Tarsal Tunnel Surgery – A Patient Guide
Introduction
Tarsal tunnel surgery is a procedure designed to relieve pressure on the posterior tibial nerve, which runs through the tarsal tunnel on the inner side of the ankle. This condition, known as tarsal tunnel syndrome, occurs when the nerve becomes compressed due to swelling, injury, or structural abnormalities, leading to pain, numbness, tingling, and weakness in the foot.
If conservative treatments such as physical therapy, medications, orthotics, or steroid injections do not provide sustained relief, tarsal tunnel release surgery may be recommended to decompress the nerve, reduce symptoms, and restore function.
At Endoscopic & Minimally Invasive Spine Specialists, we have extensive experience and expertise in back tarsal tunnel syndrome and decompression surgery and provide the highest-quality care in surgical and non-surgical treatment.
To learn more about surgical treatment of your tarsal tunnel syndrome, call the office today or request an appointment online.
Understanding Tarsal Tunnel Syndrome
What is the Tarsal Tunnel?
The tarsal tunnel is a narrow passageway on the inner side of the ankle, covered by a thick ligament called the flexor retinaculum. This tunnel contains the posterior tibial nerve, arteries, veins, and tendons that control foot movement and sensation. This condition is analagous to carpal tunnel syndrome which is also quite common.
Causes of Tarsal Tunnel Syndrome
- Flat feet or fallen arches – Can put excess strain on the nerve.
- Injuries (sprains or fractures) – May cause swelling that compresses the nerve.
- Cysts, tumors, or varicose veins – Can occupy space in the tunnel, pressing on the nerve.
- Diabetes or neuropathy – Can make nerves more susceptible to compression.
- Overuse or repetitive stress – Common in athletes or individuals who stand for long periods.
Symptoms of Tarsal Tunnel Syndrome
- Burning pain on the inside of the ankle or bottom of the foot.
- Tingling, numbness, or electric shock sensations in the heel, arch, or toes.
- Weakness or difficulty moving the foot.
- Symptoms worsen with activity and improve with rest.
What is Tarsal Tunnel Release Surgery?
Tarsal tunnel surgery, also called tarsal tunnel release, involves making a small incision along the inner ankle to release the compressed nerve by cutting the flexor retinaculum ligament. This relieves pressure and allows the nerve to heal. The compressed nerve requires several months to recover its function, but relief is remarkable most often immediately after arousal from surgery.
Who is a Candidate for Surgery?
Surgery may be recommended if:
- Symptoms do not improve with non-surgical treatments.
- There is severe pain, weakness, or numbness that affects daily activities.
- Tests such as nerve conduction studies or MRIs confirm nerve compression.
The Surgical Procedure
Before Surgery
- Your surgeon will review your medical history and imaging results.
- You may need to stop certain medications before surgery, such as blood thinners and aspirin.
- Surgery is usually performed under local or general anesthesia.
During Surgery
- A 2 inch incision is made along the inner side of the ankle.
- The flexor retinaculum ligament is carefully cut to relieve pressure on the nerve.
- If additional space is needed, surrounding scar tissue or growths may be removed.
- The incision is closed with sutures, and a bandage is applied.
- The procedure typically takes less than 30–60 minutes.
Recovery and Postoperative Care
Immediate Recovery
- Patients go home the same day.
- The foot is wrapped in a soft dressing, and a splint or boot may be used.
- Elevating the foot and using ice packs can reduce swelling.
At-Home Recovery
- Activity Restrictions: Avoid weight-bearing on the foot for 1–2 weeks.
- Pain Management: Prescribed medications or over-the-counter pain relievers may be used.
- Walking Assistance: Crutches or a walker may be needed during the first few weeks.
- Stitches Removal: Stitches are removed after 10–14 days.
- Physical Therapy: May be recommended to restore strength and flexibility.
Recovery Timeline
– 2–4 weeks: Gradual return to normal activities.
– 6–8 weeks: Walking without assistance.
– 3–6 months: Full recovery and improvement in nerve function.
Potential Risks and Complications
While tarsal tunnel surgery is generally safe, risks may include:
- Infection – Keep the incision site clean and monitor for redness or swelling.
- Nerve Damage – Rare but can cause persistent numbness or weakness.
- Scar Tissue Formation – Can lead to recurring symptoms.
- Incomplete Pain Relief – Some patients may still have mild discomfort post-surgery.
Conclusion
Tarsal tunnel surgery is an effective treatment for relieving nerve compression and restoring function in the foot. Most patients experience significant symptom relief and improved mobility within a few months. By following your postoperative care plan and rehabilitation exercises, you can ensure a smooth recovery and return to daily activities.
If you have persistent foot pain, numbness, or weakness, consult one of our specialists to determine if tarsal tunnel surgery is right for you.
To learn more about the expertise and patient-centered care of tarsal tunnel or other compression neuropathies, call Endoscopic & Minimally Invasive Spine Specialists today, or book an appointment online.
