When Is Surgery the Best Choice for Plantar Fasciitis?

Plantar fasciitis is a fairly common cause of chronic heel pain, particularly among people in their 40s and older. It’s so common that it accounts for about a million doctor visits every year in the United States and makes up about 10% of running-related injuries.

The good news is that while plantar fasciitis can cause considerable discomfort, it’s often treatable with conservative options, such as rest, ice, physical therapy, and over-the-counter anti-inflammatory medicine. Still, there are times when a surgical approach is the best choice.

At Forward Foot & Ankle, our team offers nonsurgical and surgical treatments for plantar fasciitis, ensuring each patient receives the most appropriate care based on their needs, lifestyle, and other factors. Here, learn why plantar fasciitis occurs and when our team recommends surgery to help relieve symptoms and prevent them from recurring.

Understanding plantar fasciitis

Plantar fasciitis involves a strong band of tissue called the plantar fascia that extends front-to-back across the bottom of your foot, connecting at your heel. This band of tissue supports the arch and helps your foot stay strong and flexible when walking, running, or performing other movements.

Plantar fasciitis happens when this band of tissue becomes irritated and inflamed, often near the point where it attaches to your heel. The condition is typically associated with repetitive impacts like running, but it affects plenty of non-runners, too — about 10% of the overall population.

While virtually anyone can develop plantar fasciitis, it tends to be more common among people who have:

• Flat feet
• High arches
• Tight calf muscles
• Tight Achilles tendon
• Obesity
• Heel spurs

It’s also more common among people who spend much time standing on hard surfaces and wearing shoes that don’t provide adequate arch support.

In most cases, plantar fasciitis pain worsens in the mornings or any time after prolonged rest. Walking around provides temporary relief as the tissues “loosen up,” with pain returning after subsequent rest periods.

Plantar fasciitis treatment: When surgery makes sense

Many people with plantar fasciitis benefit from rest, anti-inflammatory medicines, custom orthotics to relieve pressure and support the arch, physical therapy, and activity modification. However, these conservative approaches aren’t always effective in providing long-lasting relief.

Our team typically recommends surgery for plantar fasciitis when conservative treatments fail, even after several months, leaving patients with chronic pain or worsening symptoms that interfere with their activities.

The type of surgery we recommend depends on your specific needs. In some instances, we recommend removing damaged portions of the plantar fascia. In contrast, in others, we advise plantar fasciitis release surgery to relieve pain and promote new, healthy tissue growth where the plantar fascia attaches to the heel. 

If bony heel spurs cause pain in your plantar fascia, we can perform surgery to remove the spurs and restore a normal, smooth connection between the tissue and your heel bone. Afterward, you’ll undergo physical therapy to restore normal function, strength, and pain-free mobility.

Don’t ignore your heel pain

Like other orthotic injuries, plantar fasciitis can worsen without prompt medical attention. To learn what’s causing your heel pain and how we can help relieve it, request an appointment online or over the phone with the Forward Foot & Ankle team in Midtown Manhattan and Staten Island, New York, today.