What is the conservative treatment approach for sinus tarsi syndrome?

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From the Research

Conservative Treatment Approach

The conservative treatment approach for sinus tarsi syndrome is a crucial initial step in managing the condition. According to the available evidence:

• Conservative treatment typically consists of consecutive corticosteroid injections into the tarsal canal, along with physical therapy and correction of foot biomechanics 1.
• This approach is usually considered first, with the goal of alleviating pain and instability associated with the condition.
• The effectiveness of conservative treatment can vary, with some studies suggesting that it is successful in about two-thirds of cases 2.

Components of Conservative Treatment

The components of conservative treatment for sinus tarsi syndrome may include:

• Corticosteroid injections into the tarsal canal to reduce inflammation and relieve pain 1.
• Physical therapy to improve ankle mobility and strength, as well as to address any biomechanical issues contributing to the condition.
• Correction of foot biomechanics, which may involve orthotics, shoe modifications, or other interventions to reduce stress on the affected area.

Limitations and Next Steps

While conservative treatment can be effective for some patients, it may not be sufficient for others. In cases where conservative treatment fails, further evaluation and treatment options may be necessary, such as:

• Subtalar arthroscopy for diagnostic and therapeutic purposes 3, 4.
• Surgical procedures, such as sinus tarsal debridement, subtalar joint stabilization, or subtalar arthrodesis, may be considered for patients who do not respond to conservative treatment 5.