pain after Percutaneous Ultrasound Fasciotomy

by Jennifer
(Council Bluffs, IA, USA)

I'm 39 & female and had Percutaneous Ultrasonic Fasciotomy done to both of my feet in April. I am healed from it, but I do have residual pain in the area of incision for both feet. I feel it is nerve pain/damage, but can't say for sure. The pain does not spread from that location, which is about an inch above the heel and towards the inner side of each foot.

This is a new pain from before the surgery. I feel it every day, but usually not all day. When I do feel it, I feel the need to limp for relief. At a post-op dr. appt, my doctor told me he felt further surgery could cause additional pain, rather than relief. Ultimately did not work for me, and I also have pre-existing pain in my heels and top areas of metatarsals, which has gotten worse rather than better.

What could be done at this point? Would I be risking too much for additional surgery? It has been 3 months since the surgery. Should I give it more time?

RESPONSE

Hi Jennifer,

Let me start off by saying that three months is way too soon to start considering more surgery.
It is probably safe to say that the problem is an irritation at the incision holes but for whatever reason, occurred in both incisions.
Complications like that, if they occur at all, usually occur at one incision site, so I cannot imagine what the surgeon might have done to cause pain in both heels.
In any event there are things short of surgery that might be of help.
You could consider a cortisone injection into the area particularly if the source of the problem is the beginning of scarring.
You might also ask your doctor about physical therapy as that too may help reduce your pain.
In spite of the fact that I cannot examine you and am only guessing as to what your actual problem may be, I cannot even imagine what type of additional surgery you could have. The only things I can think of would be an irritation of the incision for which I have just offered two treatments, or an incomplete fasciotomy, or possible damage to other tissue from the actual cutting.
Since the original heel pain appears to be resolved then one can assume the fasciotomy was performed well, but it is difficult to know if additional tissue was cut.
So that leaves you with either irritation of the incisions or damage to adjacent tissue.
If the pain actually feels deeper then the skin incision, an MRI might not be a bad idea to see if there is additional damage.
Short of any additional damage, then my original recommendations stand.

Marc Mitnick DPM
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