Burning, tingling or numbness under the foot deserves an assessment that identifies the source before treatment is chosen. Tarsal tunnel syndrome involves compression of the tibial nerve or its branches near the inner ankle, but similar symptoms can arise elsewhere. The useful starting point is a diagnosis-led plan, not deciding which injection to book.
How is tarsal tunnel different from ordinary heel pain?
The tarsal tunnel is a confined passage near the inside of the ankle. Pressure on the nerve can cause pain or altered sensation into the sole. An EFORT Open Reviews review describes varied causes and emphasises that other diagnoses need consideration. Burning pain alone does not establish where a nerve problem is located.
Plantar fascia pain, a stress fracture, a nerve problem from the back and other conditions can overlap. Describe where symptoms start, where they travel and what provokes them. That map is more useful than assuming all sole pain is plantar fasciitis or that an abnormal scan must explain the symptoms.
What should assessment cover?
A clinician should ask about onset, activity changes, previous ankle injury, swelling, numbness, weakness and symptoms elsewhere. Examination may assess sensation, strength, foot mechanics and whether movements or pressure reproduce symptoms. The review describes correlating history with examination and investigations rather than relying on one manoeuvre.
Bring earlier imaging and nerve-test reports, not only their conclusions. Explain treatments tried and whether they changed pain, tingling or function. A tapping test around the nerve can contribute information, but is not a home diagnostic test or a complete reason to have an injection.
Discuss an appropriate assessment for your symptoms
Will a scan or nerve test give a definite answer?
Not necessarily. The EFORT review states that no single test diagnoses tarsal tunnel with certainty. Imaging can help identify a cause of compression, such as a space-occupying lesion. Nerve conduction studies and electromyography may contribute, but their results need interpretation alongside symptoms and examination.
Ask what question a test will answer and how it could change treatment. A negative result does not always settle every possible nerve diagnosis, while an imaging finding may not explain all symptoms. The consultation should explain remaining uncertainty and when another specialist assessment is appropriate.
What could a non-operative plan involve?
The review describes activity modification, rehabilitation, pain management and selected treatments intended to address the underlying problem. Footwear or mechanical factors may matter. The combination depends on the cause, severity and whether there is a reversible source of pressure. It is not one fixed programme for every painful foot.
Agree practical goals such as walking tolerance, the extent of numbness or recovery of function. Record a baseline so review is about meaningful change rather than completing sessions. If treatment does not help, the diagnosis and source of compression may need reconsideration instead of automatically repeating the same approach.
Where does PRP fit?
Evidence for PRP in a tendon or joint condition cannot automatically be transferred to a compressed nerve. The cited review does not establish PRP as standard treatment for tarsal tunnel. A proposal needs condition-specific evidence, explanation of uncertainty and consideration of other care routes.
If PRP is discussed, ask why it is proposed for the identified problem, what benefit is realistically expected and what alternatives exist. A consultation may conclude that injection is not appropriate. Progressive nerve symptoms or structural compression can require specialist management rather than a regenerative-treatment package.
Ask about diagnosis-led treatment choices
When does specialist management become relevant?
The review discusses surgery after conservative treatment has failed and the cause of entrapment is clearly identified. This does not mean persistent pain automatically requires an operation. The location of the problem, investigations, symptom duration and previous treatment all influence the discussion.
Ask what finding would change the plan and what a specialist opinion would add. A clear referral question is useful: for example, whether a particular lesion explains the nerve symptoms. An unexplained label should not be turned into an invasive treatment decision without understanding the evidence and alternatives.
Which symptoms need more urgent assessment?
New or progressive weakness, rapidly worsening numbness or inability to use the foot normally needs prompt assessment. A cold, pale or blue foot, major injury, severe swelling or signs of infection should not wait for a routine PRP enquiry. Seek urgent care for a possible serious circulation or neurological problem.
Call 999 for a life-threatening emergency. Contact NHS 111 if unsure about the appropriate service. This guide cannot distinguish local nerve entrapment from every cause of altered sensation. Do not continue training through deterioration while waiting for an elective appointment.
How should you plan a consultation?
Contact the clinic with symptoms, duration and earlier imaging or diagnosis. Confirm that the available consultation suits a possible nerve problem; referral may be the right route. Ask about timing, location, full consultation fee and separate investigations, procedures or follow-up before committing.
The services page explains the clinic's broader scope, and the PRP overview introduces treatment. Neither establishes suitability for tarsal tunnel. A valuable plan identifies the problem, appropriate clinician and a way to measure progress.
Contact the clinic to plan the right next step
Sources and scope
EFORT Open Reviews: tarsal tunnel syndrome, current rationale, indications and results
General adult health information, not a diagnosis or individual treatment advice. Clinical suitability, availability and complete fees need confirmation. Source checked 4 November 2026.