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Tarsal Tunnel Syndrome: Care Instructions

Bones, tendons, ligament, and tibial nerve in the inner ankle area (tarsal tunnel) of the foot


Tarsal tunnel syndrome is a squeezing or pinching of the tibial nerve. This nerve runs down the back of the leg to the inner ankle. In this area of the ankle joint, a complex mix of nerves, tendons, and ligaments meet. This makes it more likely that the tibial nerve could become pinched.

Certain things may increase your risk of the nerve being pinched. They include:

  • An injury to the ankle.
  • Being on your feet a lot.
  • Being an athlete.
  • Rolling the ankle inward when you walk or run (pronation).
  • A tissue mass or cyst.
  • Inflammation or swelling in the area.

Symptoms include burning foot pain. You may also have aching, numbness, and tingling in the sole or arch of the foot.

At first, treatment may include rest, ice, and non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen or naproxen. It can also include footwear that supports your feet. Examples are arch supports, custom orthotics, and support shoes. Your doctor might suggest physiotherapy. If these treatments don't help, you might get steroid shots or medicine that targets nerve pain.

If these treatments don't help relieve your symptoms, you may need surgery.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

  • If you can, stop or reduce the activity that causes your symptoms. If you can't stop the activity, take breaks often. Use these breaks to rest and stretch your foot and ankle.
  • Ask your doctor if you can take an over-the-counter pain medicine such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). Be safe with medicines. Read and follow all instructions on the label.
  • To ease pain, put ice or a cold pack on your foot and ankle. Do this for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin.
  • If your doctor or physiotherapist tells you to wear a splint, arch support, or orthotic, wear it as directed. This will help keep your foot and ankle in a neutral position. It also eases pressure on your tibial nerve.
  • Ask your doctor if you should have physiotherapy.

When should you call for help?

Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if:

  • Your pain or other problems don't get better with home care.
  • You want to learn more about physiotherapy.
  • You have any problems with your medicine.

Where can you learn more?

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Care instructions adapted under license by your healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.