Assess & Address: Tarsal Tunnel Syndrome by Whitney Lowe

Anatomical background Pathology Assessment & Evaluation Treatment Massage Techniques

Traditional methods of treatment
TTS is most commonly treated with conservative measures. Because this is a condition that often results from structural or biomechanical problems, addressing dysfunctional foot mechanics is key. Orthotics are used for this purpose. For example, if the primary problem involves overpronation, which stretches the tibial nerve in the tunnel, an orthotic that is built up on the medial side to prevent the foot rolling into excessive eversion is helpful.

Anti-inflammatory medications may be used to reduce swelling of the synovial sheaths of the flexor tendons in the tarsal tunnel if tenosynovitis is a factor. Corticosteroid injections into the region of the tarsal tunnel have also been used to address inflammation in the area, although there is controversy about the safety and effectiveness of this procedure.

If conservative treatment is unsuccessful, a surgical approach may be used. In this procedure the flexor retinaculum will be divided to allow greater space for the structures underneath in the tunnel. However, there are detrimental biomechanical effects to cutting the flexor retinaculum, so conservative approaches are generally preferred.