Tarsal Tunnel SyndromeNCT07837557
Ultrasound-Guided Pulsed Radiofrequency Added to Perineural Steroid Injection Versus Perineural Steroid Injection Alone in the Treatment of Tarsal Tunnel Syndrome
A study testing Ultrasound-Guided Pulsed Radiofrequency and Perineural Steroid in people with Tarsal Tunnel Syndrome and Tibial Neuropathy, run by Assiut University.
Trial summary
Tarsal tunnel syndrome (TTS) is an entrapment neuropathy caused by compression of the posterior tibial nerve at the ankle, resulting in pain, numbness, and tingling sensations in the heel and sole of the foot. Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- Tarsal Tunnel Syndrome, Tibial Neuropathy
- What is being tested?
- Ultrasound-Guided Pulsed Radiofrequency and Perineural Steroid
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 50 participants
- Where
- No sites listed yet
- Study dates
- Oct 2026to Nov 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Adult patients aged 18 to 65 years old.
- Clinical diagnosis of idiopathic tarsal tunnel syndrome (TTS).
- Abnormal electrophysiological study confirming mild-to-moderate TTS.
- Pain or paresthesia in the posterior tibial nerve distribution persisting for more than 6 months and refractory to conservative therapy (e.g., vitamin B complex, NSAIDs, oral steroids, or night splints).
- Positive Tinel's sign and/or positive triple compression test.
- Patient is willing and able to provide written informed consent and attend all scheduled follow-up visits.
Who cannot join
- Severe TTS (defined by abductor hallucis muscle atrophy, distal motor latency > 6.5 ms, or absent potentials on electrophysiological testing).
- Prior ankle or tarsal tunnel injection within the preceding 3 months.
- Secondary tarsal tunnel syndrome due to systemic diseases (e.g., endocrine disorders, rheumatoid arthritis, gout, or psoriatic arthritis).
- Concurrent use of systemic corticosteroids or antihistamines.
- Presence of coagulopathy.
- Local infection at the planned injection site.
Show all 9Show fewer
- Known allergy or hypersensitivity to any of the study medications (triamcinolone acetonide, lidocaine, or dextrose).
- Pregnancy or lactation.
- Patient refusal to participate.
About this study
Official title: Ultrasound-Guided Pulsed Radiofrequency Added to Perineural Steroid Injection Versus Perineural Steroid Injection Alone in the Treatment of Tarsal Tunnel Syndrome: A Prospective, Randomized, Double-Blind, Clinical Trial
Tarsal tunnel syndrome (TTS) is an entrapment neuropathy caused by compression of the posterior tibial nerve at the ankle, resulting in pain, numbness, and tingling sensations in the heel and sole of the foot. Perineural steroid injections under ultrasound guidance are commonly used for conservative management to decrease inflammation and relieve pressure. Pulsed radiofrequency (PRF) is a minimally invasive neuromodulatory technique that delivers electrical pulses to alter pain transmission and promote tissue healing without damaging the nerve structure.
The objective of this prospective, randomized, double-blind clinical trial is to determine whether combining ultrasound-guided pulsed radiofrequency with perineural steroid injection provides superior pain relief, improved foot function, and higher patient satisfaction compared to perineural steroid injection alone in patients with mild-to-moderate tarsal tunnel syndrome.
Read more
A total of 50 adult participants will be randomly allocated to one of two study groups:
- Group A (Active PRF + Steroid Injection): Participants receive ultrasound-guided pulsed radiofrequency applied adjacent to the posterior tibial nerve for 8 minutes (480 seconds), followed immediately by a perineural injection of 10 mL solution containing triamcinolone acetonide, dextrose 5%, and lidocaine 1%.
- Group B (Sham PRF + Steroid Injection): Participants undergo identical ultrasound-guided needle positioning and sensory/motor stimulation testing, followed by 8 minutes of sham radiofrequency (generator switched off), and then receive the identical 10 mL perineural steroid injection.
Participants will be evaluated prior to the procedure and at 2 weeks, 1 month, 3 months, and 6 months post-intervention to assess pain severity (Visual Analogue Scale), foot function and disability (Foot Function Index), global impression of recovery, and any procedure-related side effects or complications.
