Most people with plantar fasciitis (irritation of the foot sole fibrous tissue) get better without surgery. But if heel pain has been stubborn for many months despite good treatment, your care team might talk with you about surgical options to release pressure on the plantar fascia and nearby structures.
Is surgery ever needed for plantar fasciitis?
Usually not.
Guidelines and long-term studies show that:
- Most people improve with load management, plantar fascia–specific stretching, high-load strength training, and supportive footwear over weeks to months.¹ ² ³ ⁵ ⁶
- Only a small minority with long-standing, function-limiting pain end up having surgery.¹ ² ³
Surgery is best seen as a last-line option after a thorough course of evidence-based conservative care.
When is plantar fasciitis surgery considered?
Your clinician may refer you to a foot and ankle surgeon if:
Heel pain has lasted 6–12 months or more despite:
- Targeted plantar fascia–specific stretching
- High-load strengthening for calf and foot
- Taping and/or foot orthoses
- Good footwear and load adjustments
- Consideration of options like shockwave therapy and, in some cases, injections¹ ² ³ ¹³ ¹⁵
Pain is severe and daily life is significantly limited, for example:
- You cannot walk reasonable distances
- Standing at work is very difficult despite adaptations
Imaging and assessment support a diagnosis of resistante plantar fascitis, without another main cause (e.g., stress fracture, nerve entrapment, inflammatory arthritis). You understand the potential benefits, risks, and recovery time, and still want to explore surgery.
Urgent or earlier surgical review is needed if there is suspected plantar fascia rupture, major tear, or another structural problem that cannot be managed conservatively.
Types of surgery for plantar fasciitis
Procedures and techniques vary by surgeon and region, but common options include:
1. Partial plantar fascia release (proximal fasciotomy)
The surgeon cuts a portion of the plantar fascia near its heel attachment to reduce tension and load on the irritated tissue.
Can be done through:
- A small open incision on the inside of the heel, or
- A minimally invasive / endoscopic technique using tiny portals and a camera.
Modern approaches usually aim for a partial release, not a full cut, to reduce the risk of arch collapse or new pain.¹ ³
2. Gastrocnemius recession (calf muscle lengthening)
In people with very tight calf muscles and limited ankle dorsiflexion (moving the foot up), a small operation is done higher up the leg to lengthen part of the calf (gastrocnemius).
This can reduce strain on the plantar fascia without cutting the fascia itself. Sometimes performed alone, sometimes combined with a partial plantar fascia release in selected cases.
3. Baxter’s nerve or other nerve decompression (selected cases)
In a small group of people, plantar heel pain is partly due to compression of a small nerve branch (often called Baxter’s nerve). The surgeon releases tissue around that nerve, sometimes at the same time as a plantar fascia release. Your surgeon will recommend one or a combination of these based on your:
- Symptoms and duration
- Foot structure and calf flexibility
- Occupation and activity goals
- Findings on exam and imaging
Plantar fasciitis surgery risks and possible complications
All surgery carries risks. For plantar fasciitis procedures, potential issues include:
- Persistent pain or less improvement than hoped
- New pain in the arch or outer foot if too much fascia is released
- Nerve irritation or injury, leading to numbness, tingling, or burning in part of the foot
- Scar sensitivity or tenderness at the incision site
- Infection, bleeding, or delayed wound healing
- Changes in foot movement, including arch flattening in more extensive surgery
- Very rarely, more complex pain syndromes such as complex regional pain syndrome which is a severely disabling condition, after injury or surgery, which manifests as pain, swelling and a limited range of motion
Your surgeon should discuss these risks, how common they are in their hands, and how they are managed if they occur.
Did you know?
Most plantar fasciitis gets better without an operation. Clinical practice guidelines emphasize plantar fascia–specific stretching, progressive strengthening, and load management as the core of care, with surgery only for persistent, recalcitrant cases.¹ ² ³ ⁵ ⁶
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
