Plantar fasciitis does not usually necessitate surgery, and according to the NHS, less than 5% of patients have had heel pain surgery, indicating that non-surgical treatment is ineffective.

This article will explain plantar fasciitis surgery and whether it is a viable option.

The article will also discuss alternative treatments to surgery so that you are aware of all possible plantar fasciitis treatments before considering surgery as a last resort.

Do You Need Plantar Fasciitis Surgery?

As previously stated, plantar fasciitis does not necessitate surgery to alleviate pain. Before considering surgery, non-invasive treatments for heel pain should be tried first.

According to the Beacon Medical Group (part of the NHS), most cases of heel pain can take up to 12 months to resolve.

If the pain is still unbearable and other treatments have failed, surgery may be an option. According to the NHS, the operation would be considered only if you are of a reasonable weight for your height and your plantar fasciitis has not improved using the methods provided.

What Does the Surgery Involve?

Plantar fasciitis surgery entails detaching a section of the plantar fascia from the heel bone to relieve tension in the area.

This procedure is performed through a 3cm cut on the inside of your heel and is essentially open surgery, which the NHS notes isn't always safe or effective.

Another type of plantar release surgery is endoscopy, which involves making a small incision and inserting tools through it to access the plantar fascia.

This procedure has a much shorter recovery time of up to three weeks, but it must be performed by a highly-skilled surgical team. This means that the procedure will take longer to complete.

Depending on the severity of your heel and plantar fasciitis, surgeons may also remove damaged tissue and some of your heel bone to relieve tension and allow the area to heal more effectively.

Pros

Good Success Rate – According to the NHS, most people who undergo surgery feel better afterward. According to a 2014 study by Wheeler et al, 50 percent of cases were successful with no pain, and for those who weren't, the average figure for improved pain after surgery was 79 percent.

Cons

Foot Function Reduction – According to Colin Dombroski's The Plantar Fasciitis Plan Book, cutting away some of the plantar fasciitis can result in a loss of arch support of up to 25%. This is especially unsuitable for people who have flat feet.

Pain may be worse for those with long-term heel pain –Studies have shown that the outcomes following surgery may be worse for people who have had heel pain for a longer period of time.

Recovery Time and Side Effects – Although recovery time after surgery can range from 3-6 weeks, you may not notice the impact until months later. You may experience tingling or numbness in the operated foot during the recovery period and be restricted from certain activities.

Availability and Cost

If your foot pain has not improved after 12 months and is severe, your doctor may refer you to a podiatrist or orthopaedic surgeon. It is unknown how long you would have to wait for surgery if it comes to that.

If you go through a private surgeon, however, typical costs range from £1,250 just for the procedure itself, so you would also need to consider consultation, discharge, aftercare, and other costs.

Alternatives to Plantar Fasciitis Surgery

Long-term heel pain may benefit from the following non-invasive treatments:

Shock Wave Therapy

In shock wave therapy for plantar fasciitis, high energy acoustic waves (aka shock waves) are delivered to the plantar fascia to make your plantar fasciitis 'feel a little worse' in order to bring about healing and improvement.

Low-dose therapy is painless and usually performed in sessions, whereas high-dose therapy can be a little more painful, with some superficial bruising at the application site.

The procedure is simple and quick, involving the application of ultrasound gel or local anesthesia before the shock waves are delivered to your foot via a wand device.

Cortisone Injections

Cortisol is an anti-inflammatory hormone in your body and cortisone is synthetically produced to mimic this and injected into your foot through a needled syringe to relieve plantar fasciitis pain.

This treatment is one of the cheaper options and works for some people but it comes with many caveats as it can be painful; result in a temporary flare up of infection-like symptoms; and according to the Beacon Medical Group, a maximum of three cortisone injections can be given in a year.

Frequent injections run the risk of rupturing your plantar fascia and a weakening of the tissues around the injection area.

Platelet Rich Plasma Injection

A small amount of your blood is drawn for injection because platelets promote connective tissue growth and healing. Before being injected directly into your plantar fascia, your platelets are spun in a centrifuge to increase their concentration levels.

Other Plantar Fasciitis Treatments

Some of the first plantar fasciitis treatments that are still effective today are:

Custom Orthotics

A custom-made pair of orthotics is made to fit the contours of your foot using a 3D cast that fits inside your shoes to relieve pressure on your plantar fasciitis and provide support through the fitted cushions.

There are two kinds: accommodative (redistributes pressure around the foot) and corrective (directs your foot into the 'correct position').

Off-the-Shelf Orthotics

Inside your shoes, devices such as heel cups and molded insoles help to relieve discomfort and provide cushioning to absorb impact when you're on your feet.

These orthotics are made to fit the average human foot and may not suit everyone, but a heat-moldable orthotic can be molded to fit your foot.

Night Splints

A night splint is a brace that is strapped to the front or back of your leg to keep your calves and plantar fascia stretched. It is typically used 12 to 16 weeks into your treatment plan or when orthotic therapy fails.

This prevents morning pain because there is no risk of tearing the half-healing soft tissue in your foot, which happens when your foot is relaxed. This aid can be used alone or in conjunction with other orthotic treatments.

Ice Therapy

Icing can help relieve pain and swelling in your injured foot and is typically used within the first few days of the onset of plantar fasciitis.

This also helps to numb your foot and increases blood flow to the area by contracting your blood vessels.

Icing is as simple as freezing a filled water bottle and rolling your entire foot over it for 15 minutes several times a day to provide a massage to your foot.