Plantar Fasciitis Treatment

Plantar fasciitis is one of the most common causes of foot and heel pain. It is caused by inflammation of the plantar fascia, a thick band of tissue that runs across the bottom of the foot.

Many people experience stabbing pain to the bottom the heel, which is often worse after rest or the first few steps out of bed. Many of these same people have struggled with this pain for years, attempting varieties of home treatments.

Conservative plantar fasciitis treatment with stretching

Conservative Plantar Fasciitis Treatments

Plantar fasciitis does not need to be a chronic or debilitating problem. Studies have shown that 90% of people recover from plantar fasciitis pain with conservative treatments. These treatments include:

  • Stretching exercises
  • Orthotics
  • Anti-inflammatory medications
  • Physical therapy
  • Platelet-Rich Plasma (PRP) treatments are also indicated for plantar fasciitis

Generally, conservative treatments should be attempted for two to three months before advancing the discussion to surgical management.

When is Plantar Fasciitis Surgery Needed?

A surgical discussion should be held for the 10% of patients that continue to have plantar fasciitis pain. Many patients are reluctant to consider surgery due to a fear of pain, prolonged non-weightbearing period, and a reduction in long-term activity. However, Dr. Castelein utilizes an endoscopic plantar fasciotomy (EPF), a minimally-invasive, minimally-traumatic surgical treatment for chronic plantar fasciitis.

Endoscopic Plantar Fasciotomy

An endoscopic plantar fasciotomy is a quick outpatient procedure performed at a hospital or surgery center. Dr. Castelein creates two small incisions on the outside of the foot, each less than an inch long. By inserting a camera, the plantar fascia is clearly identified. A special knife is then used to release the inside half of the plantar fascia.

By releasing just a portion of the plantar fascia, the function of the plantar fascia is maintained. The release side is then able to heal in a longer state, reducing the pain long term. This allows for a faster recovery and less recovery pain overall. The procedure typically takes 10 to 15 minutes and is performed with the lightest sedation possible while still maintaining patient comfort.


Immediately after the procedure, Dr. Castelein allows his patients to walk in a surgical boot. Most patients report less pain the day after surgery than they experienced prior. Those that do experience post-op pain typically report minor discomfort for five days or less. Reported overall success rate for EPFs is listed at 90%.

Podiatrist examining foot for plantar fasciitis

The Bottom Line on Plantar Fasciitis Surgery

Aggressive conservative treatments do not need to be the end point for plantar fasciitis treatments. Approximately just 10% of people will require surgery. By utilizing the minimally-invasive endoscopic approach, Dr. Castelein offers an alternative to restore pain-free function of the foot.