Treatment:

Treatment is aimed at restoring feeling and strength to the foot and toes. In some cases, no treatment is needed, and patients will recover on their own. Severe loss of sensation may lead to toe or foot sores (ulcers) and infections.

Surgery to enlarge the tarsal tunnel will reduce pressure on the tibial nerve and may benefit some people.

Over-the-counter analgesics may be helpful for mild pain (neuralgia). Other medicines include:

• Phenytoin, carbamazepine, gabapentin, pregabalin, duloxetine, or tricyclic antidepressants such as nortriptyline may reduce the stabbing pains that some people experience.
• Opiate pain relievers, such as morphine or fentanyl, may be needed to control severe pain.

Whenever possible, medication should be avoided or reduced to lessen the risk of side effects.

Physical therapy exercises may help some people maintain muscle strength.

Job counseling, therapy, changes, or retraining may be recommended.

Expectations (prognosis):

If the cause of the tibial nerve dysfunction can be found and successfully treated, patients can recover fully. Some people may have a partial or complete loss of movement or sensation. Nerve pain may be uncomfortable and last for a long period of time.

Complications:

• Deformity of the foot (mild to severe)
• Movement loss in the toes (partial or complete)
• Repeated or unnoticed injury to the leg
• Sensation loss in the toes or foot (partial or complete)

Calling your health care provider:

Call for an appointment with your health care provider if symptoms of tibial nerve dysfunction are present. Early diagnosis and treatment increases the likelihood that symptoms can be controlled.