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Molly Maloof, MD

Director of Clinical Content

I had surgery for Plantar Fasciitis and it did not work. Now what?

I have been battling Plantar Fasciitis for almost a year. I choose to have surgery to end my pain because all other routes did not work. I am almost 4 months post op and the surgery did not work also. My doctor has told me that there is nothing more to help me besides a lifestyle change. What about my job? How am I supposed to work when I can't even tolerate to stand more than 10 minutes in one place. Has anyone ever helped someone to apply for disability assistance from this diagnosis?
  • Female | 40 years old
  • Complaint duration: 90 days
  • Medications: Advil, Vicodin
  • Conditions: No

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Featured Answer

2 UpVoted this answer
My your symptoms, it sounds like you have something other than plantar fasciits. Fasciitis is typically hurting when you start bearing weight after period of being off your feet, and then it gradually goes away or gets better. You describe that it hurts more the longer you stand. This would be more consistent with a different condition, such as nerve entrapment, ganglion, scarring, .... Remember, people have "right" to have two problems. MRI is definitely a good idea. Doing vascular studies, such as doppler ultrasound of the legs veins and legs arteries may also help. OIn addition, starting physical therapy (again) should be helpful. If no diagnosis is found, and you are still in pain, then referral to Pain Specialist, preferably Pain Specialist who is also specialist in Physical Medicine and Rehabilitation (PMNR, Physiatrist) would be in order. I hope this helps.
Petar N. Novakovic
1 UpVoted this answer
As noted by some of the other respondents below, a second opinion would be a good idea at this point. There are several possible reasons for the continued pain. I would suggest first examining to see if plantar fasciitis is truly the cause of pain. Other conditions can cause chronic heel and arch pain and mimic plantar fasciitis. One common possibility is tarsal tunnel syndrome which is similar to carpal tunnel syndrome seen in the wrist. Other possibilities include nerve entrapments (in the foot or low back), soft tissue masses, or stress fractures in the heel. There may be painful scar tissue or a nerve entrapped in scar tissue from the surgery. Even if a surgery is done perfectly from a technical standpoint, complications can happen on rare occasions. Although physical therapy can be considered as a component of treatment, I would first recommend a formal second opinion evaluation by a podiatrist who can order for additional diagnostic tests such as nerve conduction studies or an MRI if needed.
1 UpVoted this answer
Tissue health is a balance between breakdown and recovery. Soft tissue can heal if the conditions favorable to recovery, so what are barriers? Here are some of my orthopedic atypical causes for plantar fasciitis and some of its persistence.

This likely stated as a mechanical problem in the foot/ankle complex. A good manual physical therapist can assess all major and minor joints. A stuck subtalar joint, causes this problem. Remote possibility of a lumbar pathology, L5 and SI joint causing weakness in the foot stabilizers like the posterior tibialis muscle.

Has this occurrence of plantar fasciitis been marked by reoccurring use of anti-inflammatory medications and shots? I believe at is certain point anti-inflammatory medications actually can hinder healing of the soft tissues. The plantar fascia could be more like a tendinosis now. That requires a different treatment method aimed at restarting inflammation and guiding new healing.

I hope somewhere along the way you've been recommended orthotics. If you found those to be overly painful, I find that patients have had some relief by having their podiatrist repost with a forefoot varus wedge. The idea being that if your forefoot is to tilted upward, the arch then just see saws over the arch support coming to irritable the tissue.
Why don't you seek a second opinion. I have only had to do surgery on 2 patients in 15 years of practice for plantar fasciitis. You may have been completely mis-diagnosed. I would request an MRI to see if other pathologies are present
Find a physician that does PRP injections.
Dr. Nathan J. Savage
What kind of surgery did you have?
There are many directions you should consider. Physical therapy to break up scar tissue and increase joint mobilization, as well as other commensurate modalities, an ankle-foot orthotic to enhance sability when working and standing for long periods, as well as prolotherapy and sclerotherapy. Get at least one or two second opinions for your specific problems. An MRI will help to determine which soft tissures are surgically damaged.
Without repeating all of the other responders very excellent suggestions I suggest you seek a second opinion as you have are frustrated with your care thus far. It is possible as pointed out you have other reasons for your heel pain that were not addressed during your surgery. You might wish to discuss use of a removable cast to help with your pain with additional support for your foot to relieve the mechanical stress.
Gary S. Scheinin
Without knowing what your occupation may be, I take it you have to do a lot of standing throughout the day, which would involve: (1) ensuring that your footwear is supportive; (2) having a good standing mat that can supplement your shoe wear in reducing foot pain, yet offer good support; (3) seeking a physical therapist who specializes in foot conditions, and can offer other lifestyle modification changes (possible health changes, using good posture during prolonged stance, sitting, etc.) and exercises that can help alleviate your symptoms.
There is good research that plantar fasciitis is related to a lack of ankle mobility. You may want to consider an evaluation by a orthopedic PT as well. Someone skilled in manual therapy can manipulate the Joint, identify movement pathologies, and in some States provide trigger-point injections or acupuncture to effectively treat the muscle pain and spasm. Check out the AAOMPT for a provider in your area. Good luck to you.