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Plantar Fasciitis: Should I Have Surgery for Heel Pain


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Plantar Fasciitis: Should I Have Surgery for Heel Pain?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

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Plantar Fasciitis: Should I Have Surgery for Heel Pain?

Get the facts

Your options

  • Have surgery for plantar fasciitis.
  • Try other treatment to see if your heel pain improves.

Key points to remember

  • You will probably not need surgery. Only about 5% of people with plantar fasciitis do.1 This means that out of 100 people with plantar fasciitis, only 5 will need surgery and 95 will not. Experts suggest that you try at least 6 months of other treatment before you consider surgery.
  • Surgery may be right for you if you keep having bad heel pain after 6 to 12 months of home treatment. You might also think about surgery if heel pain is affecting your ability to work or do moderate exercise.
  • If you do need surgery, it will most likely reduce your heel pain. Of the few people who need surgery, about 75 out of 100 have less pain than they did before surgery.2
  • Having surgery is not a guarantee that your heel pain will go away. About 25 out of 100 people who have surgery continue to have heel pain.2
FAQs

What is plantar fasciitis?

Plantar fasciitis (say “PLAN-ter fash-ee-EYE-tus") causes heel pain, which often becomes long-lasting (chronic). It can happen when the long, flat ligament on the bottom of the foot (plantar fascia) becomes strained and starts to get small tears. These can cause the ligament to become weak, swollen, and irritated (inflamed).

The most common symptom of plantar fasciitis is heel pain when you take your first steps after getting out of bed or after sitting for a long time.

What causes plantar fasciitis?

Plantar fasciitis is often caused by:

  • Problems with the way you walk, such as walking with an inward twist or roll of the foot (pronation).
  • Having high arches, flat feet, or tight Achilles tendons.
  • Doing repetitive activities, being overweight, or wearing bad shoes. These can make plantar fasciitis worse.

All of these things can lead to small tears, which can cause pain and swelling.

What are the risks of having plantar fasciitis?

Ongoing heel pain will make walking and standing painful. To relieve the pain, you may change the way you walk. Over time, this may lead to more discomfort and pain as well as other foot, leg, hip, or back problems. Long-term (chronic) plantar fasciitis may limit your ability to work and enjoy exercise or play sports.

How is it treated?

Nonsurgical treatment for plantar fasciitis is easy to follow and usually works if you begin soon after symptoms start. This treatment includes:

  • Rest.
  • Ice. If ice has not helped after trying it for 2 or 3 days, heat may help.
  • Anti-inflammatory drugs.
  • Stretching exercises.
  • Shoe inserts (orthotics).
  • Night splints.
  • Steroid shots.

These treatments may take 6 to 12 months to relieve heel pain.

Surgery is usually not needed for plantar fasciitis. Most people (95%) who have plantar fasciitis are able to relieve heel pain without surgery.1 This means that out of 100 people who have plantar fasciitis, 95 are able to relieve their pain without surgery and 5 are not.

Surgery for plantar fasciitis involves cutting (releasing) part of the plantar fascia ligament to release the tension and relieve swelling. It may be done as open surgery, in which the surgeon makes a cut (incision) through the area. Or it may be done by inserting surgical tools through very small incisions (endoscopic surgery).

What are the risks of surgery?

Risks of surgery include:

  • A pinched nerve or tarsal tunnel syndrome.
  • Heel pain that comes back again and again.
  • Neuroma, a benign tumor made of nerve cells and nerve fibers, which can be painful.
  • Wounds that take a long time to heal.
  • A delay in being able to do your normal activities.
  • Infection.
  • Risks of anesthesia.
  • The chance that symptoms could get worse after surgery (rare).

Why might your doctor recommend surgery?

Your doctor may advise you to have surgery if:

  • You've tried other treatment for at least 6 months and it has not helped.
  • Heel pain is affecting your ability to work or to do moderate exercise.

Compare your options

Compare

What is usually involved?









What are the benefits?









What are the risks and side effects?









