Plantar fasciitis is quite a painful condition, but one that does have a lot of treatment options. This complaint occurs when one puts too much or too consistent a pressure on their foot. This could cause the collagen in their foot to develop tears and start eroding. The plantar fascia within the foot also gets inflamed. This is the tissue that links the heels and the toes.
As a result, patients with plantar fasciitis feel a deep, stabbing pain along with their heel. This is especially noticeable when they get up first thing in the morning. Since it’s runners and athletes that usually develop plantar fasciitis, patients with this condition typically want a quick and efficient remedy.
About the Surgery
There are several ways to treat the pain, including self-massage and medication. However, surgery may also be a viable option once a doctor has diagnosed this particular condition. The option of surgery is usually not the first recommendation, but one that takes place after medication, rest, and physical therapy hasn’t had the desired effect.
It may take months of contrast baths, massages, ultrasonography, taking vitamins and various other treatments before your doctor finally recommends surgery. Since this surgery is invasive, it is used as a last resort when all other options have been exhausted.
Types of Surgery
The surgery involves taking the plantar fascia right off from the heel bone. While the procedure is not a long one and the patient would probably be discharged that same day, there would be some discomfort. The patient may have to wear a splint, a boot cast, and stay off their affected foot for quite some time.
First, the surgeon would cut encircling the heel pad. The surgical procedure involves cutting some part of the ligament known as the plantar fascia. This would relieve the tension contained inside this body part. If the surgeon finds a heel spur, that would also be taken out. The same goes for any tissue that may be damaged.
One may also go for the option of endoscopic plantar fascia surgery. This means that the actual damaged part is located through some instruments. These enter the body through a small cut in the foot.
Surgery Success Rate
The success rate of plantar fasciitis is quite high. However, we should keep in mind that only about five percent of plantar fasciitis cases get to the point where surgery is required.
Some literature on the subject points to the surgery having a success rate of around 87%. Other studies say that this rate is 83%, while more recent studies have found a success rate of 90%. These statistics are quite positive, but they still point to a marginal percentage of surgeries that have not been successful.
Risks of Surgery
Like any surgery, the one for plantar fasciitis is subject to certain risks and complications. This, along with the expense and facilities required, is the main reason why doctors would try to avoid surgery in such a condition. Below are some risks arising from this sort of surgery:
- Since the surgery is open, it may expose the patient to several types of infections. This risk could become a reality if the surgical wound is not cared for, cleaned, and dressed appropriately.
- The surgery could also reduce the arch of the foot’s heel. This may be a result of the plantar fascia becoming too relaxed when it’s cut.
- There could be a numb feeling in some part of the foot. This could arise if the nerves surround the plantar fascia have been damaged surgery
- If plantar fasciitis is so severe as to warrant surgery, it may not become fully healed even with the surgical process. The pain might not go away completely.
Even with all the risks and complications involved, plantar fasciitis is a safe surgery. Most of the patients who go through it find themselves fully recovered within due time. However, the decision for surgery should be made after careful consultation with an orthopedic surgeon.
Requirements for Surgery
The decision for undergoing plantar fasciitis surgery is quite a serious one. Since the success rate is not a hundred percent, the doctor must take the case into careful consideration. There have to be certain criteria in place to make the surgery finally come into play. These could be different according to the seriousness of the condition and the doctor’s opinion, but they include the following:
- The plantar fasciitis should have been in place for around nine months to a whole year.
- During this time, other non-invasive treatments should have been consistently applied to the problem area.
- The treatment methods should include both medicated and non-medicated ones. Along with painkillers, one should also try icing, stretching massaging, soaking, arch supports, etc.
- The patient should be fully aware of the possible risks involved in such a surgery.
- The patient should be mentally prepared that the pain may not entirely cease even after surgery, along with the risks and complications involved.
- A specialist should be consulted and approve of the decision for surgery after trying all other options.
If one has health insurance, it could cover most of the costs of plantar fasciitis surgery. If a patient has met their deductible for the year, the cost may be completely covered by their insurance according to real life experiences. However, the patient may still have to copay for the doctor appointments and visits.
Since plantar fasciitis surgery does not fall into the category of cosmetic procedures, you should always check to see how much your insurance can pay. Even if one needs multiple surgeries, the insurance could cover it if the deductible is met. If not, the patient may have to pay a few hundred dollars.
