What You Need to Know About Surgery for Plantar Fasciitis

By Janet Pearl, M.D., M. Sc. | Published 7/15/2019 71

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Severe or advanced cases of plantar fasciitis only rarely require surgical treatment. Some of the conditions where surgical intervention may become inevitable include the following:

  • when an injury is left untreated
  • in the minority of cases for which conservative treatment or regenerative medicine treatments are ineffective and damage accumulates
  • when injuries in the plantar fascia have progressed to a point where there is an accumulation of tension in the ligament that causes its gradual degeneration. 

The surgical procedure for plantar fasciitis is called Plantar Fascia Release. As its name suggests, the main goal of Plantar Fascia Release surgery is to release the tension on the plantar fascia. The goal is to restore the foot’s flexibility and relieve pain.

Plantar fasciitis surgical procedures

The procedure for Plantar Fascia Release involves making small cuts in a fraction of the fibers that make up the plantar fascia. This is done in order to relieve tension and stress in the ligament.

Plantar Fascia Release can be performed via either open surgery or endoscopic surgery:

  • In open surgery, a small area in the bottom of the foot is cut to give access to the plantar fascia to allow your surgeon to see it.
  • In endoscopic surgery, only very small incisions are made to insert an instrument equipped with a micro camera that allows the visualization of the ligament and the release of the plantar fascia.

Endoscopic surgery is usually preferred due to the shorter recovery time, but the choice of open or endoscopic surgery may depend on your anatomical and clinical characteristics.

In some advanced cases of plantar fasciitis, heel spurs may develop. When that is the case, they can also be removed during the surgery. When necessary, damaged tissues or a small portion of the heel bone may also be removed to reduce tension and stimulate healing.

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Plantar fasciitis surgery recovery

Recovery time depends on the type of surgery that you undergo.

  • Open surgery

If you undergo open surgery, you will need to wear a cast or brace for the first two or three weeks of recovery to keep your foot stable. This also minimizes the pressure on the heel and foot and allows the tissues to heal.

Recovery time for open plantar fasciitis surgery is usually between six to ten weeks. At this point, you should be able to walk without assistance.

  • Endoscopic surgery

Since only small incisions will have been made if you undergo endoscopic surgery, you will not need a cast. In fact, you can go back to wearing shoes whenever you feel comfortable doing so.

Recovery time is shorter, with most patients being able to walk normally after three to six weeks.

In both cases, full recovery and the return to high-impact activities and exercises like running or jumping may take around three months. During the recovery period, healing will also be promoted with foot strengthening stretching exercises.

Related content: Trainer Rx Helps You Take Charge of Your Physical Therapy

Plantar fasciitis surgery success rate

Plantar Fasciitis Release is successful in relieving heel pain in the majority of patients.

Complications of plantar fasciitis surgery

As with any surgery, there is always a risk of complications. It is important that you are fully aware of what may happen.

Possible complications of plantar fascia release include:

  • Infection

A small risk of infection exists in any surgery, particularly if the wound is not appropriately cleaned. Infections that are detected early can be easily resolved with antibiotics.

  • Nerve damage

There is also always a risk of nerve damage in any surgery. If damage to the nerves surrounding the fascia occurs during the procedure, you may develop numbness, weakness or tingling in your foot.

  • Excessive release

A specific and unlikely complication of this procedure is an excessive release of the plantar fascia. This can greatly reduce the height of the foot arch, which will increase the likelihood of further foot injuries.

  • Unresolved symptoms

In some cases, the surgery may not be successful and symptoms may persist.

Before considering surgery

Plantar Fascia Release is an invasive procedure that should only be considered as an option in very severe cases that can not be resolved with conservative treatments. Around 95% of plantar fasciitis patients are able to recover with non-invasive treatment options within a few months.

Surgery should be your last resort.

There are many options for the conservative management of plantar fasciitis, including,

  • rest
  • stretching exercises
  • ice massage
  • deep tissues massage
  • over-the-counter or custom-made orthotics
  • night splints

There are also additional alternative therapeutic options with good results in plantar fasciitis that you may also consider. These include extracorporeal shock wave therapy and ultrasound-guided platelet-rich plasma injections.

Before you consider Plantar Fascia Release surgery, be sure you have exhausted all other possibilities.


Related content: 6 Standing Desk Tips That Help You Avoid Pain

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Originally published September 23, 2018, this post has been updated for republication.

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Janet Pearl, M.D., M. Sc.

Website: http://fasciitis.com/

Janet Pearl, M.D., M. Sc., Member of the American Pain Society, The Massachusetts Medical Society, the Massachusetts Society of Anesthesiologists, the Massachusetts Society of Interventional Pain Physicians and more. Received her M.D. from the Columbia College of Physicians and Surgeons and received an M. Sc. in Health Planning and Financing at the London School of Hygiene and Tropical Medicine.
Medical Director at The Center for Morton's Neuroma and
Faciitis.com

Comments:

  • I had open plantar fasciitis surgery a month ago also having 5 verclose veins removed and a main nerve repaired. I still have no feeling in my foot at all but am just barely able to walk with walking cast boot. I will say it has been very painful and you need lyrica for the nerve pain but my doctor has been amazing and tells me I still have a long recovery since I had so much done at once. I’m sure this didn’t help anyone just wanted to let people know to please take care of foot pain early because this surgery is no joke.

  • I tried everything doctor told me to do before my surgery. Night splints, Orthopedic soles, orthopedic shoes, deep penetration oils and lotions, and foot stretches. A very painful 7 months. Some days at work at felt like pain level of 8 to 9. I had the plantars fasciitis release surgery. And I was off work for 6 weeks. Pain level is at a 5 to 6 after the surgery but it doesn’t seem like it’s healing after 6 weeks at work. So doctor put me off work for another 4 weeks and physical therapy. At work I’m on my feet all day. So at this point I need to let it heal. Correct

    • it takes 3 months of non weight bearing to heal that’s from my doctor I’m 6 weeks out of surgery and can walk in boot for hours with no pain on plantar fasciitis. take your time let it heal.

  • I had surgery 8 months ago , and the pain is worse now after surgery than it was before hand and i done wverything doctors and physio’s told me to do , i went back to docs to be told my plancter fasciitis is back again .i would not recommend getting this surgery.

  • Nice article about surgery of plantar fasciitis surgery. But the surgery is rarely needed, as you mentioned. Most of the cases are amenable to footwear change, drugs and exercises.

    • When it is needed to think twice. Not a thing to take lightly. Mine was a failure.

  • Even though it has been years since I had the plantar fasciitis surgery done I am now having issues with balance standing on one foot is damn near impossible they tell me to keep working on it and even use a balance pad but it’s hard and it’s painful so good luck on getting your balance back

  • This was THE BEST tutorial ever! Thank you so much & I will be sharing this with everyone I know!

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