Brief Answer:
It does not need surgery.

Detailed Answer:
Hello,
Thanks for posting your query.
The pain in heels and feet can be due to a condition called plantar fasciitis. Its one of the commonest reason for feet pain. Pain in morning and improvement on walking for some time is its classical presentation. The initial treatment is with anti inflammatory medicines with rest and cold fomentation works fine for most of the patients. Cortisone injection is a good mid to long term treatment. You might need a repeat dose in a few months. Beware not to take it frequently since it causes induced tear of plantar fascia. Consider using soft silicone heel cushions for preventing any further damage to fascia.

Exercises also play an important role and I'm afraid they are the only long term mainstay of the treatment. I'm sure you already know but these are few exercises you'll have to do for long time-

1. Calf stretch- Lean forward against a wall with one knee straight and the heel on the ground. Place the other leg in front, with the knee bent. To stretch the calf muscles and the heel cord, push your hips toward the wall in a controlled fashion. Hold the position for 10 seconds and relax. Repeat this exercise 20 times for each foot. A strong pull in the calf should be felt during the stretch.

2. Plantar fascia stretch- This stretch is performed in the seated position. Cross your affected foot over the knee of your other leg. Grasp the toes of your painful foot and slowly pull them toward you in a controlled fashion. The fascia should feel like a tight band along the bottom of your foot when stretched. Hold the stretch for 10 seconds. Repeat it 20 times for each foot.
These exercises are best done in the morning before standing or walking. You also need to understand that with help of medicines, injections and physiotherapy the effects shall be appreciated after a year or so.
Surgical treatment is not needed in such cases.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal

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Brief Answer:
Can be a spur.

Detailed Answer:
Hello.
Thanks for writing again.
A bone spur also causes similar symptoms and causes plantar fasciitis refractive to conservative treatment that I have suggested. If a spur is detected on X-ray or MRI scan then surgical removal of the spur is needed if local steroid injections do not provide relief.
The spur forms due to degenerative changes in the heel bone.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.

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