Plantar fasciitis – does it reoccur following surgery?
I saw a fellow this morning for heel pain. Clinical and x-ray finding were consistent with plantar fasciitis, right heel. But there was a problem with that diagnosis. The problem was that we had performed an endoscopic plantar fasciotomy on the same foot 5 years ago. Had the plantar fasciitis returned? It sure did seem that way.
Plantar fasciotomy, regardless of the method used (open with medial approach, open plantar approach, endoscopic, etc) is a reliable, time tested method of caring for recalcitrant cases of plantar fasciitis. But can plantar fasciitis recur following surgery? And after a 5 years period of being pain free? It appears the answer is yes.
The scientist in me knows that things happen for a reason. So what would be the reason that plantar fasciitis would reoccur? I’d have to guess that the patient had changed. Think of it this way, when you treat plantar fasciitis with a surgical procedure, you’re treating a patient who weighs a certain amount, has a certain level of activity and has a certain tissue elasticity specific to their age. That can change. And in this case, I think that change in this specific patient is at the heart of why the plantar fasciitis recurred.
What can change and what are the dynamics that could contribute to the return of plantar fasciitis post surgery? Body weight, age and tissue elasticity are important factors. And an increase in the duration of time on the feet could also be a significant variable. Plantar fasciitis doesn’t reoccur without a reason. It comes back for a specific reason. And I’d assume that it’s a combination of one or more of the above.
I’m not aware of any articles in the literature regarding the return of plantar fasciitis following surgery. So quoting return rates would be just a guess. But for those considering a plantar fasciotomy, the procedure can still be a very good choice to treat heel pain.Â
Jeffrey A. Oster, DPM
Dr. Oster cannot answer medical questions or provide medical care through this blog.
Tags: heel pain, heel spur, plantar fasciitis
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