Conservative vs Operative Treatment of Tarsal Tunnel Syndrome: A Comparative Study

Abstract

Background:    The most common compression neuropathy affecting the foot and ankle is tarsal tunnel syndrome. The tibial nerve is constricted beneath the flexor retinaculum (laciniate ligament).
Objective:    To analyze the clinical results of conservative versus operative treatment of tarsal tunnel syndrome.
Methods:    Twenty-seven patients (thirty feet, as three patients manifested with bilateral tarsal tunnel syndrome) were treated at Al-Imamein AL-Kadhimein Medical City in 2016. Fourteen patients (17 feet) underwent surgical intervention after a diagnosis of tarsal tunnel syndrome, while thirteen patients received exclusively conservative treatment for six months.
Results:    Two months after initiating treatment, a clinical assessment and follow-up were conducted in accordance with Takakura's severity rating scale. The clinical results after conservative treatment showed some improvement at the 4-month and 6-month follow-ups; however, there was no significant difference, and postoperative treatment showed virtually no changes. There was no substantial improvement in the nerve conductive investigations.
Conclusion:    In the beginning stages, especially if the issue is due to tenosynovitis or a flexible foot deformity, non-surgical treatment can be helpful, and neurophysiologic studies are not very important for early monitoring and evaluating the results.
Keywords:    Operative treatment, conservative treatment of tarsal tunnel syndrome
Citation:    Al-Banaa MAG, Jasam  BS, Alwan HH. Conservative vs operative treatment of tarsal tunnel syndrome: A comparative study. Iraqi JMS. 2025; 23(2): 404-414. doi: 10.22578/IJMS.23.2.23