experience sudden numbness, loss of mobility, or severe pain, seek medical attention immediately or visit your nearest emergency center.