Do you feel burning, numbness, or tingling in your heel? You might assume it’s plantar fasciitis. However, these symptoms often point to a different condition called tarsal tunnel syndrome (TTS).
At Aloha Foot and Ankle Associates in Mission Viejo, California, Dr. Stephanie Dal Porto-Kujanpaa and our team specialize in treating complex nerve issues. We’re here to help you find lasting relief from foot pain.
Tarsal tunnel syndrome occurs when the posterior tibial nerve becomes squeezed or pinched. This nerve runs down the inside of your ankle and into your foot, passing through a narrow space called the tarsal tunnel.
You may have TTS if you feel burning, tingling, or numbness on the bottom of your foot. These symptoms often worsen at night or during physical activity. Unlike other foot issues, this condition is a nerve problem rather than a muscle strain.
Many people mistake this condition for plantar fasciitis because both cause heel discomfort. However, a clinical review in Cureus explains that plantar fasciitis typically causes a dull ache that’s worse with your first morning steps. In contrast, TTS produces distinct nerve pain that’s usually worse at night.
Diagnosing this condition can be challenging. A study in Egyptian Rheumatology and Rehabilitation found that standard nerve tests had a sensitivity of only 60.9% for the condition. These electrical tests frequently show normal results even when a nerve is pinched.
Because of this, we rely heavily on a physical exam and your symptoms. We take the time to listen to your symptoms and perform a comprehensive evaluation to target the true source of your pain.
We always start with conservative, nonsurgical treatments to relieve pressure on your nerve and reduce inflammation. These options include custom orthotics, physical therapy, and targeted injections.
According to guidelines from the American Academy of Physical Medicine and Rehabilitation, conservative care should address foot structure issues through orthotics and physical therapy. We offer custom orthotics to support your arch and prevent it from collapsing. This simple adjustment reduces the physical stretch and pressure placed on your tibial nerve when you walk.
If you experience severe swelling or sudden pain flares, we may recommend local corticosteroid injections. A review in EFORT Open Reviews notes that these injections help reduce swelling directly around the nerve. This temporary relief can give you a comfortable window to participate in physical therapy.
Our team designs a personalized treatment plan tailored to your daily activities and foot structure.
We consider surgery only when conservative treatments fail after several months. It’s also an option if a physical growth presses on the nerve. The procedure, called tarsal tunnel release, involves opening the ligament that forms the roof of the tunnel to give the nerve more room.
If surgery is necessary, it’s important to have realistic expectations about your recovery. A review in EFORT Open Reviews reports that surgical success rates range widely from 44% to 96%. Your outcome depends on how long the nerve has been compressed.
Nerves heal slowly. The American Academy of Physical Medicine and Rehabilitation notes that maximum functional recovery can take 6 to 12 months. Our surgical team guides you through every step of your recovery to ensure the best possible outcome.
If you’re dealing with persistent foot pain or tingling, don’t wait for the nerve damage to worsen. Schedule a visit with our team at Aloha Foot and Ankle Associates today to get an accurate diagnosis and a personalized treatment plan.
