What are the outcomes of posterior tibial nerve (PTN) decompression surgery via tarsal tunnel release?

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Last updated: May 9, 2025View editorial policy

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From the Research

Tarsal tunnel release surgery typically leads to significant improvement in symptoms for most patients with tarsal tunnel syndrome, with approximately 62% to 69% of patients achieving minimal clinically important difference in pain interference and depression, as reported in the most recent study 1. The outcomes of tarsal tunnel release surgery can be summarized as follows:

  • Improved symptoms: Patients often experience reduced pain, numbness, and tingling in the foot and ankle as pressure on the tibial nerve is relieved 1.
  • Significant improvement: The mean t-score change after surgery was 7.2 for physical function, -6.1 for pain interference, and -5.93 for depression, indicating significant improvement in these areas 1.
  • Minimal clinically important difference: 35% to 69% of patients achieved minimal clinically important difference in physical function, pain interference, and depression, respectively 1.
  • Recovery time: Complete recovery may take several months, with initial improvement in symptoms occurring within weeks of the procedure.
  • Complications: Some patients may experience complications such as infection, scarring, continued pain, or rarely, damage to nearby structures.
  • Prognostic factors: Diabetes and longer duration of symptoms before surgery have been identified as prognostic factors for residual pain following tarsal tunnel release 2. The most recent and highest quality study 1 provides validated outcomes after tarsal tunnel release surgery, and its findings should be prioritized when making clinical decisions. Key points to consider when evaluating the outcomes of tarsal tunnel release surgery include:
  • The severity and duration of nerve compression before surgery can impact outcomes, with better results typically seen in patients who undergo surgery earlier 3.
  • Physical therapy is usually recommended after surgery to restore strength and mobility.
  • Recovery typically involves a period of limited weight-bearing using crutches or a walking boot for 2-4 weeks, followed by gradual return to normal activities over 6-12 weeks.
  • Patients with diabetes or other conditions affecting nerve health may experience slower recovery or less complete symptom resolution 2.

References

Research

Patient-reported outcomes using PROMIS after tarsal tunnel release surgery.

The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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