Angela, there is also a procedure called "ultrasonic fasciotomy".
Fortunately, a minimally invasive treatment is available for patients with plantar fasciitis who otherwise have not found relief. Percutaneous ultrasonic fasciotomy uses the Tenex Health TX tissue removal (debridement) system, which Mayo Clinicdoctors helped develop. The procedure, which can be done in a doctor's office, can be used on elbows, shoulders or other places where tendinopathy (irritation in the tendons) may develop, as well.
Here's how it works. Before the procedure, imaging tests -- such as ultrasound or MRI -- are done to determine the location and extent of the degenerated tissue. Once the specially trained physician has a clear picture of what's going on, her or she numbs the skin over the area and makes a small incision -- just large enough to insert a needle-like probe.
The physician then inserts the probe into the opening, guided by ultrasound imaging. The probe's oscillating tip produces ultrasonic energy, which breaks down the damaged tissue directly ahead of it. At the same time, a built-in inflow-outflow fluid system simultaneously irrigates and sucks up the broken down, or emulsified, tissue. Once all of the degenerated tissue is cleared away, the probe is removed, and the incision is closed with adhesive skin tape and a pressure bandage. The whole procedure takes only a few minutes, and complications are few.
After the procedure, patients must rest the area for several days and may need crutches or a walking boot to relieve pressure on the foot. But, they usually can get back to their regular routine within a week to 10 days, although it might take several months before returning to the activity that prompted the plantar fasciitis. Improvement continues as the tissue heals. Some people may benefit from additional physical therapy.
The procedure may not be appropriate for patients who have a complete tear in the fascia, but those with plantar fasciitis that hasn't responded to initial treatment should talk to their doctor about all of their treatment options, including ultrasonic fasciotomy. -- Jay Smith, M.D., Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minn.