Have surgery Have surgery
  • With open surgery, you wear a brace for 2 to 3 weeks after surgery.
  • With endoscopic surgery, you can begin weight-bearing activities right away. You will be able to wear normal shoes as soon as they are comfortable.
  • Most people return to normal activities 3 to 6 weeks after endoscopic surgery.
  • After either type of surgery, you shouldn't run or jump for at least 3 months.
  • Up to 25 out of 100 people who have surgery continue to have pain.2
  • Other risks of surgery include:
    • Heel pain that comes back again and again.
    • Neuroma, a benign tumor made of nerve cells and nerve fibers, which can be painful.
    • Wounds that take a long time to heal.
    • A delay in being able to do your normal activities.
    • Infection.
    • A pinched nerve or tarsal tunnel syndrome.
    • The chance that symptoms could get worse after surgery (rare).
    • Risks of anesthesia.
  • Your age and your health also affect your risk.
Try other treatment Try other treatment
  • Treatment at home includes rest, ice, anti-inflammatory drugs, stretching exercises, shoe inserts (orthotics), and night splints.
  • You may have steroid shots to reduce swelling.
  • These treatments may take 6 to 12 months to relieve heel pain.
  • Treatment is easy to follow and is usually successful if you begin soon after symptoms start.
  • Out of 100 people who try other treatment for heel pain, 95 are able to get relief.
  • You avoid the cost and risks of surgery.
  • If this treatment doesn't work, you may still have pain that limits your daily activities.
  • You may still need to have surgery later.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

Read More
close

Personal stories about surgery for plantar fasciitis

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

I know that I am not the kind of person who can completely stop running for as long as it would take to heal my plantar fasciitis. The non-surgical treatments, like ice and my night splint, help relieve the pain, but the problem isn't getting any better. I know there are risks involved in having surgery, and I'm willing to accept that chance if I can keep running. My doctor has done a lot of plantar fascia surgery, and she says that I will probably be able to run again within a few weeks.

John, age 37

I have been thinking of looking for a different job for several years now. Right now, I am on my feet all day and I've gradually developed a lot of heel pain that my doctor says is due to plantar fasciitis. She says it may be related to the fact that I stand all day at work. I really don't want to have surgery, so I'm going to try some of the treatments she suggested while I look for another job that won't require me to stand all day.

Tomas, age 50

I feel like I have given all the plantar fasciitis treatments a fair trial. I've had the problem for over a year now, and even though it has gotten a little better, the pain still interferes with my ability to walk or stand comfortably for very long. I'm no athlete, but I want to be able to walk comfortably. I heard that most people have less pain after surgery, so that's my next step.

Mary Ann, age 45

It is ironic that my plantar fasciitis didn't start until I started walking as part of my weight-loss program. Losing weight is supposed to help plantar fasciitis! My doctor said it isn't unusual for people like me, who have been inactive for a long time, to get heel pain when they start to exercise. He recommended some home treatments, like stretching, icing my foot, and doing another form of exercise such as riding a stationary bicycle, while still working to lose weight. It's been over 6 months, and my foot is definitely getting better, but slowly. But the fact that it is improving gives me hope that I can avoid surgery.

Kate, age 47

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have surgery

Reasons to choose other treatment

I'm not willing to go through 6 to 12 months of home treatment.

I'm willing to go through 6 to 12 months of home treatment.

More important
Equally important
More important

I can't do daily activities because of my heel pain.

My heel pain doesn't prevent me from doing my daily activities.

More important
Equally important
More important

I accept the risks of surgery.

I feel that surgery is too risky for me.

More important
Equally important
More important

I want to have surgery so I can feel better right now.

I don't want to have surgery for any reason.

More important
Equally important
More important

I've already tried other treatment, and it hasn't worked.

I haven't tried other treatment yet.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having surgery

Using other treatment

Leaning toward
Undecided
Leaning toward

What else do you need to make your decision?

Check the facts

1.

Do most people with plantar fasciitis need surgery?

  • YesSorry, that's not right. Only about 5 out of 100 people with plantar fasciitis need surgery.
  • NoYou're right. Only about 5 out of 100 people with plantar fasciitis need surgery.
  • I'm not sureIt may help to go back and read "Get the Facts." Only about 5 out of 100 people with plantar fasciitis need surgery.
2.

