For people who commonly experience foot pain, increased heel pain might not seem like a cause for concern. But plantar fasciitis is the most common cause of this pain, WebMD states. That means that many people who experience pain have ligament damage that can affect their mobility.
People may develop this condition as they age, but it also happens to younger populations who are athletes or those who work in industries that require them to be on their feet for most of the day. The strained ligaments involved in plantar fasciitis are vital to the strength and structure of your feet.
For patients who experience severe heel pain, surgery is one option that could provide long-term relief. Surgery may also increase mobility after the recovery period following surgery. Here is everything you need to know about plantar fasciitis surgery to determine whether it is right for you.
What is Plantar Fasciitis Surgery
Plantar fasciitis surgery involves creating an incision on the heel of the foot to access the plantar fascia ligament. Patients who experience heel spurs will typically have those removed at the same time. The surgery requires a cut in the plantar fascia ligament and substantial recovery time.
As medical technology advances, endoscopic surgery is also an option for this type of treatment. Endoscopic surgery removes the need for large incisions to access the ligament, which can help speed recovery time post-surgery.
Most patients with heel pain never need surgery. In fact, many people can relieve their heel pain with home treatments or methods under the direction of their doctor. However, some people will require surgery to relieve ongoing pain.
Who Should Have Plantar Fasciitis Surgery
Doctors often recommend non-surgical measures to help relieve the symptoms of plantar fasciitis. Those include resting, icing painful areas, stretching your toes and lower legs, and trying new shoes to support your feet better.
Other methods of treating heel pain involve using alternating hot and cold packs on the affected areas, taking nonsteroidal anti-inflammatory medications, wearing night splints, or using orthotics for better foot positioning.
If your weight is contributing to the stress and pain of your foot condition, your doctor may recommend weight loss before resorting to surgical means of eliminating pain. Also, physical therapy may help alleviate symptoms, especially when combined with shock wave treatments.
A study on painful heel syndrome documented the results of nonoperative treatment in one hundred and five patients. That study showed that with anti-inflammatory medications, rest, heel cushions, stretches, and occasionally injections, 89.5 percent of patients saw improvement within eleven months.
Only five patients opted to undergo plantar fascia release operations after the nonoperative course of treatment. Six patients continued to have pain but decided not to undergo surgery. This study shows that conservative treatment may prevent the need for surgery in many cases.
However, doctors do recommend surgery when you have tried other methods of relieving pain for a long period, usually six months to a year. If no other methods help your heel pain, your doctor will either cut apart part of the plantar fascia ligament or loosen certain nerves.
By cutting the plantar fascia ligament, the surgeon releases the tension on the ligament. This relieves pain and can help reduce swelling. In most cases, surgery is a last resort when patients are dealing with severe pain and can’t manage it with rest and the methods noted above.
What Are the Risks and Complications
Because the surgery involves the feet, recovery time is dependent on staying off your feet or significantly reducing physical activity for a period of six to ten weeks. You’ll likely have to wear a brace for support and to protect the treated area after surgery.
Usually, within three months, plantar fasciitis surgery patients can resume regular activity and exercise. With endoscopic surgery options, patients may experience faster healing periods and less pain during recovery. A smaller incision means easier wound care post-surgery as well.
While rare, complications do occur with plantar fascia release surgery. Podiatry Today reports that cutting the right amount of the ligament is vital for avoiding complications. Their research notes that the appropriate incision is less than 40 percent of the ligament.
Also, incision placement can affect patient healing. Therefore they recommend a medial in-step technique. However rare, risks of any plantar fasciitis surgery include painful scars or potential nerve entrapment. Regular scarring is common, although typically minimal.
While rest is an important part of the recovery period, Podiatry Today’s expert recommends that patients walk with the support of a surgical shoe to keep the ligament flexible. This way, patients avoid the ligament reattaching and causing continued pain.
What Results Can Patients Expect
According to one study by Foot & Ankle International, most patients who had plantar fasciitis surgery experienced less pain and increased mobility. After treatment, 75.6 percent of patients reported pain-free or mildly painful heels.
The study followed a total of forty-one patients who reported severe heel pain before the procedure. Overall, 48.8 percent of the participants were totally satisfied with the outcome of their surgeries. Only four patients in the study reported no improvement in their mobility.
However, one of the participants had another condition that affected recovery. Pre-existing conditions, as well as a patient’s overall health, can influence individual recovery times and outcomes. Also, some cases of plantar fasciitis seem resistant to nonsurgical treatment methods. Those severe cases may see lasting effects even after surgery.
Another possible side effect is numbness. This outcome depends on whether nerves in the surrounding area remain intact. It is uncommon, but a risk that exists with any surgery. In general, properly caring for the surgical site afterwards is the most important step toward a full recovery.
While the surgery outcome study was small, so is the population that truly requires surgical intervention to cure heel pain. In general, surgery effectively cures severe pain due to plantar fasciitis. It also increases most patients’ quality of life and prevents the same issue from reoccurring.