What You Need to Know About Surgery for Plantar Fasciitis

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

Surgeon in scrubs in OR 1280 x 853

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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’m 2wks post op. Haven’t had any pain at all, only thing I do have is the numbess from the tips of my toe to my heel.. Does the numbness ease up at all. Top of my foot is fine

  • Wanted to share my experience of bilateral PF release for those who are active.
    Pre-surgery was able to easily put in 15-20 miles of running a week, even with my arches feeling like rubber bands snapping with every foot stroke. Had bilateral surgery October 2017 and didn’t feel comfortable putting in a good run until about 6 months later (March). Post-surgery, both feet still have pain but it’s heel pain and the snapping feeling is no longer there. However, it is a struggle to run more than 2-3 miles at a time. Had an MRI February 2020, which revealed moderate PF in both feet, as well as tendinitis with a few tears. New podiatrist suggested orthotic braces, but will most likely need surgery… again.
    While my experience was not successful, I hope others are luckier. Take care of your feet!

  • I’m 2.5 weeks post pf surgery and I’m having the worst pain in my foot All the time especially in my toes at night, there isn’t a break in pain and the pain meds don’t work, The pain is so bad I can’t sleep, I’m bearing light weight with a walking boot on. Has anyone experienced this problem? Any advice will help! Thanks in advance.

  • Hi, how long was it till you had 95% pain free? I’m 3 months post release opp, I have started running but it starts to hurt and have similar pain pre op after my runs.

  • My doctor scheduled me for this surgery but after reading that reviews on here, it appears that 90-95% experience the same if not more pain or complications afterwards. And I have a job where I walk 6-8 miles on concrete everyday. Think I’m going to reconsider. And I’m very glad we have forums like this for ppl to share the experiences, otherwise no one would ever know. Thanks for all your feedback.

  • I have a consult for orthopedic surgery on Monday for my severe planter fasciitis. I am scared to death now after reading this information. Sounds like a crapshoot to me. I appreciate everyone’s honesty though.

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