Tarsal Tunnel Syndrome: Treatment in Palm Beach
Tarsal tunnel syndrome involves compression of the posterior tibial nerve as it passes through the tarsal tunnel behind and below the inner ankle. It produces foot and ankle pain, numbness, and tingling that is frequently misdiagnosed as plantar fasciitis, delaying effective treatment.
Dr. Ghattas’s neurological expertise and proficiency with lower extremity nerve hydrodissection make Palm Beach Regenerative well-suited to accurately diagnose and treat tarsal tunnel syndrome. Contact us today to schedule an appointment at Palm Beach Regenerative.
What Is Tarsal Tunnel Syndrome?
The tarsal tunnel is a narrow passageway formed by the ankle bones and the flexor retinaculum ligament on the inner ankle. The posterior tibial nerve, along with tendons and blood vessels, passes through this tunnel. Compression or irritation of the nerve here produces the characteristic symptoms of tarsal tunnel syndrome.
Signs and Symptoms
- Burning, tingling, or numbness on the bottom of the foot and toes
- Symptoms that may radiate from the inner ankle down into the arch and heel
- Pain that worsens with prolonged standing, walking, or activity
- Tenderness and a positive Tinel’s sign with percussion behind the inner ankle
- Symptoms that may worsen at night in some cases
Common Causes and Risk Factors
- Flat feet (overpronation) increasing tension on the posterior tibial nerve
- Prior ankle fracture, sprain, or surgery creating scar tissue
- Space-occupying lesions within the tarsal tunnel (cysts, lipomas)
- Systemic conditions affecting nerve health (diabetes, hypothyroidism)
- Prolonged standing or walking on hard surfaces
How It Is Diagnosed
Electrodiagnostic testing (nerve conduction studies of the medial and lateral plantar nerves) objectively confirms posterior tibial nerve dysfunction and distinguishes tarsal tunnel syndrome from plantar fasciitis and peripheral neuropathy.
Ultrasound allows direct visualization of the posterior tibial nerve at the tarsal tunnel and identifies any space-occupying lesions contributing to compression.
Conventional Treatment Options
- Orthotic arch support to reduce nerve tension from overpronation
- Anti-inflammatory medications and nerve pain agents
- Corticosteroid injection into the tarsal tunnel
- Surgical tarsal tunnel release for confirmed entrapment with adequate trial of conservative care
The Palm Beach Regenerative Approach
Dr. Ghattas uses real-time ultrasound-guided posterior tibial nerve hydrodissection at the tarsal tunnel, delivering targeted platelet preparation around the nerve to reduce perineural inflammation and free compressive adhesions.
Accurate diagnosis differentiating tarsal tunnel syndrome from plantar fasciitis ensures that treatment is directed at the correct structure, which is the most important factor in achieving relief.
The BioMod Advantage: MLS Robotic Laser Therapy applied to the inner ankle and foot reduces posterior tibial nerve inflammation and the surrounding soft tissue that compresses the tarsal tunnel. Xymogen nerve support and anti-inflammatory protocols provide systemic support for nerve recovery and reduce the inflammatory burden on the tarsal tunnel.
Like all medical procedures, interventional orthobiologics have potential risks and benefits. Results vary by individual. Not all patients are candidates. Dr. Ghattas will discuss your specific situation, realistic expectations, and all treatment options, including when surgery or other interventions may be more appropriate.
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"Honestly one of the best experiences, I’ve had a really stiff neck for a couple weeks I tried seeing a chiropractor for and it helped marginally but the real jump in relief was coming to see Dr. Ghattas! He has been incredible, wonderful staff, and minimally invasive technique for my pain relief which was super important to me! Thank you Dr. Ghattas recommending to anyone with pain!"Monica A
"Ghattas was instrumental in helping my torn rotator cuff. I did Barbotage for the stone, and then PRP. Great experience. Been about a month or 2 since and I feel great."Ahmet B
"I had severe knee pain and was looking for proper knee pain treatment, which is how I found Dr. Ghattas on Instagram. I was a bit hesitant at first, but it turned out to be one of the best decisions I’ve made for my health. Francia was amazing at coordinating all my consultations and making the whole process easy and stress-free. If you’re dealing with knee pain and looking for a reliable doctor and team, I highly recommend them."Roger L
"Over a year ago, both my daughter and I underwent PRP treatment with Dr. Ghattas—PRP for my left knee and PRP for my daughter’s L4-L5 and sacral region. We wanted to wait long enough to truly evaluate the results before sharing our experience. I am pleased to say that the outcomes have been outstanding. My daughter’s improvement has been remarkable, and the treatment has made a significant difference in her quality of life. I have also experienced excellent results with my knee. Dr. Ghattas is an exceptional physician who combines expertise, professionalism, and genuine care for his patients. We are incredibly grateful for the treatment we received and the positive impact it has had on our lives. Thank you, Dr. Ghattas. We are truly grateful for everything you have done. You are simply the best."Dr Jorge A
"Dr. Ghattas is very knowledgable and a sympathetic doctor. Hard to find in America. All questions answered, my procedure went very smoothly, very little pain. Follow up is excellent, I highly recommend his practice."Luciana D
“ I had severe knee pain and was looking for proper knee pain treatment, which is how I found Dr. Ghattas on Instagram. I was a bit hesitant at first, but it turned out to be one of the best decisions I’ve made for my health. Francia was amazing at coordinating all my consultations and making the whole process easy and stress-free. If you’re dealing with knee pain and looking for a reliable doctor and team, I highly recommend them. ”Roger L
“Dr. Ghattas was terrific today. He spent a good amount of time examining me and explaining the regenerative process which I intend to have done next month. More to come after the procedure.”Louie R
“I found Dr Ghattas and his staff very welcoming and informative. The process was well explained and gave me encouragement about the potential for fully restoring my knee joint integrity.”Eric C
“I received two treatments from Dr. Ghattas With excellent results, he takes great care in his assessment and in his treatment you couldn’t be in better hands. I highly recommend his work.”Gisela S
“Apart from the exemplary personal service by the reception and the staff that makes us feel we're at home at the clinic, I have experienced remarkable healing in several episodes from shoulder issue to knee injuries and hip pain. The doctor is so thorough in the diagnosis phase that he administered exactly what was needed, no more no less! Thank you folks for a wonderful experience.”RG G
“Went to Dr. Ghattas for chronic knee and neck issue. I’ve already had multiple procedures done on my neck and multiple epidurals with minimal success. My knee I was told needed surgery to fix. I already had surgery in the past with minimal difference. I ended up getting stem cells in my knee and neck and could t be happier with the outcome. Anyone considering surgery I recommend checking out Regenex first. Next I’m doing the ganglion block and look forward to the results.”Logan H
“Dr. James Ghattas and his team are truly top-notch. His office is equipped with state-of-the-art technology and a staff that's exceptional in their fields. I've referred several clients to him, and they've all been incredibly satisfied. Dr. Ghattas is absolutely ahead of the curve, and I wholeheartedly endorse his work.”Ron H
“I am quite active and go to pilates 3-4 times per week. I was having left knee pain and which was treated with PRP. It took about 3 months for me to feel better but then the pain completely subsided. I now am able to exercise without the fear that I will tear a ligament and am pain free.”Ellipsis P
“Transparency, thoroughness, attention to detail, immediate, high quality, follow ups and follow through are just a few words that come to mind throughout my experiences with Palm Beach Regenerative Sport and Spine.”Milton L
