HEEL SPUR SURGERY
Your doctor has elected to schedule you for a heel spur surgery. The surgical procedure most commonly performed by the doctors at Beaumont Foot Specialists is a fluoroscopic assisted plantar fascial release. This procedure is an evolution of the most state of the art techniques that have been developed through more than 35 years of combined experience. In this procedure, the spur is isolated through the use of an x-ray imaging device known as a fluoroscope. Next, a small 1/2″ incision is made on the inside of your heel, and either a portion or the entire plantar fascia is released with a microsurgical scalpel. Frequently, your doctor may elect to remove a portion, if not all of the heel spur, as a means of preventing reattachment of the spur to the ligament. It is felt that the majority of heel pain is caused solely by the inside portion of the ligament. Your doctor may elect to leave the lateral portion attached, along with the spur to which it is attached to.
It is important for you to realize that it is not necessary to remove the spur in order to resolve the symptoms. The spur is merely a bony outgrowth from a chronic pull of plantar fascia to the heel bone and is parallel, not perpendicular, to the weight-bearing surface. This means that you are not stepping on the spur when you walk.
You will find that your postoperative convalescence will vary based on your activity and work requirements. Those patients with sedentary jobs typically can go back to work in 3-5 days, as long as they can keep their foot propped up. Those whose work requires them to stand for prolonged periods of time may require 6-8 weeks minimum and as long as 3-6 months for those who are involved in heavy industrial lifting or carrying. The natural process of healing from heel spur surgery requires an initial reparative stage where the plantar fascia will lengthen as a result of the release, and the void will then fill in with scar tissue that will then be replaced by normal fascia, in effect, creating a “lengthened plantar fascia.” This entire process, which we call the remodeling stage, may take up to a full year to complete.
It is not uncommon for you to go through cycles during your healing process where the foot and heel feel much better, but after excessive activity, you have exacerbations of pain and symptoms. You may also have lateral heel pain after surgery during the remodeling phase if an incomplete fascial release was performed. This is a normal phenomenon associated with the increased demand being placed on the lateral plantar fascia as a result of the medial fascia being released. This typically will self-limit over time; however, your doctor may wish to adjunct injections, taping or even orthotics if you have an extremely active lifestyle.
Please realize that the outcome from this surgery is usually very good; however, as with any surgical procedure of medicine, there is no guarantee of a 100% successful outcome. Most outcomes can be improved by a reduction in weight preoperatively and a decrease in the immediate postoperative activity level to allow for the healing process to occur. Please realize that you may experience improvement in your postoperative pain for as long as 1-2 years, but the majority of relief will be experienced in the first six months. Typically, most patients state that the pain from the surgery is no worse, if not less, than the pain they had prior to the surgery.
Although there is a potential for recurrent heel pain after surgery, the percentage in our practice is extremely low. Activities such as hiking, swimming and non-impact aerobics are permitted after six weeks postoperatively. It is important for you to do toe curl exercises and heel cord stretches that will be given to you by your doctor. If you have not received these instructions, please make sure to ask for them after surgery.
We also ask that if you are overweight that you make a serious commitment to weight reduction before, during and after your surgical procedure, if at all possible.
We, the physicians and staff at Beaumont Foot Specialists, are here to answer any questions and help you in anyway possible to insure a rewarding and successful outcome. Please feel free to contact us at any point during your postoperative convalescence with any questions or problems.