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Foot & AnkleSecond Opinion Guide

Should you get a second opinion for plantar fasciitis surgery?

Plantar fasciitis resolves without surgery in 90% of patients within 12 months. Surgery should only be considered after 6-12 months of conservative treatment has failed. A second opinion is appropriate if surgery is being recommended before completing a full course of conservative care.

Red flags - consider a second opinion if you notice these

  • Surgery was recommended before 6 months of conservative treatment
  • Platelet-rich plasma (PRP) injection was not offered as a non-surgical option
  • Night splints have not been tried
  • Physical therapy targeting calf stretching and plantar fascia stretching was not completed
  • Your foot biomechanics and footwear were not assessed

Questions to ask the second surgeon

  1. 1Have I truly exhausted conservative treatment, including physical therapy, orthotics, and PRP?
  2. 2What is the specific procedure you recommend: plantar fascia release, gastrocnemius recession, or both?
  3. 3Is there any evidence of a nerve entrapment that might explain why I am not improving?
  4. 4What are the risks of plantar fascia release, including arch collapse?
  5. 5What percentage of your surgical patients achieve complete resolution?

What to expect from a second opinion visit

Given that 90% of plantar fasciitis resolves without surgery, a second opinion often reveals that more conservative treatment options remain. Bring records of your treatment history, including what physical therapy was performed and for how long. A foot and ankle specialist or a sports medicine physician can evaluate whether the diagnosis is correct and whether further non-surgical options exist.

Common questions

What is the success rate of plantar fasciitis surgery?
When performed after failed conservative treatment, plantar fascia release reduces pain in approximately 70-80% of patients. However, it comes with risks including prolonged recovery, arch weakness, and in rare cases, the development of lateral column pain from changes in foot mechanics.
Is PRP effective for plantar fasciitis?
Evidence for PRP in plantar fasciitis is mixed. Some studies show improvement compared to cortisone injection, particularly for longer-lasting relief. It is a reasonable option to try before surgery, particularly for patients who have had cortisone injections without lasting benefit.

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