Heel Spur Surgery? But do you really need it?
A heel spur is bony growth on the bottom of your heel bone (the “calcaneus”).
It was thought that heel pain, usually more severe in the morning, was due to the bony spur which showed up on a lateral x-ray of your foot.
Current thinking is that the pain is from the pulling of the tissues (the “plantar fascia”) attached to the heel bone around the spur. Surgery to cure this kind of heel pain is usually aimed at releasing part of the plantar fascia from the heel bone. After the cut is made partially through the plantar fascia (think of it as a thick rubber band), the ends are left as is and the space between heals with scare tissue effectively making the plantar fascia a bit longer. This surgery can now be done endoscopically or by the traditional “open surgery” where an incision is made. Beware of those podiatrists who doe not have modern training and who still make an incision on the bottom of the foot to do this surgery. You should need in incision on the bottom or your foot.
For condition of painful heel pain, or “plantar fasciitis,” it is crucial for the podiatrist to try all non surgical treatments before suggesting surgery because it is known that non surgical treatment can eliminate much of the pain in many patients and avoid surgery. Many insurance companies will not pay for a plantar fascia release or “heel spur” surgery without the podiatrist first proving he or she gave the patient all of the non surgical treatments.
Malpractice in this area usually involves
- not trying all treatments and going straight to surgery
- injury to parts of the inside of the foot due to carelessness or inexperience
- nerve injury
- too much of the plantar fascia is cut. There is a saying in surgery: if you cut too little, you can go back and cut more. If you cut too much, you cannot go and put it back.
The podiatrist cannot, and should not, guarantee that your heel pain will be better after surgery. However, if your pain is worse after surgery, your podiatrist should find out why and not simply tell you that “these things happen.” We find that after a thorough investigation it turns out that for those who are worse after surgery, a mistake was made during surgery.