Quick answer: Treatment for tarsal tunnel syndrome symptoms diagnosis treatment surgery follows a stepwise approach: 1) conservative care first (rest, ice, supportive footwear, OTC anti-inflammatories), 2) physical therapy and targeted exercises, 3) in-office treatments (injections, custom orthotics) if conservative fails at 4-6 weeks, 4) surgery for refractory cases. Most patients resolve at step 1 or 2. Call (810) 206-1402.
Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Township, MI. Last updated April 2026.
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Medically Reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist, Balance Foot & Ankle Specialists, Michigan. Last updated April 2026.
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Howell Office
4330 E Grand River Ave
Howell, MI 48843
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Bloomfield Township Office
43494 Woodward Ave, Suite 208
Bloomfield Township, MI 48302
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Your Board-Certified Podiatrists
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Same-week appointments available at both locations.
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When to See a Podiatrist
Foot and ankle surgery in 2026 is dramatically different than a decade ago — most procedures are now minimally-invasive, outpatient, and allow weight-bearing within days. Balance Foot & Ankle surgeons have performed 3,000+ foot/ankle surgeries with modern techniques. If another surgeon has recommended a traditional open procedure, a second opinion may reveal a faster, less-invasive option.
Call Balance Foot & Ankle: (810) 206-1402 · Book online · Offices in Howell & Bloomfield Township
Differential Diagnosis: What Else Could It Be?
Not every case of tarsal tunnel syndrome is straightforward. In our clinic we routinely rule out three look-alike conditions before confirming the diagnosis. If your symptoms don’t match the classic presentation, one of these may explain the pain — which is why physical exam matters more than self-diagnosis.
| Condition | How It Differs |
|---|---|
| Plantar fasciitis | Sharp morning heel pain at the medial calcaneal tubercle, NOT numbness or shooting pain into the toes. |
| Diabetic peripheral neuropathy | Bilateral stocking-glove distribution, progressive, affects toes first — NOT reproduced by Tinel’s at medial ankle. |
| S1 radiculopathy | Pain originates in low back, follows S1 dermatome, positive straight-leg raise. |
Red Flags — When to See a Podiatrist Now
Seek same-day evaluation at Balance Foot & Ankle if you notice any of the following:
- Progressive foot weakness
- Muscle atrophy in the foot
- Severe night pain disrupting sleep
- Space-occupying lesion palpable at the medial ankle
Call (810) 206-1402 or request an appointment. Our Howell and Bloomfield Township offices reserve same-day slots for urgent foot and ankle issues.
In Our Clinic: What We See
Clinical perspective from Dr. Tom Biernacki, DPM — Balance Foot & Ankle, Howell & Bloomfield Township, MI:
In our Balance Foot & Ankle clinic, tarsal tunnel patients typically describe burning, tingling, or shock-like pain on the bottom of the foot, often worst at night. Unlike plantar fasciitis (sharp morning pain at the heel), tarsal tunnel causes neuropathic symptoms extending into the arch and toes. The classic exam finding is a positive Tinel’s sign over the posterior tibial nerve at the medial ankle. We assess for space-occupying lesions (ganglion, varicosity, accessory muscle) with ultrasound or MRI. Conservative management with orthotics, anti-inflammatories, and night splints resolves most cases; refractory cases may need surgical release.
In-Office Treatment at Balance Foot & Ankle
When conservative care isn’t enough, Dr. Tom Biernacki and the team at Balance Foot & Ankle offer advanced, same-day options — including Tarsal Tunnel Release Michigan at our Howell and Bloomfield Township clinics.
Same-week appointments available. Call (810) 206-1402 or book online.
In-Office Treatment at Balance Foot & Ankle
If home treatment isn’t providing relief for your foot and ankle conditions, our podiatry team at Balance Foot & Ankle can help with same-week evaluations and advanced in-office care.
Same-week appointments available. (810) 206-1402
Get Expert Care at Balance Foot & Ankle
Same-week appointments at our Howell and Bloomfield Township offices. Board-certified podiatric surgeons. Most insurance accepted.
Dr. Tom Biernacki, DPM is a board-certified foot & ankle surgeon (ABFAS & ABPM) at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has made him one of the most-followed foot & ankle educators on YouTube.