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.
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
Understanding the underlying cause allows for precise, long-term relief.
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
In advanced cases, symptoms may persist even at rest or during the night, affecting sleep and daily comfort.
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
This comprehensive approach ensures a treatment plan tailored to your individual condition.
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
- Including stretching, strengthening, and nerve-gliding exercises
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
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
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
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
Prompt diagnosis and care improve the likelihood of full recovery and prevent nerve deterioration.
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.
