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 was told today I may need the release done! I’ve had cortisone shots twice and I’ve had zero relief! I bought brooks tennis shoes like my podiatrist said and still no relief I have 2 pairs of shoes I can wear comfortably but by the end of the day my feet are hurting terribly! Dr told me today he’s going to give me shots in 6 weeks and I am to in the mean time get me some orthotics I go Monday to get fitted for them! I see everyone’s negative comments about the surgery! This pain is unreal and it’s in both my feet! I’m so frustrated with the pain I walk in my feet all day at work except for lunch. I’m worried now that I’m always going to be in pain! I’m only 38 years old too!

  • I had it done almost a year ago after years of PF custom orthotics shots shoes etc. NEVER again I still have heel pain and a nerve entrapment after all this time 8 weeks in a boot…now in physical therapy trying to work it out……..If I would have known this would not work I would have never let the doctor talk me into the surgery……wish I would have researched it more.

    • After 3 years of pain and doing everything suggested to help with of, I decided to do surgery. Worst mistake, I would rather pain of of. It’s been 1 month since surgery. I cant walk at all. Cant bear any weight on foot. Feels like my bones are cracking, and my muscles are ripping open. Worst pain, and no boot helps. Feet turn purple and swell everyday. Very sensitive to touch and cant hardly move my toes. I’m waiting for MRI, after having 3 doctor’s take 5 xrays, maybe I’ll finally get answers to what’s wrong. All I want is my ability to walk again. Everyday is hard and frustrating, cant tell anyone what to do but if I could go back I would have never had the surgery.

    • Same here I still have lots of pain I wish I could gave given the wave treatments a shot even though I would have had to pay out of pocket

  • Just had an open plantar fascia release. I was non weight bearing for two weeks and have been in a walking boot for one week. My doctor is trying to send me back to work next week after only 4 weeks. I’m a nurse and on my feet nonstop working in the OR is this normal or safe to do. Still extremely tender to try to walk on

    • From everything that I can research 5-6 weeks for open surgery is the normal time frame for being out of work, and transitioning into a more stable environment. I hope you all the best as I am going to have the surgery in two weeks on both feet.

  • I am 10 days after surgery. Had horrible heel pain and arch pain was insane…had done the shots for 2 yrs…have horrible numbness on the top half of my foot …the bottom half the sole is fine..find out more on thursday…

    • This is my fiest night and my heel pain is so bad i cry it feel like i beoke in a new shoe ans my heel just feels like its burning idk if thats nor mal but would be great to get sleep

  • GOD BLESS THESE DRS WHO TELL YOU THE SURGERY IS THE BEST THING!! …I WAS TOLD BY MY PODIATRIST THAT I NEED SURGERY IF THE INTENSIFIED P/T DONT WORK…I AM PRAYING AFTER READING ALL OF THE ABOVE THAT IT DO WORK. I HAD STEROID INJECTION THE FIRST TIME PF STARTED ..THEN I WAS GIVEN PRESCRIBED ORTHOTICS $350-$400… I LOST 20 SOME ODD LBS WITH THE HELP OF MY NIECE & P/T FOR A FEW WEEKS & THE PAIN WENT AWAY LAST WINTER ..NOW ITS BACK I GOT THE INJECTION AGAIN WGICH IS SUPPOSED TO BE 3 CONSECUTIVES INJECTIONS & INSTEAD OF MENTIONING THE STINT TO REST WITH AT NIGHT… PLUS THE OTHER OPTIONS ABOVE THE DR WANT TO GO TO FULL BLAST SURGERY NO!! I LOOKED UP ON LINE THANK YOU GOOGLE CONCERNING PF SURGERY & THE AFTERMATH SIDE AFFECTS I SEEN THE OPTIONS ….AND END RESULTS I READ THE COMMENTS ..I WENT TO WALGREENS GOT A FOOT SUPPORT FOR PF OVERNIGHT FOOT WEAR THE PAIN IS ACTUALLY NOT AS BAD IN THE MORNING WHEN I STEP DOWN…. IM PRAYING FOR HEALING FOR ALL OF YOU & THANK YOU ALL FOR POSTING HERE …DRS SEE A BUSINESS THAN A PERSON …THE SURGERY CAUSES MORE COMPLICATIONS SO THE PATIENT HAVE TO KEEP COMING BACK…NO MATTER WHO PAYS…I LOVE GOOGLE, YOU AND HONEST DRS WHO POSTED THE ABOVE INFO ALTOGETHER AGAIN THANK ALL OF YOU STILL PRAYING IT GOES AWAY OR ATLEAST LIGHTEN …NUMBESS IM SURE IS A VERY UNCOMFORTABLE EXPERIENCE

  • after reading all the comments i decided to share my experience .
    its been 2 months ago i ve done the surgery , spent 3 weeks without walking on my foot and since that day things are getting worse am feeling pain on my heel ı started to feel ıt when i wake up 1st step , i thought it needs more time to heal but till the day came and i decided to play soccer back everything was ok and there was a pain which am used to since before surgery , after 1 hour of playing i couldnt stand anymore and my heel was really in pain its been 3 days now and the pain isnt going away . i wish i didint do the surgery since it didint give any advatages for me .

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