Posted by Tommy Moch on 11/28/2017

Plantar fasciotomy is often considered after conservative treatment has failed to resolve the issue after six months and is viewed as a last resort. Minimally invasive and endoscopic approaches to plantar fasciotomy exist but require a specialist who is familiar with certain equipment. The availability of these surgical techniques is currently limited. A 2012 study found 76% of patients who underwent endoscopic plantar fasciotomy had complete relief of their symptoms and had few complications (level IV evidence). Heel spur removal during plantar fasciotomy has not been found to improve the surgical outcome.

Plantar heel pain may occur for multiple reasons and release of the lateral plantar nerve branch may be performed alongside the plantar fasciotomy in select cases. Possible complications of plantar fasciotomy include nerve injury, instability of the medial longitudinal arch of the foot, fracture of the calcaneus, prolonged recovery time, infection, rupture of the plantar fascia, and failure to improve the pain. Coblation surgery has recently been proposed as alternative surgical approaches for the treatment of recalcitrant Plantar Fasciitis.

Botulinum Toxin A injections as well as similar techniques such as platelet-rich plasma injections and prolotherapy remain controversial.

Dry needling is also being researched for treatment of Plantar Fasciitis. A systematic review of available research found limited evidence of effectiveness for this technique. The studies were reported to be inadequate in quality and too diverse in methodology to enable reaching a firm conclusion.

Family doctors, in particular, are not prepared to treat Plantar Fasciitis or any other musculoskeletal condition
Podiatrists (foot doctors) especially in North America, where podiatrists are mainly focused on surgical procedures often provide poor quality advice about chronic repetitive strain injuries like Plantar Fasciitis, Iliotibial Syndrome, or Shin Splints. In all fairness, a limited few take a special interest in these conditions, but most do not, and the occasional tough case of Plantar Fasciitis is not on their radar - understandable but unfortunate. 
Physical Therapist can be the overall best bet for overall Plantar Fasciitis in conjunction with treatments which provide support, stabilization, and elongation of the Plantar Fascia Ligament care but often lack the skill, experience, and ability to treat tough cases

Improperly sized insoles and orthotics may contribute to other ailments such as back or perhaps hip pain
Loosely fitting compression socks, compression sleeves or improperly applied wrapping and taping may as well be counterproductive

Warmest regards,