Without insurance, however, plantar fasciitis surgery can be very hard on the pocket. However, the exact cost would depend on some factors. This includes the location, the specialist’s fees, follow-up charges, the country, anesthesia, etc. On an average, the whole procedure could cost a $10,000 or even more.
Recovery Time after Surgery
Since plantar fasciitis surgery is open and invasive, it may take quite some time to recover from it. The usual recovery time given by surgeons ranges from six to ten weeks. After this time, the patient may be able to walk without anyone helping them. However, it may take a full three months before the patient can resume a vigorous and active lifestyle.
While recovering, the patient may have to bear a brace, cast, or splint for some weeks if they want to move around. This would help to keep weight off the affected foot and its heel. This is important since the tissues have been cut and need to heal properly. It is also necessary to avoid further damage or infection.
If one has opted for endoscopic surgery, they may expect to recover a bit more quickly. Typically, endoscopic surgery patients may be able to walk on their own after three to six weeks.
What to Expect after Surgery
After having a procedure for plantar fasciitis surgery, there are several things to consider. Since it’s likely you had this condition as a result of an active lifestyle, you may find it difficult to be immobile or sedentary for some time. However, since you would probably be allowed to go home on the very day of surgery, you wouldn’t be stuck in a hospital room at the very least.
It can be difficult for a physically active individual to be stuck in a limited space for weeks at a time. However, you must take care to follow all the doctor’s orders. Remain with the cast or boot for as long as your specialist thinks best. You can utilize this time to look up and practice exercises you can do to remain somewhat in shape even while you’re recovering. Remember the following guidelines in order to help along your recovery progress:
- Stay completely off your feet for at least a week. Only get up to use the bathroom or when it’s necessary.
- Your affected foot and its bandage or cast should be completely dry. Otherwise, you may run the risk of infection and swelling.
- When your doctor removes the cast, invest in a pair of shoes that provide arch support. These may not be attractive shoes, but they are best for your feet.
- Try to wear your arch-support shoes even after a full recovery. You may also consider getting some orthotic shoes customized for yourself.
- You will probably have some sutures on your foot. They would be removed in 10-14 days after the surgery.
- Once the sutures are removed, you can bath your foot along with putting your full weight on it.
- Regular walking may take three weeks or even longer if it’s not an endoscopic surgery. Do not try to resume your previous routine before the doctor says so.
- When you’re back on your feet, you can relieve any discomfort by trying icing or elevating the foot after you sit back down.
- You can stretch your foot along with icing if you roll a frozen water bottle underneath it.
- You will probably be scheduled for some physical therapy appointments. Make sure you attend every one of these sessions.
- Practice the physical therapy exercises as often as recommended. These are usually simple, such as rolling a frozen golf ball under your foot.
- You may expect some pain from the surgery to remain for some time. This would be different from the plantar fasciitis pain if the operation were indeed successful.
- You may have to take prescribed pain medication to do away with the pain from the incisions.
- Consult your doctor before you start doing strenuous exercises even when you feel like your old self.
- Your doctor may recommend that you take up swimming, cycling, or something that is less impactful on foot than your usual jogging or running. This may not be a permanent switch, but it would affect your lifestyle for some time.
How painful is the surgery?
Since the doctor would probably inject a local anesthetic, there should be no pain experienced during the surgery itself. Of course, since a ligament might be cut to release tension, there might be quite a bit of pain afterward. There would also be some discomfort from the incisions and sutures made.
Pain after the surgery?
Plantar fasciitis surgery involves opening up a body part. Hence, it is very likely that even if the plantar fasciitis pain goes away, the pain of the surgery will remain for some time. For this, your doctor may prescribe some pain medication.
Time, icing, proper arch support, and physical therapy would all contribute towards getting rid of the surgery pain as soon as possible. However, the pain from plantar fasciitis may not completely fade away. You may still feel a slight ache in your feet, especially early in the morning.
Can plantar fasciitis come back after surgery?
While there have been instances of repeat surgeries with plantar fasciitis, those are a very small minority of cases. You may get scared by failure reports of such surgeries online. However, these reports are usually by a very tiny percentage of the people who have undergone the surgery. Plus, they probably had other health problems or were careless with their foot, thereby triggering the condition again.
It is possible that your condition might come back, but one can take intelligent precautions against it. The icing, stretching, and other after-care techniques described above are a step towards making sure your plantar fasciitis doesn’t come back.