Typically, your doctor will recommend nonsurgical treatment methods. These include:
Rest. A period without using your foot can reduce pain and inflammation. Your doctor may also recommend using a cane, walker or rolling knee scooter to help you with weight-bearing.
Ice therapy. You can apply ice to the area several times a day. Medications. Your doctor can prescribe NSAIDs to ease your pain.
Open Surgery
Plantar fascia surgery, known as a plantar fasciotomy, is an option for treating persistent pain that doesn’t respond to nonsurgical treatment. During this outpatient procedure, an orthopedic surgeon cuts a portion of the thick band of tissue that supports your foot’s arch. This relieves tension and allows the tendon to lengthen.
After administering local anesthesia or sedation, the surgeon makes small surgical cuts in your skin and the soft tissue around your heel bone. They then detach the plantar fascia from your heel bone. This procedure is usually faster and less invasive than endoscopic surgery.
However, both procedures have some potential complications.부산족부정형외과 For example, nerve damage can cause numbness in the operated area. Also, over-release of the fascia can create a flat foot deformity or reduce your foot’s natural arch. If you opt for this treatment, it will likely take a long time to recover and return to your normal activities. However, a physical therapy regimen should help you heal and strengthen your foot muscles.부산무지외반증
Endoscopic Surgery
In this minimally invasive procedure, your Manhattan foot specialist makes two small incisions in your heel and inserts an endoscope (a tiny camera) to look at the fascia. Then they use a hooked knife to cut a section of the ligament. This allows the fascia to stretch and loosen, alleviating your pain.
There may be fat overlying the fascia, so the surgeon removes it using sterile swabs and a hooked probe. The surgeon then inserts the endoscope into the lateral portal and uses it to visualize the inferior plantar fascia on the monitor. They can also see if the fascia has any calcifications.
They can remove these with a hook knife through the slotted cannula. Once the fascia is free, the surgeon closes the incisions and applies dressings. Patients are allowed to return home with a surgical shoe and are encouraged to weight bear as tolerated. After several weeks, the dressings are removed and physical therapy can begin.
Topaz Coblation Therapy
The TOPAZ procedure is a minimally invasive procedure that breaks up scar tissue in the plantar fascia, encouraging healing. This device, which resembles a specialized sewing needle, is inserted into the affected area of the foot for just a half-second. It is then moved and inserted again in a grid pattern over the affected fascia or tendon.
Once activated, the device emits radiofrequency waves that break up inflamed scar tissue without harming surrounding tissues. This deliberate “micro-trauma” stimulates your body’s natural healing process by promoting blood flow.
A small study published in 2016 compared results for patients who underwent percutaneous radiofrequency microtenotomy with those who underwent endoscopic surgery for plantar fasciitis. Both groups reported similar increases in American Orthopedic Foot and Ankle Society (AOFAS) questionnaire scores and decreases in pain on the Numerical Rating Scale (NRS).
Nonsurgical Treatment
Most cases of plantar fasciitis respond to nonsurgical treatment including wearing supportive shoes, stretching, and doing physical therapy. However, if pain persists, your doctor may recommend fascia release surgery. This involves partially cutting the plantar fascia ligament to relieve tension in the tissue band. Your doctor can do this surgery using an open or endoscopic procedure.
Unlike most treatments that are directed at decreasing inflammation, the new Tenex FAST procedure uses ultrasound guided radio frequency ablation to permanently numb your pain by breaking apart scar tissue and increasing blood flow.2
In addition to numbing your pain, this procedure increases the flexibility of the plantar fascia, which can help you return to normal activities more quickly. You will need to wear a walking boot or nonweight-bearing cast for two to three weeks to allow your foot and ligament to heal. Talk with your orthopaedic surgeon about the benefits and risks of this procedure, as well as other nonsurgical options for treating plantar fasciitis.