Will surgery always cure your heel pain?

  • YesSorry, that's not right. Having surgery is not a guarantee that your heel pain will go away. About 25 out of 100 people who have surgery continue to have heel pain.
  • NoYou're right. Having surgery is not a guarantee that your heel pain will go away. About 25 out of 100 people who have surgery continue to have heel pain.
  • I'm not sureIt may help to go back and read "Get the Facts." Having surgery is not a guarantee that your heel pain will go away. About 25 out of 100 people who have surgery continue to have heel pain.
3.

If you have already tried treatment at home and you still have heel pain, should you think about having surgery?

  • YesYou are right. You might think about surgery if you've tried treatment at home for 6 to 12 months and you still have bad heel pain.
  • NoSorry, that's not right. You might think about surgery if you've tried treatment at home for 6 to 12 months and you still have bad heel pain.
  • I'm not sureIt may help to go back and read "Get the Facts." You might think about surgery if you've tried treatment at home for 6 to 12 months and you still have bad heel pain.

Decide what's next

1.

Do you understand the options available to you?

2.

Are you clear about which benefits and side effects matter most to you?

3.

Do you have enough support and advice from others to make a choice?

Certainty

1.

How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure
3.

Use the following space to list questions, concerns, and next steps.

Your Summary

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Your decision

Next steps

Which way you're leaning

How sure you are

Your comments

Your knowledge of the facts

Key concepts that you understood

Key concepts that may need review

Getting ready to act

Patient choices

What matters to you

Credits and References

Credits
CreditsHealthwise Staff
Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency Medicine
Specialist Medical ReviewerBarry L. Scurran, DPM - Podiatry and Podiatric Surgery
References
Citations
  1. American Academy of Orthopaedic Surgeons and American Academy of Pediatrics (2010). Plantar fasciitis chapter of Foot and ankle section. In JF Sarwark, ed., Essentials of Musculoskeletal Care, 4th ed., pp. 839–844. Rosemont, IL: American Academy of Orthopaedic Surgeons.
  2. Mann JA, et al. (2006). Heel pain section of Foot and ankle surgery. In HB Skinner, ed., Current Diagnosis and Treatment in Orthopedics, 4th ed., pp. 502–504. New York: McGraw-Hill.
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Plantar Fasciitis: Should I Have Surgery for Heel Pain?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
  1. Get the facts
  2. Compare your options
  3. What matters most to you?
  4. Where are you leaning now?
  5. What else do you need to make your decision?

1. Get the facts

Your options

  • Have surgery for plantar fasciitis.
  • Try other treatment to see if your heel pain improves.

Key points to remember

  • You will probably not need surgery. Only about 5% of people with plantar fasciitis do.1 This means that out of 100 people with plantar fasciitis, only 5 will need surgery and 95 will not. Experts suggest that you try at least 6 months of other treatment before you consider surgery.
  • Surgery may be right for you if you keep having bad heel pain after 6 to 12 months of home treatment. You might also think about surgery if heel pain is affecting your ability to work or do moderate exercise.
  • If you do need surgery, it will most likely reduce your heel pain. Of the few people who need surgery, about 75 out of 100 have less pain than they did before surgery.2
  • Having surgery is not a guarantee that your heel pain will go away. About 25 out of 100 people who have surgery continue to have heel pain.2
FAQs

What is plantar fasciitis?

Plantar fasciitis (say “PLAN-ter fash-ee-EYE-tus") causes heel pain, which often becomes long-lasting (chronic). It can happen when the long, flat ligament on the bottom of the foot (plantar fascia ) becomes strained and starts to get small tears. These can cause the ligament to become weak, swollen, and irritated (inflamed).

The most common symptom of plantar fasciitis is heel pain when you take your first steps after getting out of bed or after sitting for a long time.

What causes plantar fasciitis?

Plantar fasciitis is often caused by:

  • Problems with the way you walk, such as walking with an inward twist or roll of the foot (pronation ).
  • Having high arches, flat feet, or tight Achilles tendons.
  • Doing repetitive activities, being overweight, or wearing bad shoes. These can make plantar fasciitis worse.

