I have Anterior Tarsal Tunnel following three foot surgeries and am facing the same decision. The difference is that it is my deep peroneal nerve that is entrapped so my pain is more at the front of the ankle, going across the top towards the big toe. My first diagnosis came by way of a nerve conduction study/EMG. My ortho sent me to the neurologist after I developed some foot drop and weakness. The test showed that I basically had no conduction past the ankle joint. I went for a round of PT and the foot drop did resolve. However, I still have the pain and numbness.
That was a year ago. I have managed the pain with injections to block the nerve. So far I've had two. My doctor really doesn't want to do surgery (nor do I) as he isn't happy with the success rate of nerve release and my foot has already had a lot of trauma. Also, there is no guarantee the nerve is not damaged. We wouldn't know that until after the surgery (and I didn't get better). That being said, there are those who have had successful nerve release surgeries. However, many have to have them repeated.
As far as the MRI, my neuro told me it is difficult to show up in an MRI but you sometimes see things that indicate it. I had an MRI about a month ago to evaluate things and it showed atrophy of the EDB muscle which is the one supplied by the deep peroneal nerve. So, in effect, the MRI confirmed the Tarsal Tunnel.
The decision whether to have surgery or not is indeed a difficult one when you have had multiple surgeries as we have. Every time they go in there the foot suffers more trauma. However, the prospect of living with pain the rest of my life is daunting. But surgery is no guarantee either. I am now with a pain management doctor. My pain is manageable and fortunately, I am on fairly mild pain relievers which give me very few side effects and I am able to do most anything I want to within reason. I can't walk long distances without pain and I can't be on my feet for long without having to take a break, but I've learned to adapt. For now, I've chosen to take a wait and see approach. If the pain gets much worse or I develop too much weakness then I may have no choice.
You can always get another opinion, but I would have the MRI done anyway so you can see exactly what's going on. Tarsal tunnel may not show up, but it would rule out other problems. It is a tough decision. I would recommend taking your time, researching, possibly getting another opinion, then decide what is best for you. Only you can ultimately decide but I would be happy to answer any questions you may have or someone else on here may offer some additional insight.
Best of luck to you. Let us know how you are doing.