Heel Spur Surgery
For those of you who are are my colleagues and reading this page, wondering if I am going to “diss” on the prospect of surgery for this condition as I did with Neuromas, you can relax. After twenty five years as a podiatric surgeon, one of the most beneficial surgical procedures that I performed was plantar faschiotomy with calcaneal exostectomy.
Don’t get me wrong as I am not advocating this procedure as treatment of choice for heel Spur Syndrome but at least when necessary, probably less than one out of a hundred cases, it is a good procedure, with moderate disability and few complications. More importantly the outcome is consistently predictable with at least a partial resolution of the disabling pain.
In essence dissection of the plantar faschia from its attachment to the calcaneous with or without removal of the spur provides the relief that most patients want and need , as it lengthens the plantar faschia, and decreases the pull responsible for the pain. Because it truly is the break down of the arch, pull on the plantar faschia, and the resultant inflammation from stress on the anatomy involved, that causes the pain, this procedure will work when performed by an experienced surgeon.
Regardless as to technique, weather open with a two inch incision on the inside of the heel, or closed using edoscopic technique through a couple of small incisions on both inside and outside of the heel, the results are consistently quite good and very similar.
My most serious objection to surgical intervention for treatment of severe plantar Fasciitis or heel spur syndrome, is that it does not truly address the overall problem with foot function and subsequently does nothing to limit:
1. The occurrence of the same condition on the opposite foot, about seventy percent of the time with in two years form the resolution of symptoms in the first foot.
2. Presentation of a host of other conditions that are caused by the same poor foot function that causes heel spur syndrome including neuromas, tendonitis, hammer toes, bunions, keen pain, chronic back pain, and poor posture. What good is it to resolve the disability of one condition when it is replaced by the disability of another condition.
3. The obvious expense, additional disability associated with recovery, and the potential for surgical complications although minimal yet very real.
When orthotic treatment is employed with levels of theta correction above 25 degree as the treatment of first choice, the need for surgical intervention is about one in one hundred.
Theta-Orthotics
PO Box 1574
Riverton, Utah 84065
1-800-558-4382