Tarsal tunnel release surgery is performed when conservative measures have failed and has one simple purpose: to release pressure off of the nerve and its branches running through the tissue tunnel. Under general anesthesia, a curved incision a few inches long is made on the inner side of the foot just under the ankle. The ligament that covers the top of the tarsal tunnel is released and left in an open position to permanently relieve pressure on the nerve. The nerve is then carefully separated from the artery and vein that accompany it, and the surgeon follows it as far back and as far forward as needed within the tarsal tunnel and the region outside of it to ensure there is no further restriction. A search is also made for any masses, abnormally thick muscle tissue, or varicose vein branches that may be pinching on the nerve. If these are found, they will be removed.
Once the procedure is completed, the foot is protected in a sterile dressing and is supported in a walking boot to prevent undue stress to the incision. Healing of the skin usually takes up to three weeks to complete, and full activity is usually regained within five to six weeks, although everyone heals at different rates.