Surgery for foot pain

Is surgery right for foot pain?

Surgery is rarely the first step for foot pain. Most people improve with movement, supportive footwear, and a structured plan to reduce pressure across the foot. Surgery may be considered when pain lasts a long time despite these approaches, or when there is a clear structural problem that limits everyday activities.

Doctors may talk about surgery when symptoms keep you from standing, walking, or sleeping, or when nerve symptoms like burning or tingling begin to affect your confidence moving around. In some cases, surgery is discussed for fractures or for deformities that continue to progress.

There is no automatic timeline for surgery. Decisions are based on your goals, the type of foot problem you have, and how your body responds to conservative care. A shared conversation with your doctor helps you understand your options and decide what feels right for you. Studies show that surgery for non-traumatic foot pain is usually reserved for cases that do not improve with long and consistent conservative care¹.

Common surgical options for foot pain

Below are the types of surgeries that may be discussed depending on the underlying condition. These procedures aim to reduce pressure, improve alignment, or relieve nerve or tendon irritation. They are considered only when conservative care has not provided enough relief.

• Plantar Heel Pain (Plantar Fasciitis): Partial plantar fasciotomy is designed to reduce stress on the tight band of tissue under the foot (cutting the plantar fascia). It may be discussed only after months of structured exercise and footwear changes. Evidence shows it is reserved for select long-lasting cases².
• Achilles Tendinopathy: Tendon debridement or repair focuses on removing irritated tissue or addressing tears that limit function. This is considered when loading programs do not improve symptoms and when daily activities remain limited³.
• Morton’s Neuroma: Neurectomy or decompression reduces pressure on the nerve between the toes. It may be discussed when supportive shoes, insoles, and injections no longer help. Outcomes vary and numbness between your toes occurs afterward⁴.
• Posterior Tibial Tendon Dysfunction (PTTD): Reconstruction, tendon transfer, or osteotomies (bone cuts) aim to improve alignment and support the arch when the tendon can no longer do that job alone. These are considered when deformity progresses despite bracing, exercise, and footwear changes⁵.
• Foot or Ankle Arthritis: Joint fusion or joint replacement may be discussed for severe arthritis that limits walking and daily life. These procedures aim to reduce pain from worn joint surfaces. They are used for advanced, long-term cases⁶.
• Stress Fractures: Internal fixation with screws or plates is used for high-risk fractures that do not heal well on their own, such as the navicular or parts of the fifth metatarsal. These decisions aim to improve stability and reduce the chance of non-union⁷.

These options are not a checklist. They are tools used in specific situations, and many people with foot pain never need them.

What to expect during recovery

Recovery depends on the type of surgery, your general health, and how long symptoms were present before surgery. Many people notice soreness, swelling, and stiffness during the early weeks. Weight-bearing may be limited at first and often increases gradually with your surgeon’s guidance.

Rehabilitation focuses on rebuilding strength, improving mobility, and returning to daily activities at a pace that feels safe. Tendon and ligament surgeries often require longer periods to regain full strength, while bone procedures may depend on how quickly the fracture heals. Studies show that incomplete relief, nerve irritation, infection, and the need for future procedures are possible risks, although these vary by surgery type⁸. Planning ahead for help at home, supportive footwear, and clear guidance from your surgeon can make recovery feel more manageable.

Can surgery be avoided?

Many people recover fully without surgery. Research shows that structured exercise programs, gradual load changes, and appropriate footwear help reduce foot pain across many conditions, including plantar heel pain, Achilles tendinopathy, and forefoot disorders^{2 3 4}. Education about pacing, activity levels, and footwear can make daily loads easier on your feet.

Sword Health’s digital care programs have also shown strong results for people living with chronic musculoskeletal pain. In one randomized trial, people using Sword’s digital program improved more in pain and function than those receiving conventional physical therapy⁹. When used early, these approaches may help reduce the need for surgery by improving symptoms before they become long-lasting.

If you want to explore conservative care, visit the Physical Therapy for Foot Pain page.How Sword can support you before and after surgery

Physical therapy can play an important role in preparing for surgery, supporting recovery, and, in some cases, helping people manage symptoms without surgery. Sword offers physical therapy programs designed to support you at different points along that journey.

Sword supports recovery before and after surgery, with care designed to fit into your life. You receive high-quality physical therapy at home, guided by licensed clinicians and supported by smart technology.

• Care that adapts as your body and recovery needs change
• Licensed physical therapists guiding your care at every stage
• Non-invasive, evidence-based physical therapy programs

Support for preparation, recovery, and long-term movement health

Clinical insight

Guidelines recommend avoiding routine imaging for non-traumatic heel pain because many scan findings do not match symptoms. This helps reduce worry about common changes and keeps the focus on movement and recovery¹⁰.