- Conditions
- Tarsal Tunnel Syndrome, Tibial Neuropathy
- Being tested
- Ultrasound-Guided Pulsed Radiofrequency and Perineural Steroid, Ultrasound-Guided Perineural Steroid Injection with Sham Radiofrequency
- Keywords
- Pulsed radiofrequency, Perineural injection, Ultrasound guidance, Posterior tibial nerve, Triamcinolone acetonide, Nerve entrapment, Neuropathic pain
- Medical subject headings
- Tarsal Tunnel Syndrome, Tibial Neuropathy, Nerve Compression Syndromes, Neuralgia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Ultrasound-Guided Pulsed Radiofrequency and Perineural SteroidProcedure or surgery
Under real-time ultrasound guidance, a 22-gauge, 54-mm radiofrequency cannula with a 5-mm active tip is placed adjacent to the posterior tibial nerve. Sensory (50 Hz, ≤0.5 V) and motor (2 Hz, >0.5 V) stimulation are confirmed, followed by active pulsed radiofrequency (PRF) delivery (parameters: 42°C maximum tip temperature, 45 V, 2 Hz, 20 ms pulse width, for 480 seconds delivered as two consecutive 240-second cycles). Immediately following PRF, a 10 mL solution (8 mL dextrose 5%, 1 mL triamcinolone acetonide 40 mg, and 1 mL lidocaine 1%) is injected through the same cannula around the nerve (5 mL superficial and 5 mL deep).
Ultrasound-Guided Perineural Steroid Injection with Sham RadiofrequencyProcedure or surgery
Under real-time ultrasound guidance, the cannula is positioned adjacent to the posterior tibial nerve using the identical technique, followed by identical sensory and motor stimulation testing. The cannula is maintained in place for 480 seconds with the radiofrequency generator switched off (sham PRF). Immediately following the sham phase, the identical 10 mL solution (8 mL dextrose 5%, 1 mL triamcinolone acetonide 40 mg, and 1 mL lidocaine 1%) is injected around the nerve (5 mL superficial and 5 mL deep).
| Study group | Role | What they receive |
|---|---|---|
| Group A: Pulsed Radiofrequency Plus Steroid Injection | Experimental | Participants undergo ultrasound-guided pulsed radiofrequency (PRF) adjacent to the posterior tibial nerve using a 22-gauge cannula with a 5 mm active tip (parameters: pulse width 20 ms, frequency 2 Hz, output 45 V, maximum tip temperature 42°C, delivered for 480 seconds in two consecutive 240-second cycles). Following PRF, a 10 mL perineural injectate (8 mL dextrose 5%, 1 mL triamcinolone acetonide 40 mg, and 1 mL lidocaine 1%) is administered around the nerve (approximately 5 mL superficial and 5 mL deep). Receives: Procedure: Ultrasound-Guided Pulsed Radiofrequency and Perineural Steroid |
| Group B: Sham Radiofrequency Plus Steroid Injection | Sham comparator | Participants undergo the identical ultrasound-guided cannula placement and sensory/motor nerve stimulation protocol, after which the cannula is left in position for 480 seconds with the radiofrequency generator switched off (sham PRF). Following the sham phase, the identical 10 mL perineural injectate (8 mL dextrose 5%, 1 mL triamcinolone acetonide 40 mg, and 1 mL lidocaine 1%) is administered around the posterior tibial nerve. Receives: Procedure: Ultrasound-Guided Perineural Steroid Injection with Sham Radiofrequency |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change from Baseline in Pain Severity on the Visual Analogue Scale (VAS) at 6 Months
Pain intensity is assessed using a 10-cm Visual Analogue Scale (VAS), where 0 indicates "no pain" and 10 indicates "worst pain imaginable" (higher scores indicate worse pain). The change in foot and heel pain and paresthesia from baseline to 6 months post-intervention will be evaluated.
Measured: Baseline and 6 months post-intervention
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted23 Sep 2026
- Study startOct 2026 (estimated)
- Primary completionOct 2027 (estimated)
- Study completionNov 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Tarsal Tunnel SyndromeStudies of the same condition, open and under way.
