It is often described as a "stone bruise" on the bottom of the heel by the patient. Pain is usually worse in the morning, especially the first several steps, or when first standing after periods of rest. As the pain worsens, the heel can hurt even while not weight-bearing.

What causes it?
Heel Spur Syndrome, or heel pain, is usually caused by a mechanical problem involving the structural alignment of the foot. There is a dense fibrous band of tissue in the bottom of the foot known as the plantar fascia. The plantar fascia inserts into the heel bone and spreads out into the foot. Because of mechanical misalignment of the foot, excessive tension is placed on this band of tissue, causing inflammation and pain. The size or presence of a heel spur does not always correlate with the amount of pain.

Maybe it will just go away.
This is possible, in some patients. However, this is not usually the case. In most cases the longer the patient waits to seek treatment, the more chronic the condition becomes, and thus requires a more lengthy and involved treatment.

What then?
If all of your symptoms go away with conservative care then surgery will not be necessary. If, however, pain and discomfort are still present after conservative care has been tried, then surgery is recommended.

What is endoscopic plantar fasciotomy?
Endoscopic Plantar Fasciotomy is a recent advance in foot surgery for the correction of Heel Spur Syndrome and Plantar Fasciitis. The new technique allows for a quicker recovery and a faster return to normal activity. The procedure is performed by utilizing specially designed instruments that allow the surgeon to directly visualize the foot structures on a video screen. It involves an outpatient surgical visit that takes approximately 20 minutes and only requires 2 small incisions.

Am I a candidate for this surgical procedure?
If you have failed to obtain complete relief of heel pain symptoms with the use of conservative treatments such as: taping, orthotics, cortisone injections, oral medication or physical therapy, then you may benefit from an Endoscopic Plantar Fasciotomy. A complete evaluation and discussion with Dr. Benjamin will help determine your best options.

How is this procedure different?
In classic heel spur surgery, a large open incision is made to sever the tight ligament in the arch known as the plantar fascia and to remove the bone spur which has formed within this fascia. Studies have proven that the actual bone spur is formed over a long period of time because of constant pulling. The injury produces inflammation, pain and inability to bear weight on the heel comfortably. The inflammation stimulates spur formation. The spur is a symptom of the inflammation and not the cause of the heel pain. In Endoscopic Plantar Fasciotomy it is not necessary to remove the heel spur in order to cure the pain.

What are the expected results?
Most patients return to their regular shoes in 3-5 days. Most return to work after the first week, and return to their normal activities by the end of the third week. Everyone heals slightly differently. Other factors such as age, weight, and occupation can contribute to healing times.

What are the risks and complications?
Fortunately, there are few complications that are relatively minor and usually resolved with careful follow-up. As with all other surgery, no procedure is risk free, and there is no guarantee as to the success of this procedure. The most common risks inherent to this procedure include delayed healing with aching at the surgical site or instep, infection, and a possibility of a small area of numbness at the incisions.

Will my insurance cover this procedure?
You should have benefits for this procedure if you have surgical coverage. You may be responsible for a portion of the surgical fees including insurance deductibles and copays.

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