For patients who have tried conservative treatments (i.e. stretches, exercise, ultrasound therapy, shoe inserts) without successful results, plantar fasciitis surgery may be recommended, especially if pain and other symptoms persists after 9 months. Surgery on the plantar fascia is normally day surgery that only requires a local anesthesia.
Plantar Fasciotomy
Endoscopic partial plantar fascia release (also known as a Plantar Fasciotomy) involves the surgeon making small incisions on the sides of your foot. A small camera and scalpel are inserted into tiny incisions to perform the surgery.
The inflamed or damaged plantar fascia tissue will be cut or part of it will be removed to relieve pressure and reduce pain. The hope is that your body will grow new fascia in the gap created by the incision.
Heel-Spur Fasciotomy
Open heel-spur fasciotomy surgeryinvolves removing any calcium deposits and/or bone spurs from the heel area. During this procedure, an incision is made at the bottom of the heel over the area of the spur so it can be removed and the fascia may be cut to relieve tension.
This procedure has mixed results, as it is addressing a symptom of inflammation, but not the problem itself. If the plantar fascia is not repaired at the same time, your heel spur will most likely reappear.
Neurolysis
Neurolysis involves cutting the nerve sheath of the abductor digiti minimi muscle and breaking up adhesions(scar tissue) to free the nerve and relieve the pressure and pain from inflammation. Radio frequency, heat, or chemical injection, have also been used.
Most of the surgeries for plantar fasciitis require a recovery time of approximately 1.5 months. Sometimes a removable cast will be used to support and immobilize the foot. Occasionally crutches or a cane will be used to minimize weight bearing.
Potential Complications
- Partial wound dehiscence (rupture of a surgical wound)
- Foot pain
- Nerve damage
- Hypersensitive neuroma
- Infection
- Fallen arch if there is an over release of the plantar fascia
Plantar Fasciitis Treatments
Conservative treatments tend to be the best way to treat plantar fasciitis. However, it can take months to years to heal depending on your situation and commitment to treatment (6 weeks to 6 months or longer). To improve healing time and treat your pain naturally, cold compression therapy and Blood Flow Stimulation Therapy™ are recommended.