Plantar fasciitis is a common cause of heel pain. The plantar fascia is a ligament that runs along the bottom of the foot and supports the arch. Plantar fasciitis occurs when the tissue becomes damaged, inflamed, and irritated.

The plantar fascia absorbs impact and stress, but too much can cause damage. Risk factors for plantar fasciitis include having high arch feet and tight calf muscles, engaging in high-impact activities, and starting new activities. Most cases of plantar fasciitis can be treated nonsurgically. NCSH foot and ankle specialists offer plantar fasciitis surgery for persistent cases.

When Is Surgery Considered for Plantar Fasciitis?

If you have persistent heel pain that limits your activity, it’s a good idea to see an orthopedist. First, they can determine if it’s plantar fascia heel pain or something else. Diagnosis includes a review of symptoms, a physical examination, and in some cases, imaging tests to rule out fractures or other causes of heel pain.

If it is plantar fasciitis, they can offer various management strategies and nonsurgical treatments. These include rest and changes in activity, a plantar fasciitis night splint, stretches, over-the-counter medications, supportive shoes, and plantar fasciitis physical therapy.

Up to 90% of patients with plantar fasciitis heal without surgery. For this reason, specialists usually reserve surgical treatment for those experiencing pain for six to twelve months, even with aggressive nonsurgical treatments.

Surgical Procedure: Plantar Fasciitis Release

Patients who are good candidates for surgery can obtain relief from a plantar fascia release procedure, also known as a fasciotomy. During the procedure, the surgeon partially detaches the fascia from the heel bone to relieve the tension that is causing pain. As it heals, the fascia should grow and lengthen.

To perform this as a minimally invasive procedure, the surgeon makes two small incisions under the ankle bone. They insert an endoscope, a small camera in one incision, and a surgical knife in the other to perform the release. This is typically an outpatient procedure. An open procedure requires a larger incision on the bottom of the foot.

Many people with plantar fasciitis also have bone spurs on the heel. The surgeon may remove these during the procedure.

Benefits and Risks of Surgery

The primary benefit of plantar fasciitis surgery is pain relief. Releasing tension in the plantar fascia should lessen or completely remove heel pain after recovery. This should then allow the patient to resume more normal activities.

Any surgery comes with risks, but plantar fascia release can be done as a lower-risk, minimally invasive procedure. Potential complications include infection, nerve damage, ruptured plantar fascia and flattening of the arch. NCSH surgeons are skilled at performing these types of procedures and take all preventive measures to lower the risk of complications.

Recovery After Surgery

Recovery from endoscopic plantar fasciitis surgery is typically three to six weeks. You should be able to wear regular shoes within a day or two of the procedure. The exact timeline and expected milestones vary by individual. Your surgeon will give you detailed information about what to expect in recovery, as well as what you can and cannot do as the foot heals.

Recovery time is longer, usually up to six weeks, for open surgery. You will probably need to wear a special boot or use crutches after the procedure to allow the wound to heal and to avoid putting weight on it. Regardless of surgery type, most patients go through several weeks of physical therapy as part of the recovery process.