In order to provide the right treatment, you need to identify the correct cause. Say, for example, your car won’t start. Replacing your starter won’t do you much good if your battery is dead. And a fresh battery won’t last long if the problem is really a bad alternator.

So it goes with many foot problems, including tarsal tunnel syndrome. When the posterior tibial nerve gets pinched or pressed as it runs through the narrow tarsal tunnel on the inside of your ankle, the result can be tingling, burning, numbness, and tenderness that radiates throughout the heel, arch, and sometimes even the toes.

How do we fix it? Well, that depends on what, exactly, is pinching that nerve in the first place. For example, many people overpronate when they walk or run (that means your feet roll too far inward with each step); this can collapse the amount of space available in the tarsal tunnel and press painfully on the nerve. In such situations, in addition to taking a break from nerve-aggravating activities and allowing time to heal, custom orthotics and/or bracing that provide extra foot support and prevent your feet from rolling too far inward may offer the best long-term solution.

In other situations, the problem may stem from inflammation. This could be the result of an injury, which likely means rest and physical therapy. It could be the result of a systemic disease such as diabetes, which means keeping your sugar in check and managing the underlying condition will be your No. 1 concern. Sometimes the problem may even be a ganglion cyst, arthritic bone spur, or other obstruction competing for space inside the narrow tarsal tunnel. Serious cases of tarsal tunnel syndrome may require decompression surgery to cut, excise, or loosen soft tissue structures applying pressure to the nerve.