All of these things can lead to small tears, which can cause pain and swelling.

What are the risks of having plantar fasciitis?

Ongoing heel pain will make walking and standing painful. To relieve the pain, you may change the way you walk. Over time, this may lead to more discomfort and pain as well as other foot, leg, hip, or back problems. Long-term (chronic) plantar fasciitis may limit your ability to work and enjoy exercise or play sports.

How is it treated?

Nonsurgical treatment for plantar fasciitis is easy to follow and usually works if you begin soon after symptoms start. This treatment includes:

  • Rest.
  • Ice. If ice has not helped after trying it for 2 or 3 days, heat may help.
  • Anti-inflammatory drugs.
  • Stretching exercises.
  • Shoe inserts (orthotics).
  • Night splints.
  • Steroid shots.

These treatments may take 6 to 12 months to relieve heel pain.

Surgery is usually not needed for plantar fasciitis. Most people (95%) who have plantar fasciitis are able to relieve heel pain without surgery.1 This means that out of 100 people who have plantar fasciitis, 95 are able to relieve their pain without surgery and 5 are not.

Surgery for plantar fasciitis involves cutting (releasing) part of the plantar fascia ligament to release the tension and relieve swelling. It may be done as open surgery, in which the surgeon makes a cut (incision) through the area. Or it may be done by inserting surgical tools through very small incisions (endoscopic surgery).

What are the risks of surgery?

Risks of surgery include:

  • A pinched nerve or tarsal tunnel syndrome.
  • Heel pain that comes back again and again.
  • Neuroma, a benign tumor made of nerve cells and nerve fibers, which can be painful.
  • Wounds that take a long time to heal.
  • A delay in being able to do your normal activities.
  • Infection.
  • Risks of anesthesia.
  • The chance that symptoms could get worse after surgery (rare).

Why might your doctor recommend surgery?

Your doctor may advise you to have surgery if:

  • You've tried other treatment for at least 6 months and it has not helped.
  • Heel pain is affecting your ability to work or to do moderate exercise.

2. Compare your options

Have surgery Try other treatment
What is usually involved?
  • With open surgery, you wear a brace for 2 to 3 weeks after surgery.
  • With endoscopic surgery, you can begin weight-bearing activities right away. You will be able to wear normal shoes as soon as they are comfortable.
  • Most people return to normal activities 3 to 6 weeks after endoscopic surgery.
  • After either type of surgery, you shouldn't run or jump for at least 3 months.
  • Treatment at home includes rest, ice, anti-inflammatory drugs, stretching exercises, shoe inserts (orthotics), and night splints.
  • You may have steroid shots to reduce swelling.
  • These treatments may take 6 to 12 months to relieve heel pain.
What are the benefits?
  • Most people (over 75 out of 100) have less pain after surgery.2
  • Treatment is easy to follow and is usually successful if you begin soon after symptoms start.
  • Out of 100 people who try other treatment for heel pain, 95 are able to get relief.
  • You avoid the cost and risks of surgery.
What are the risks and side effects?
  • Up to 25 out of 100 people who have surgery continue to have pain.2
  • Other risks of surgery include:
    • Heel pain that comes back again and again.
    • Neuroma, a benign tumor made of nerve cells and nerve fibers, which can be painful.
    • Wounds that take a long time to heal.
    • A delay in being able to do your normal activities.
    • Infection.
    • A pinched nerve or tarsal tunnel syndrome.
    • The chance that symptoms could get worse after surgery (rare).
    • Risks of anesthesia.
  • Your age and your health also affect your risk.
  • If this treatment doesn't work, you may still have pain that limits your daily activities.
  • You may still need to have surgery later.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

Personal stories about surgery for plantar fasciitis

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"I know that I am not the kind of person who can completely stop running for as long as it would take to heal my plantar fasciitis. The non-surgical treatments, like ice and my night splint, help relieve the pain, but the problem isn't getting any better. I know there are risks involved in having surgery, and I'm willing to accept that chance if I can keep running. My doctor has done a lot of plantar fascia surgery, and she says that I will probably be able to run again within a few weeks."

