Vein Treatment Relieves “Tarsal Tunnel” Ankle and Heel Pain

Patient: Female, 66 years old

Background: 
Sharon S. had 5 months of persistent pain along the inside of her right ankle and heel that was diagnosed as tarsal tunnel syndrome. Conservative treatments did not help, and she was close to having tarsal tunnel release surgery when she was referred for a vein evaluation.

Diagnosis and Testing: 
A vein ultrasound showed valve failure (insufficiency) in both great saphenous veins, worse on the left, even though her main symptoms were on the right. Because vein disease might be contributing to her pain, she underwent radiofrequency ablation of the right great saphenous vein from the groin area (saphenofemoral junction) down to where the vein leaves its normal compartment in the thigh.

Treatment and Early Results: 
After the right leg vein ablation, Sharon reported dramatic improvement. Her inner ankle (tarsal tunnel–like) pain resolved, her heel pain went away, and she could walk more comfortably. She also noticed less swelling in her right leg.

Follow-up Imaging and Next Steps: 
Follow-up ultrasound confirmed successful closure of the treated segment of the right great saphenous vein down to the mid–distal thigh, but showed a remaining refluxing branch vein over 3 mm in size running toward the knee. Completion treatment with Varithena was recommended to close this remaining faulty segment. Treatment of the left leg will be delayed for now because symptoms there are minimal, but it may be addressed in the future given the documented insufficiency.

Clinical Insight:
Sharon’s case shows that vein problems can sometimes cause nerve-like symptoms around the ankle and heel that mimic tarsal tunnel syndrome. Evaluating and treating superficial venous insufficiency can lead to major relief in patients with persistent medial ankle neuropathic pain, potentially avoiding unnecessary surgery.