Point-Counterpoint: Should We Do Plantar Fascia Releases For Heel Pain?

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Author(s): 
Mark Hofbauer, DPM, FACFAS, and Alexander Pappas, DPM; and Steven Shannon, DPM, FACFAS

In Conclusion

There is certainly a role for the plantar fasciotomy in the lexicon of treatment for plantar heel pain. I personally do perform these procedures. However, I would say that I only perform about two or three of these procedures a year. I think this number reflects that the non-surgical treatments for plantar heel pain are extremely effective to this day.

   As physicians, we need to be cognizant of the fact that other diagnoses may be involved and be sure to treat the correct pathology conservatively for an appropriate period of time prior to consideration of more invasive or surgical options.

   Dr. Shannon is affiliated with the Division of Podiatric Surgery at Penn Presbyterian Medical Center in Philadelphia. He is a Fellow of the American College of Foot and Ankle Surgeons.

References

1. Speed C. A systematic review of shockwave therapies in soft tissue conditions: focusing on the evidence. Br J Sports Med. 2013; epub ahead of print.
2. Kumar V, Millar T, Murphy PN, Clough T. The treatment of intractable plantar fasciitis with platelet-rich plasma injection. Foot (Edinb). 2013; epub ahead of print.
3. Leach RE, Seavey MS, Salter DK. Results of surgery in athletes with plantar fasciitis. Foot Ankle. 1986; 7(3):156–61.
4. Daly PJ, Kitaoka HB, Chao YS. Plantar fasciotomy for intractable plantar fasciitis: clinical results and biomechanical evaluation. Foot Ankle. 1992; 13(4):188–95.
5. Benton-Weil W, Borrelli AH, Weil LS, Weil LS. Percutaneous plantar fasciotomy: a minimally invasive procedure for recalcitrant plantar fasciitis. J Foot Ankle Surg. 1998; 37(4):269–72.

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