Tarsal Tunnel Syndrome Treatment
at Foot Foundation
Burning, tingling, or numbness in the sole may signal tibial nerve compression at the ankle. Differentiating it from plantar fasciitis is essential.
At Foot Foundation, we combine precise diagnosis with orthotics, footwear optimisation, manual therapy, and rehabilitation—and arrange nerve studies or surgical referrals when required.
What is Tarsal Tunnel Syndrome?
Tarsal Tunnel Syndrome is a form of nerve entrapment neuropathy, similar to carpal tunnel in the wrist, but occurring in the ankle. It involves compression of the posterior tibial nerve (or its branches) as it passes through the tarsal tunnel, a narrow space on the inside of the ankle bounded by bone and a thick ligament.
When compressed, the nerve becomes irritated, causing burning pain, tingling, or numbness in the sole of the foot. If untreated, long-term nerve compression can lead to weakness and muscle wasting.
At Foot Foundation, we specialise in accurate diagnosis (distinguishing tarsal tunnel from plantar fasciitis, neuropathy, or referred pain) and provide comprehensive treatment to relieve pressure on the nerve and restore function.
Causes & Risk Factors
Flat feet / overpronation – stretching the tibial nerve in the tunnel
Swelling or inflammation – from ankle sprains or injury
Space-occupying lesions – ganglion cysts, lipomas, varicose veins
Systemic conditions – diabetes, inflammatory arthritis
Poor footwear – overly tight or unsupportive shoes
Biomechanical overload – excessive standing, walking, or running
Scar tissue – following trauma or surgery
Treatment at Foot Foundation
Custom orthotics – correct overpronation and reduce nerve tension
Footwear modification – supportive, cushioned shoes with medial support
Manual therapy and mobilisation – improve ankle joint mechanics and reduce compressive forces
Shockwave therapy – can help with associated tendon pain but not nerve compression itself
Anti-inflammatory strategies – activity modification, strapping, and offloading
Strengthening & mobility programs – calf and intrinsic foot exercises to improve stability
Referral pathways – to orthopaedics or neurology if surgery or nerve testing required (surgical decompression in severe cases)
Symptoms
Burning, tingling, or shooting pain in the sole of the foot
Numbness in the arch, heel, or toes
Symptoms that worsen with prolonged standing, walking, or at night
Pain radiating from the ankle into the foot
Weakness or loss of intrinsic foot muscle control in advanced cases
Symptoms often confused with plantar fasciitis
Diagnosis
At Foot Foundation, diagnosis includes:
Clinical history and symptom mapping (distribution of nerve pain vs plantar fascia pain)
Palpation and percussion (Tinel’s sign – tapping nerve at the tarsal tunnel reproduces symptoms)
Biomechanical assessment – pronation, arch collapse, or ankle instability contributing to nerve irritation
Imaging:
Ultrasound or MRI – to rule out space-occupying lesions
Nerve conduction studies – in severe or persistent cases to confirm nerve compression
Tarsal Tunnel Syndrome – FAQs
It is compression of the tibial nerve inside the ankle, causing burning, tingling, or numbness in the sole of the foot.
Patients often describe burning, shooting, tingling, or numbness in the arch or toes. Pain may worsen at night or with standing/walking.
Common causes include flat feet, injury swelling, cysts, varicose veins, or arthritis that narrow the tunnel and compress the nerve.
Diagnosis is based on symptom pattern, clinical testing, and imaging. Tinel’s sign is a classic test, and nerve studies or MRI may confirm the diagnosis.
Yes. With early intervention, symptoms can often be managed conservatively using orthotics, footwear changes, and rehabilitation. Severe cases may require surgical decompression.
Plantar fasciitis causes heel and arch pain in the morning that improves with movement. Tarsal tunnel causes burning/tingling pain, often at rest or night, and may involve numbness or neurological symptoms.
Yes. Orthotics correct biomechanical overload (such as overpronation) and reduce traction forces on the tibial nerve, often relieving symptoms.
Flat feet, ankle injuries, arthritis, space-occupying lesions, and systemic conditions like diabetes increase risk.
If you experience burning, tingling, or numbness lasting more than two weeks, or if pain worsens at night, you should seek assessment. Early care prevents long-term nerve damage.
Why Choose Foot Foundation?
Foot Foundation provides specialist care for nerve entrapments, with detailed biomechanical assessment, orthotic prescription, and advanced rehabilitation. We focus on accurate diagnosis, targeted treatment, and collaboration with neurologists and orthopaedic surgeons where needed.
With clinics in Rosedale, Takapuna, Remuera, Botany, Hamilton, and Tauranga, expert nerve pain care is available across New Zealand.
