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Not yet recruitingNCT07837557Updated Sep 23, 2026

Ultrasound-Guided Pulsed Radiofrequency Added to Perineural Steroid Injection Versus Perineural Steroid Injection Alone in the Treatment of Tarsal Tunnel Syndrome

An interventional study of Ultrasound-Guided Pulsed Radiofrequency and Perineural Steroid and Ultrasound-Guided Perineural Steroid Injection with Sham Radiofrequency in Tarsal Tunnel Syndrome and Tibial Neuropathy, sponsored by Assiut University. Not yet recruiting. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2026-09-23.

Sponsored by Assiut University · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
50
Allocation
Randomized
Ages
18 Years to 65 Years
Sex
All
01

Study 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. 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.

02

Conditions studied

  • Tarsal Tunnel Syndrome
  • Tibial Neuropathy

Keywords

  • Pulsed radiofrequency
  • Perineural injection
  • Ultrasound guidance
  • Posterior tibial nerve
  • Triamcinolone acetonide
  • Nerve entrapment
  • Neuropathic pain
03

In context

Nerve Compression Syndromes

38 studies on the registry are indexed under Nerve Compression Syndromes; 8 are open to participants now.

This study's planned enrollment of 50 is below the median of 62 across 27 interventional studies indexed under Nerve Compression Syndromes.

Browse Nerve Compression Syndromes studies →

Lead sponsor

Assiut University is the lead sponsor of 5,078 studies on the registry; 2,178 are open to participants now.

Of its 14 completed or terminated interventional studies of FDA-regulated products, 0 (0%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • 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 to conservative therapy (e.g., vitamin B complex, NSAIDs, oral , or night splints).
  • Positive Tinel's sign and/or positive triple compression test.
  • Patient is willing and able to provide written and attend all scheduled follow-up visits.

Exclusion criteria

Exclusion Criteria:

  • 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 or antihistamines.
  • Presence of coagulopathy.
  • Local infection at the planned injection site.
  • Known allergy or to any of the study medications (triamcinolone acetonide, lidocaine, or dextrose).
  • Pregnancy or lactation.
  • Patient refusal to participate.
Terms in these criteria, in plain language(4)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Relapsed and refractory

Relapsed: the illness came back after treatment had worked. Refractory: it did not respond to treatment, or stopped responding while still on it.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Outcomes assessor)
Enrollment
50 participants (estimated)

Study arms

  • Experimental
    Group A: Pulsed Radiofrequency Plus Steroid Injection

    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).

    Procedure: Ultrasound-Guided Pulsed Radiofrequency and Perineural Steroid

  • Sham comparator
    Group B: Sham Radiofrequency Plus Steroid Injection

    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.

    Procedure: Ultrasound-Guided Perineural Steroid Injection with Sham Radiofrequency

Interventions

  • ProcedureUltrasound-Guided Pulsed Radiofrequency and Perineural Steroid

    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).

  • ProcedureUltrasound-Guided Perineural Steroid Injection with Sham Radiofrequency

    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).

06

What researchers measure

Primary outcomes

  1. 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.

    Time frame: Baseline and 6 months post-intervention

07

Study locations

No study locations are listed for this record.

08

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for Oct 2026; primary completion for Oct 2027, 12 months later.

Of 17 interventional studies with no phase under Nerve Compression Syndromes, half reached primary completion within 36 months of starting (the median), counting those still running; a quarter within 7 and three quarters within 50. This study's planned 12 months is below that.

How these figures are worked out, and which studies are left out of them.

Registered
Sep 18, 2026
First posted
Sep 23, 2026
StartEst.
Oct 2026
Primary completionEst.
Oct 2027
CompletionEst.
Nov 2027
Last update
Sep 23, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Sep 23, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT07837557
Lead sponsor
Assiut University
Responsible party
Ahmed Bahgat Ramadan Amin (Resident of Anesthesia, Intensive Care, and Pain Management, Assiut University) — Principal investigator
First posted
Sep 23, 2026
Start date
Oct 2026 (estimated)
Primary completion
Oct 2027 (estimated)
Completion
Nov 2027 (estimated)
Last update
Sep 23, 2026

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Sep 2026. You cannot join it, but the record below documents what was studied.

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