What Should I Expect from Plantar Fasciitis Surgery?

Mike Howells

A common ailment among athletes, plantar fasciitis is the inflammation of various connective tissues on the underside of the foot. It can be a debilitating condition, and due to the constant weight-bearing nature of human feet, is in fact often degenerative and may get worse if left untreated. Plantar fasciitis surgery is considered a last resort in correcting the problem, if less invasive treatments fail to resolve the issue.

A scalpel is a small, sharp knife that is used in surgeries to make incisions.
A scalpel is a small, sharp knife that is used in surgeries to make incisions.

Collectively known as the plantar fascia, the band of fibers that run from the base of the toes to the front of the heel are subjected to tension whenever the feet bear weight. Given the extraordinary stresses placed on the feet by most athletes, these fibers are prone to inflammation and tearing with relative frequency, compared to the general population. In non-athletes, occurrences of plantar fasciitis increase along with body weight as the logical result of an abnormally high load on the feet. Roughly one in ten people overall will develop the condition at some point in their life.

Plantar fasciitis often causes feet to hurt in the morning.
Plantar fasciitis often causes feet to hurt in the morning.

The most common symptoms of plantar fasciitis are stiffness and intense pain on the underside of the foot, particularly when trying to flex the toes upward. Pain is more pronounced when the flexing occurs in the act of walking or running. Diagnosis is fairly straightforward and typically done on the basis of described symptoms and visual observation. Advanced scans, such as magnetic resonance imaging (MRI) or ultrasound, are generally only needed when there are confusing or atypical symptoms, like numbness or discoloration of the skin.

Massage therapy for an afflicted foot can be an alternative to plantar fasciitis surgery.
Massage therapy for an afflicted foot can be an alternative to plantar fasciitis surgery.

Prior to plantar fasciitis surgery, a number of treatments are typically administered to try to bring down the inflammation in a non-invasive way. Though hard to isolate given the location and function of the plantar fascia, rest of the affected foot is among the first and most important steps to relieving swelling and pain. Orthotic footwear is another early treatment option, and considered the single most effective option barring surgery.

Plantar fasciitis is the inflammation of various connective tissues on the underside of the foot.
Plantar fasciitis is the inflammation of various connective tissues on the underside of the foot.

Along with these, regular stretching of the foot and the calf muscle and use of anti-inflammatory drugs make up the bulk of non-surgical treatment. Other less-used alternatives include massage therapy, nighttime use of splints, and corticosteroid shots. The latter is controversial, however, and runs the risk of doing more harm than good with repeated injections. In nine out of ten cases, one or a combination of these treatments are successful in relieving the condition.

A common cause of pain in the heels is plantar fasciitis, an inflammation of a tendon stretching from the heel to the front of the foot.
A common cause of pain in the heels is plantar fasciitis, an inflammation of a tendon stretching from the heel to the front of the foot.

If pain and stiffness remain after more conservative efforts, however, plantar fasciitis surgery may ultimately be recommended as a last resort. Traditional plantar fasciitis surgery is known as plantar fascia release, and as its name implies involves releasing the inflamed connective tissues slightly from their original location, decreasing pressure and pain. Newer types of surgery that utilize arthroscopic techniques and ultrasound are less invasive and more precise. Though generally the most successful approach in ultimately resolving the condition after other attempts fail, surgery of any type also runs the greatest risks.

Besides sharing the typical high costs associated with any kind of medical operation, plantar fasciitis surgery can sometimes result in lengthy or even permanent nerve damage to the foot, or rupture the plantar fascia tissue entirely. Recovery time, even in successful surgeries, can be lengthy and still painful. Plantar fasciitis surgery has a relatively low success rate of 70-80% compared to other types of operations, like knee replacements, but for long-time sufferers the potential may nevertheless be ultimately worthwhile.

Before scheduling plantar fasciitis surgery, a podiatrist will pursue non-surgical options.
Before scheduling plantar fasciitis surgery, a podiatrist will pursue non-surgical options.

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