Question
Since being dx with plantar fasciitis, three years ago, I have been wearing custom orthotics, good shoes; have done night splints, stretching, eswt and two rounds of cryo with ultrasound guidance. Despite all of these interventions, I am still plagued with plantar fasciitis with increased thickness (6.5 right 7.5 left) confirmed by a recent ultrasound (symptoms which are much less severe than three years ago.  I have always had a large bone under the ankle bone on the inside of my feet.  Recently, the bone has become sensitive to the touch. When I was younger, I had to be careful getting shoes because if a shoe rubbed against the bone, it was painful. Now, in addition the pain at the site of the bone, I also am getting arch pain which sometimes extends to the heel. I went back to the podiatrist today and a recent ultrasound which shows the fascia is 6.5 in one foot and 7.5 in the other.  The plantar fascia pain is only about a two on most days. The podiatrist feels my primary problem is tibial tendonitis.  Considering the fact that I have been using good shoes and orthotics for about three years, and the size of the extra bone,

the doctor feels that the only way to treat the tendonitis is by shaving down accessory bone to take the stress off of the tendon. He is also recommending a partial release of the lateral and medial fascia while he is in the foot. He said that I would be on crutches (non weight bearing) and out of work for about 5 days and then in a boot for several weeks. I am a school based slp and want to wait until my summer vacation starts before doing the surgery.

 

I am aware that the release CAN cause the foot to become destabilized, causing lateral Colum problems etc. I don't want to go from bad to worse. How risky is this procedure? What are the possible complications of the surgery to shave down the bone? If I just did the surgery for the accessory bone, could this also help with the plantar fasciitis? I could live with mild symptoms if it means that I will not be at risk for complications that will make me feel ever worse than I am now.

 

Does the tendon surgery carry the same risks of destabilization as the fascia release?. The tendon symptoms make it vey difficult to even wear my orthotics as they irritate the area near the accessory bone and I definitely have discomfort in the arch. I am trying to relieve the symptoms while reducing the chances of unwanted side effects.



Thank you for your help


Answer
HI Amy,

I would seek several other opinions before having this surgery.  I think you need to be sure that all of this is necessary.  It would be difficult for me to know the outcome of this procedure for you because I have not examined your foot.  Each person is different.

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
www.thetampapodiatrist.com
www.tampacryosurgery.com

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