Minimally invasive procedure provides relief from plantar fasciitis pain
Looking back, Deanna Brennan never realized how much pain she was in.
For years, the Cedar Rapids resident’s every step sent pain coursing up her legs from the heels of her feet. Simple tasks like walking down the hallway became unbearable.
As a nurse, Deanna has spent a lot of time on her feet, so she wasn’t surprised 10 years ago when she was diagnosed with plantar fasciitis, a common cause of heel pain. Plantar fasciitis develops when the plantar fascia, a tendon in the foot that connects the heel to the toes, is damaged.
She tried years of treatments, including physical therapy and frequent steroid injections into her feet. But the pain continued. By fall 2015, Deanna had reached her breaking point.
“I didn’t feel like I was actually living my life. I used to be so active; I ran and trained my dogs. But with the pain, it hurt to walk. I felt like I was living from the couch,” Deanna says.
She visited her primary care doctor, who referred Deanna to the Orthopedics Clinic at University of Iowa Hospitals & Clinics. After discussing her condition with an orthopedic surgeon, Deanna met with Mederic Hall, MD, an orthopedics specialist with UI Sports Medicine in Iowa City. The state-of-the-art sports medicine facility, part of the UI Department of Orthopedics and Rehabilitation, is located just minutes from the main hospital campus.
Deanna was relieved to hear that she was an ideal candidate for a percutaneous ultrasonic fasciotomy, a minimally invasive outpatient procedure that would remove the damaged tendon tissue from her feet and stimulate the growth of new, healthy tissue.
In this procedure, an ultrasound is used to visualize the area and identify damaged tissue. A specialized device is guided into the region where it uses ultrasonic energy—energy created by high-frequency sound waves—to break down the damaged tissue, leaving the healthy tissue unharmed. The damaged, pain-causing tissue is removed through suction.
Percutaneous ultrasonic fasciotomy is not a first-line treatment for plantar fasciitis, as many patients will see improvement with physical therapy and rest, according to Hall.
“This procedure is for that segment of patients who have experienced several months of pain and have failed to respond to other treatment methods,” Hall says.
Deanna, anxious and hopeful this procedure would provide relief, went to the UI Sports Medicine Clinic to have the procedure done on her left foot, the one that gave her the most pain. The procedure needed only local anesthetic into the bottom of her foot.
Deanna walked out of the clinic wearing a boot. She was back to work 48 hours later.
UI Hospitals & Clinics is one of the first medical centers in Iowa to use this technology, Hall notes.
“I was absolutely amazed because I can’t remember the last time I’d taken a step and not had my foot hurt. I’d had the issues for so long that it never really occurred to me how much pain I was actually in,” Deanna says.
Most patients feel the full benefit from the procedure and have unrestricted movement within six weeks to four months, depending on how quickly the tissue heals. Physical therapy after the procedure facilitates the healing process and restores normal range of motion.
“I was really impressed with the process in my follow-up visit. I saw the nurse, Dr. Hall, and physical therapist all in one visit that only lasted 45 minutes. They provided me with a lot information and had exercises for my foot I’d never tried before,” Deanna says.
Deanna was so impressed with the results that a month later she had the procedure performed on her right foot. She is excited to get back to spending time outside with her family hiking and training her dogs.
“I’m looking forward to pain not being the factor that decides what I do. It’ll be a while before my feet are completely healed, but compared to how they were feeling pre-procedure, Dr. Hall and his team are my heroes,” Deanna says.
— Amanda Franzen
Spring/Summer 2016