— John, age 37

"I have been thinking of looking for a different job for several years now. Right now, I am on my feet all day and I've gradually developed a lot of heel pain that my doctor says is due to plantar fasciitis. She says it may be related to the fact that I stand all day at work. I really don't want to have surgery, so I'm going to try some of the treatments she suggested while I look for another job that won't require me to stand all day."

— Tomas, age 50

"I feel like I have given all the plantar fasciitis treatments a fair trial. I've had the problem for over a year now, and even though it has gotten a little better, the pain still interferes with my ability to walk or stand comfortably for very long. I'm no athlete, but I want to be able to walk comfortably. I heard that most people have less pain after surgery, so that's my next step."

— Mary Ann, age 45

"It is ironic that my plantar fasciitis didn't start until I started walking as part of my weight-loss program. Losing weight is supposed to help plantar fasciitis! My doctor said it isn't unusual for people like me, who have been inactive for a long time, to get heel pain when they start to exercise. He recommended some home treatments, like stretching, icing my foot, and doing another form of exercise such as riding a stationary bicycle, while still working to lose weight. It's been over 6 months, and my foot is definitely getting better, but slowly. But the fact that it is improving gives me hope that I can avoid surgery."

— Kate, age 47

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have surgery

Reasons to choose other treatment

I'm not willing to go through 6 to 12 months of home treatment.

I'm willing to go through 6 to 12 months of home treatment.

More important
Equally important
More important

I can't do daily activities because of my heel pain.

My heel pain doesn't prevent me from doing my daily activities.

More important
Equally important
More important

I accept the risks of surgery.

I feel that surgery is too risky for me.

More important
Equally important
More important

I want to have surgery so I can feel better right now.

I don't want to have surgery for any reason.

More important
Equally important
More important

I've already tried other treatment, and it hasn't worked.

I haven't tried other treatment yet.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having surgery

Using other treatment

Leaning toward
Undecided
Leaning toward

5. What else do you need to make your decision?

Check the facts

1. Do most people with plantar fasciitis need surgery?

  • Yes
  • No
  • I'm not sure
You're right. Only about 5 out of 100 people with plantar fasciitis need surgery.

2. Will surgery always cure your heel pain?

  • Yes
  • No
  • I'm not sure
You're right. Having surgery is not a guarantee that your heel pain will go away. About 25 out of 100 people who have surgery continue to have heel pain.

3. If you have already tried treatment at home and you still have heel pain, should you think about having surgery?

  • Yes
  • No
  • I'm not sure
You are right. You might think about surgery if you've tried treatment at home for 6 to 12 months and you still have bad heel pain.

Decide what's next

1. Do you understand the options available to you?

2. Are you clear about which benefits and side effects matter most to you?

3. Do you have enough support and advice from others to make a choice?

Certainty

1. How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure

2. Check what you need to do before you make this decision.

  • I'm ready to take action.
  • I want to discuss the options with others.
  • I want to learn more about my options.

3. Use the following space to list questions, concerns, and next steps.

Credits
ByHealthwise Staff
Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency Medicine
Specialist Medical ReviewerBarry L. Scurran, DPM - Podiatry and Podiatric Surgery
References
Citations
  1. American Academy of Orthopaedic Surgeons and American Academy of Pediatrics (2010). Plantar fasciitis chapter of Foot and ankle section. In JF Sarwark, ed., Essentials of Musculoskeletal Care, 4th ed., pp. 839–844. Rosemont, IL: American Academy of Orthopaedic Surgeons.
  2. Mann JA, et al. (2006). Heel pain section of Foot and ankle surgery. In HB Skinner, ed., Current Diagnosis and Treatment in Orthopedics, 4th ed., pp. 502–504. New York: McGraw-Hill.
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.

Last Revised: July 14, 2011

Author: Healthwise Staff

Medical Review: William H. Blahd, Jr., MD, FACEP - Emergency Medicine & Barry L. Scurran, DPM - Podiatry and Podiatric Surgery


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