Plantar Fasciitis - Surgical Treatment
Treating plantar fasciitis with minimally invasive surgical treatment is sometimes necessary. Dr. Julien Lopez explains the principles of plantar fasciitis surgery.
As a specialist in sports-related pathologies, he performs microsurgery procedures to alleviate your daily discomfort and pain. He provides information on the stages of your treatment and supports you throughout each of them.
Plantar Fasciitis: Symptoms, Causes, Diagnosis, and Non-Surgical Treatments
Plantar fasciitis, also known as plantar fasciopathy or heel spur, is a foot condition characterized by inflammation of the membrane that supports and protects the sole of the foot. This relatively inelastic tissue, known as the plantar fascia, serves to protect the arch of the foot and plays an active role in weight-bearing during walking and various weight-bearing activities.
Plantar fasciitis (or fasciopathy) is an inflammation that occurs in this membrane, which is part of the suro-achilleo-plantar system, starting at the knee and ending at the toes.
When inflammation of the plantar fascia occurs, the following symptoms may appear:
- Talalgia (localized pain) in the heel
- Pain of increased intensity upon waking up, during prolonged standing, or after physical activity
- Burning, tension, and sharp pain in the sole of the foot
- Pain when putting pressure on the foot and heel
- Swelling of the heel
Certain factors can worsen plantar fasciitis, including:
- Wearing shoes with inadequate arch support
- Prolonged walking, especially on hard surfaces
- Frequent prolonged standing
- Foot shape (flat feet or high arches)
- Overweight or obesity
- Engaging in physically demanding activities that stress the feet
- Failing to stretch after physical exercise
Without treatment for your heel spur, possible progressions include:
- Pain when attempting to put on shoes
- Intense pain that makes it difficult to bear weight on the affected foot
- Inability to stand due to heel swelling
- Daily walking difficulties
- Inability to engage in sports
- Formation of fibrous nodules
- Formation of fissures in the plantar fascia
- Secondary conditions like Achilles tendonitis
During your initial consultation, Dr. Julien Lopez conducts a detailed and thorough interview to gather all the information that can help identify potential causes and aggravating factors related to your condition. Additional diagnostic tests are performed to precisely diagnose your foot condition and its extent, including:
- X-rays of your foot to detect potential bone issues
- Bone scintigraphy for a precise image of your foot and ankle skeleton
- Ultrasound to diagnose soft tissue conditions in the sole of the foot
- MRI for a detailed view of the entire suro-achilleo-plantar system
Depending on the severity of your condition and associated injuries, Dr. Julien Lopez may initially recommend non-surgical treatments such as:
- Dietary guidance to address potential excess weight, which can worsen fasciitis
- Stretching and physiotherapy exercises to reduce pain during weight-bearing and walking
- Wearing shoes with custom-made insoles, gel inserts, and reinforcements tailored to your foot shape
- Selecting shoes with heel inserts to prevent inflammation of the plantar fascia
- A period of rest without any sports activities to allow inflammation to decrease
In some cases, the surgeon may also consider certain medications and medical procedures, including:
- Platelet-Rich Plasma (PRP) injections to encourage membrane healing
- Shockwave therapy to break down damaged parts of the plantar fascia and promote collagen production
- Corticosteroid injections to reduce inflammation
If symptoms persist after these non-surgical treatments, surgical intervention may be necessary and should be discussed.
Dr. Julien Lopez - Minimally Invasive Plantar Fasciitis Surgery
Minimally invasive plantar fasciitis surgery is sometimes the only way to overcome disabling and debilitating discomfort caused by inflammation of your plantar fascia. This condition requires a plantar fasciotomy to resolve.
Non-invasive surgical intervention for a heel spur is performed under local or regional anesthesia and typically lasts between 15 and 30 minutes. As a result, the patient can undergo this procedure on an outpatient basis, ensuring a quick return home and a faster recovery. A small incision, a few millimeters in size, is made under the heel to access the inflamed area. With the assistance of medical imaging, the specialist in sports-related pathologies performs a section of the plantar fascia using a dedicated percutaneous surgery instrument. This action involves cutting the plantar fascia with an appropriate instrument to relax the fibrous membrane. In some rare cases, a simple smoothing procedure may be performed. PRP injection is often combined with the surgical procedure, regardless of the specific surgery performed. If necessary, calcaneal spur planing can be performed using a suitable surgical burr.
Dr. Julien Lopez guides you through each step of your treatment journey. The surgeon's recommendations optimize your post-surgical recovery. You will be advised to:
- Refrain from driving for one week
- Walk with moderate weight-bearing on your operated foot
- Avoid engaging in sports activities for four weeks
- Wear adapted insoles
Although pain may persist for up to three months after surgical intervention, Dr. Julien Lopez remains available to answer your questions and address your concerns at each stage of your treatment journey.