Surgical Decompression for Diabetic Neuropathy in the Foot

Inclusion Criteria: * Age \>18 years * Presence of Type 1 or 2 diabetes mellitus (fasting plasma glucose \> 7 mmol/L or casual plasma glucose \> 11.1 mmol/L and symptoms of diabetes or a 2hr plasma glucose in a 75g oral glucose tolerance test \> 11.1 mmol/L) * Symptoms of paresthesias (including burning pain) or numbness present symmetrically in both feet, determined to be on a peripheral nerve basis * Total Neuropathy score of ≥ 2 based on symptoms, signs, and nerve conduction study abnormality * Average pain on Likert scale (range 0 - 10) ≥5 * Good diabetic control with Hgb A1C \< 8 * Presence of Tinel's sign at the Tarsal Tunnel * Possession of valid Ontario Hospital Insurance Plan (OHIP) coverage Exclusion Criteria: * Other types of diabetes mellitus (gestational, drug-induced, etc.) * Other cause of neuropathy than diabetes such as vasculitis, amyloidosis, toxic neuropathy, HIV, renal failure, alcohol abuse, etc. Pure entrapment neuropathy without evidence of DSP * Symptomatic lumbosacral spine disease * Symptomatic lower extremity vascular disease * Previous foot ulceration or amputation. Other contraindications to surgery such as significant ankle edema, venous stasis, morbid obesity, or previous surgery/injury which would be incompatible with appropriate wound healing * History of Peripheral Arterial Disease * HbA1c \> 8.0 - Adults lacking capacity to consent, pregnant women, prisoners, non-English speakers who require an interpreter, and those unwilling or unable to participate in the full study follow-up