One frequently encountered foot issue is plantar fasciitis, which arises when the plantar fascia (a tissue band situated on the underside of the foot) is overly stressed or strained. Various factors can contribute to this condition, such as weight gain as well as insufficient stretching or warm-up exercises before running or engaging in physical activity.
If you are experiencing pain in your heel, there are several methods that can help alleviate the discomfort. Activities like walking and wearing shoes that provide proper support can often improve the pain. However, in situations where the pain persists and does not show signs of improvement, your doctor might suggest a surgical intervention to address the issue effectively.
One of the primary indicators of plantar fasciitis is the presence of discomfort in the area beneath the heel or sole of the foot. This discomfort tends to intensify after transitioning from a seated or reclined position to a standing one. Additionally, the condition can be exacerbated by extended periods of standing or by wearing ill-fitting shoes that do not adequately support the foot.
Most people who have plantar fasciitis do not need surgery to treat it. Nonsurgical treatments like rest, ice, and stretching work well in most cases. However, for some patients with severe plantar fasciitis that does not improve, surgery may be needed.
How often is surgery needed?
There are many different types of surgeries that can be used to treat plantar fasciitis. Your doctor will select the best one for you based on your symptoms and medical history.
1. Open plantar fascia release – This is done in a hospital and typically requires general anesthesia or a regional block with sedation. A 1- to 2-inch incision is made to expose your plantar fascia and detach it from your heel bone. Your doctor can loosen any trapped nerves and remove bone spurs at this time, too.
2. Endoscopic plantar fascia release – This is a minimally invasive procedure that uses a small camera and a tiny knife to cut part of the plantar fascia to release tension.
3. Ultrasonic plantar fascia repair – This is a type of surgery that involves using ultrasound imaging to guide a needlelike probe into the damaged plantar fascia tissue. The probe tip vibrates rapidly to break up the damaged tissue, which is then suctioned out.
4. Proximal medial gastrocnemius release – This is a surgical procedure that helps patients who have tightness of the gastrocnemius muscle, which causes problems with ankle movement and knee extension.
5. Partial plantar fascia release – This is also a surgery that can help patients who have a normal range of ankle motion but continue to have pain in their heel. This type of surgery has a very high success rate, but it can’t be used for everyone.
6. Postoperative rehabilitation – Several weeks after your surgery, you will need to follow up with physical therapy and take part in activities that stretch the plantar fascia and calf muscles. If you are able to walk well, you can stop your rehabilitation program and resume daily activities.
7. Recovery time – After either type of surgery, you will need to rest and wear a supportive shoe or boot for several weeks. Your doctor may recommend icing the affected area, applying heat to it, or wrapping it with a special device called a brace.