- More trials run by Assiut UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 50 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Assiut University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Ahmed Bahgat Ramadan Amin, Assiut University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07837557
- Sponsor's protocol ID
- PRF for Tarsal Tunnel Syndrome
- Status last verified
- Sep 2026
- First submitted
- 18 Sep 2026
- Last updated
- 23 Sep 2026
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 23 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Ultrasound-Guided Pulsed Radiofrequency Added to Perineural Steroid Injection Versus Perineural Steroid Injection Alone in the Treatment of Tarsal Tunnel Syndrome: A Prospective, Randomized, Double-Blind, Clinical Trial
- ClinicalTrials.gov ID
- NCT07837557
- Acronym / sponsor ID
- PRF for Tarsal Tunnel Syndrome
- Conditions
- Tarsal Tunnel Syndrome, Tibial Neuropathy
- Keywords
- Pulsed radiofrequency, Perineural injection, Ultrasound guidance, Posterior tibial nerve, Triamcinolone acetonide, Nerve entrapment, Neuropathic pain
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 50 participants (estimated)
- Lead sponsor
- Assiut UniversityUniversity, hospital or other
- Study start
- Oct 2026 (estimated)
- Primary completion
- Oct 2027 (estimated)
- Study completion
- Nov 2027 (estimated)
- First posted
- 23 Sep 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Tarsal tunnel syndrome (TTS) is an entrapment neuropathy caused by compression of the posterior tibial nerve at the ankle, resulting in pain, numbness, and tingling sensations in the heel and sole of the foot. Perineural steroid injections under ultrasound guidance are commonly used for conservative management to decrease inflammation and relieve pressure. Pulsed radiofrequency (PRF) is a minimally invasive neuromodulatory technique that delivers electrical pulses to alter pain transmission and promote tissue healing without damaging the nerve structure.
The objective of this prospective, randomized, double-blind clinical trial is to determine whether combining ultrasound-guided pulsed radiofrequency with perineural steroid injection provides superior pain relief, improved foot function, and higher patient satisfaction compared to perineural steroid injection alone in patients with mild-to-moderate tarsal tunnel syndrome.
A total of 50 adult participants will be randomly allocated to one of two study groups:
- Group A (Active PRF + Steroid Injection): Participants receive ultrasound-guided pulsed radiofrequency applied adjacent to the posterior tibial nerve for 8 minutes (480 seconds), followed immediately by a perineural injection of 10 mL solution containing triamcinolone acetonide, dextrose 5%, and lidocaine 1%.
- Group B (Sham PRF + Steroid Injection): Participants undergo identical ultrasound-guided needle positioning and sensory/motor stimulation testing, followed by 8 minutes of sham radiofrequency (generator switched off), and then receive the identical 10 mL perineural steroid injection.
Participants will be evaluated prior to the procedure and at 2 weeks, 1 month, 3 months, and 6 months post-intervention to assess pain severity (Visual Analogue Scale), foot function and disability (Foot Function Index), global impression of recovery, and any procedure-related side effects or complications.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Group A: Pulsed Radiofrequency Plus Steroid Injection | Experimental | Procedure: Ultrasound-Guided Pulsed Radiofrequency and Perineural SteroidParticipants undergo ultrasound-guided pulsed radiofrequency (PRF) adjacent to the posterior tibial nerve using a 22-gauge cannula with a 5 mm active tip (parameters: pulse width 20 ms, frequency 2 Hz, output 45 V, maximum tip temperature 42°C, delivered for 480 seconds in two consecutive 240-second cycles). Following PRF, a 10 mL perineural injectate (8 mL dextrose 5%, 1 mL triamcinolone acetonide 40 mg, and 1 mL lidocaine 1%) is administered around the nerve (approximately 5 mL superficial and 5 mL deep). |
| Group B: Sham Radiofrequency Plus Steroid Injection | Sham comparator | Procedure: Ultrasound-Guided Perineural Steroid Injection with Sham RadiofrequencyParticipants undergo the identical ultrasound-guided cannula placement and sensory/motor nerve stimulation protocol, after which the cannula is left in position for 480 seconds with the radiofrequency generator switched off (sham PRF). Following the sham phase, the identical 10 mL perineural injectate (8 mL dextrose 5%, 1 mL triamcinolone acetonide 40 mg, and 1 mL lidocaine 1%) is administered around the posterior tibial nerve. |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- Adult patients aged 18 to 65 years old.
