Surgical Treatment of Heel Pain

Unfortunately surgical treatment of heel pain has never been a great option. Surgery involves some method of cutting the plantar fascia off the heel bone.

Since the plantar fascia is the main ligament supporting the foot, cutting it involves a major loss of foot support. it is something to be performed only in extreme  cases. Traditionally an incision was made on the side of the foot and the ligament cut. A less traumatic method involves cutting the fascia via a small opening in the bottom of the foot (Minimal Incision Method). More recently a more "elegant" method knwon as EPF or Endoscopic Plantar Fascial Release was designed. It really is not a less traumatic method than the Minimal Incision Method and the end effect is the same but use of the high tech endoscope made this method seem more high tech and acceptable to those whom such high tech methods may seem impressive.

The success rate on surgery, depending on the author is about 60%. The hope is that the cut ligament eventually regrows and re-attaches itself to the heel bone in a longer fashion with less tension on it.

Because ESWT (Extracorporeal Shockwave Therapy) discussed on this site has virtually no downside and a much higher success rate in has replaced or will replace almost all surgery for heel pain caused by plantar fasciitis. Why , then, is surgery even being done?  Not an easy question to answer. Sometimes medical progress moves slowly, sometimes insurance companies will pay for surgery but not ESWT, sometimes the doctor has not kept up with more recent knowledge and finally financial considerations (unfortunately not that of the patient) may come into play.