Minimally invasive surgical treatments versus non-surgical treatments or placebo for plantar fasciopathy: A systematic review

Foot Ankle Surg. 2025 Dec;31(8):672-683. doi: 10.1016/j.fas.2025.04.009. Epub 2025 May 1.

Abstract

Background: Due to advances in minimally invasive surgical treatments (MIST), this systematic review with a narrative synthesis aimed to investigate the effectiveness of MIST in improving pain compared with non-surgical treatment or placebo in patients with plantar fasciopathy (PF).

Methods: We systematically searched relevant databases for peer-reviewed studies comparing MIST to non-surgical treatments or placebo.

Results: Eight studies were included. The results demonstrated statistically significant superiority in pain reduction for percutaneous needle treatments compared to non-surgical treatments or placebo in five studies. One study compared endoscopic plantar fascia release to exercise and corticosteroid injections and found a statistically significant superiority of endoscopic plantar fascia release.

Conclusions: This systematic review found promising effects of needle treatments to reduce pain among patients with PF. Endoscopic plantar fascia release was superior to the comparator in one of three studies. High risks of bias and methodological heterogeneity limit the strength of the available evidence.

Level of clinical evidence: II.

Keywords: Minimally invasive treatment; Non-surgical treatment; Plantar fasciopathy; Plantar heel pain.

Publication types

  • Comparative Study
  • Systematic Review

MeSH terms

  • Endoscopy
  • Fasciitis, Plantar* / surgery
  • Fasciitis, Plantar* / therapy
  • Humans
  • Minimally Invasive Surgical Procedures* / methods
  • Pain Management / methods