- Clinical diagnosis of idiopathic tarsal tunnel syndrome (TTS).
- Abnormal electrophysiological study confirming mild-to-moderate TTS.
- Pain or paresthesia in the posterior tibial nerve distribution persisting for more than 6 months and refractory to conservative therapy (e.g., vitamin B complex, NSAIDs, oral steroids, or night splints).
- Positive Tinel's sign and/or positive triple compression test.
Key exclusion criteria (9 listed)
- Severe TTS (defined by abductor hallucis muscle atrophy, distal motor latency > 6.5 ms, or absent potentials on electrophysiological testing).
- Prior ankle or tarsal tunnel injection within the preceding 3 months.
- Secondary tarsal tunnel syndrome due to systemic diseases (e.g., endocrine disorders, rheumatoid arthritis, gout, or psoriatic arthritis).
- Concurrent use of systemic corticosteroids or antihistamines.
- Presence of coagulopathy.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Ultrasound-Guided Pulsed Radiofrequency and Perineural SteroidUnder real-time ultrasound guidance, a 22-gauge, 54-mm radiofrequency cannula with a 5-mm active tip is placed adjacent to the posterior tibial nerve. Sensory (50 Hz, ≤0.5 V) and motor (2 Hz, >0.5 V) stimulation are confirmed, followed by active pulsed radiofrequency (PRF) delivery (parameters: 42°C maximum tip temperature, 45 V, 2 Hz, 20 ms pulse width, for 480 seconds delivered as two consecutive 240-second cycles). Immediately following PRF, a 10 mL solution (8 mL dextrose 5%, 1 mL triamcinolone acetonide 40 mg, and 1 mL lidocaine 1%) is injected through the same cannula around the nerve (5 mL superficial and 5 mL deep). | Procedure or surgery | Group A: Pulsed Radiofrequency Plus Steroid Injection |
| Ultrasound-Guided Perineural Steroid Injection with Sham RadiofrequencyUnder real-time ultrasound guidance, the cannula is positioned adjacent to the posterior tibial nerve using the identical technique, followed by identical sensory and motor stimulation testing. The cannula is maintained in place for 480 seconds with the radiofrequency generator switched off (sham PRF). Immediately following the sham phase, the identical 10 mL solution (8 mL dextrose 5%, 1 mL triamcinolone acetonide 40 mg, and 1 mL lidocaine 1%) is injected around the nerve (5 mL superficial and 5 mL deep). | Procedure or surgery | Group B: Sham Radiofrequency Plus Steroid Injection |
Primary outcome
Change from Baseline in Pain Severity on the Visual Analogue Scale (VAS) at 6 Months
Time frame: Baseline and 6 months post-intervention
Pain intensity is assessed using a 10-cm Visual Analogue Scale (VAS), where 0 indicates "no pain" and 10 indicates "worst pain imaginable" (higher scores indicate worse pain). The change in foot and heel pain and paresthesia from baseline to 6 months post-intervention will be evaluated.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 23 Sep 2026.
Related trials for Tarsal Tunnel Syndrome
Not yet recruitingPhase 2
NAC-REPAIR for Post-surgical Pain
Carpal Tunnel Surgery, Trigger Finger Disorder
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
The record lists no contact. Use the official record to reach the sponsor.
Questions about this trial
What is this clinical trial studying?
A study testing Ultrasound-Guided Pulsed Radiofrequency and Perineural Steroid in people with Tarsal Tunnel Syndrome and Tibial Neuropathy, run by Assiut University.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 23 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change from Baseline in Pain Severity on the Visual Analogue Scale (VAS) at 6 Months (time frame: Baseline and 6 months post-intervention). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 Sep 2026; AzTrials last refreshed its copy on 8 Nov 2026.