What to Expect at Your Plantar Fasciitis Embolization Consultation
If you’ve been living with chronic heel pain for months — or even years — and nothing has provided lasting relief, scheduling a consultation to learn about plantar fasciitis embolization (PFE) is an important first step. It’s completely normal to feel uncertain about a procedure you may have only recently heard about, and many patients arrive at their appointment with a mix of curiosity and cautious hope.
At Fox Vein & Vascular, we believe in empowering our patients with knowledge. Dr. David Fox, MD, FACS, RPVI — a board-certified vascular surgeon with more than 28 years of experience — takes the time to ensure every patient understands the process, feels heard, and leaves with the information they need to make a confident decision. Here’s exactly what to expect when you come in for your PFE consultation.
Before Your Appointment
A little preparation can help your consultation run smoothly and ensure Dr. Fox has everything he needs to give you a thorough evaluation. Before your visit, gather the following:
- A list of current medications — including over-the-counter pain relievers, anti-inflammatories, and supplements
- Any imaging you’ve already had — MRI, X-ray, or ultrasound results related to your heel pain
- Notes on your treatment history — write down what you’ve tried (orthotics, physical therapy, cortisone injections, shockwave therapy, stretching exercises) and how long you used each treatment
- Your insurance information — bring your insurance card and any referral paperwork from your podiatrist or primary care physician
- Questions you want answered — writing them down ahead of time helps make sure nothing gets missed during your appointment
If your podiatrist has referred you for a PFE evaluation, ask their office to send over any relevant medical records and imaging before your visit. This allows Dr. Fox to review your case in advance and make the most of your time together.
Your Medical History Review
- How long you’ve had heel pain — PFE is typically considered for patients whose symptoms have persisted for six months or longer
- What treatments you’ve already tried — including physical therapy and orthotics, cortisone injections, shockwave therapy, stretching, night splints, and any other approaches
- How the pain affects your daily life — whether it limits your ability to walk, exercise, work, or enjoy time with your family
- Other medical conditions — particularly anything related to vascular health, diabetes, or blood clotting disorders
- Current medications — some medications may need to be adjusted before a procedure
This conversation is one of the most important parts of the consultation. The more Dr. Fox understands about your experience with conservative treatments that haven’t worked, the better he can assess whether PFE is likely to help.
The Physical Examination
After reviewing your medical history, Dr. Fox will perform a focused physical examination of your foot and heel. This is a hands-on evaluation designed to confirm the clinical picture and assess your overall foot health. The exam typically includes:
- Palpation of the heel — checking for tenderness at the plantar fascia insertion point, which is where the fascia connects to the heel bone
- Evaluation of your gait — observing how you walk to identify any mechanical factors that may contribute to your pain
- Range of motion assessment — testing the flexibility of your ankle and foot
- Checking for signs of neovascularity — looking for physical indicators that abnormal blood vessel growth may be present in the affected area
The exam is straightforward and shouldn’t cause more than momentary discomfort. Dr. Fox is looking for specific clinical markers that help him determine whether your heel pain is the type that responds well to targeted embolization.
Imaging Review
Imaging plays a critical role in determining whether PFE is right for you. If you’ve already had an MRI or diagnostic ultrasound, Dr. Fox will review those results during your consultation. If not, he may order imaging to get a clearer picture of what’s happening inside your foot.
Here’s what Dr. Fox is looking for on imaging:
- Thickening of the plantar fascia — a hallmark sign of chronic plantar fasciitis that indicates ongoing inflammation
- Neovascularity — the presence of abnormal blood vessels growing into the damaged fascia, which is a key finding that suggests PFE may help
- Other structural issues — ruling out conditions like stress fractures, nerve entrapment, or heel spurs that may require a different treatment approach
Neovascularity is especially important. These tiny, abnormal blood vessels feed the inflammatory cycle that keeps your heel pain going. PFE works by delivering microscopic embolic particles through a catheter to reduce blood flow to these vessels — targeting the source of the problem rather than just masking the symptoms. Dr. Fox will walk you through your imaging in detail so you can see exactly what he sees and understand why it matters.
Is PFE Right for You?
After the examination and imaging review, Dr. Fox will sit down with you to discuss his findings and recommendation. This is a candid, honest conversation — not a sales pitch. He’ll cover:
Whether your imaging supports PFE
the presence of neovascularity and fascia thickening are strong indicators
Your candidacy based on your full medical history
including how long you’ve had symptoms and what you’ve already tried
Realistic expectations for your specific situation
most patients see gradual pain relief over two to six weeks, with significant improvement by two to three months
PFE is a same-day, outpatient procedure, and most patients return to light activity within 24 to 48 hours
Alternative options if PFE isn’t the best fit
Dr. Fox will never recommend a procedure unless he believes it’s genuinely in your best interest
If you’re a good candidate for PFE, you’ll also learn about how the procedure uses the same proven embolization technology behind genicular artery embolization (GAE) for knee osteoarthritis — applied to the foot to address chronic plantar fasciitis.
Questions to Ask Dr. Fox
Your consultation is your opportunity to get answers. There are no wrong questions, and Dr. Fox welcomes them. Here are a few that many patients find helpful:
How many PFE procedures have you performed?
What results do you typically see in patients with a case similar to mine?
What does the recovery process look like for someone in my situation?
Are there any reasons PFE might not be effective for me?
What does insurance coverage look like for this procedure?
What risks or side effects should I be aware of?
How does PFE compare to other treatments I haven’t tried yet?
Don’t feel rushed. Dr. Fox takes the time to answer every question thoroughly, and he wants you to leave feeling informed and confident — whether you decide to move forward with PFE or explore other options.
Next Steps After Your Consultation
What happens after your consultation depends on Dr. Fox’s evaluation and your decision.
If you’re a good candidate and want to move forward:
- Dr. Fox’s team will help you schedule your procedure at a time that works for you
- You’ll receive detailed pre-procedure instructions — including any medications to pause and what to expect on the day of your appointment
- The office will work with your insurance provider to verify coverage and discuss any costs with you in advance
If PFE isn’t recommended for your situation:
- Dr. Fox will explain exactly why and what alternative treatment paths may be more appropriate
- He may refer you back to your podiatrist with specific recommendations or suggest other treatment options to consider
- You’ll still leave with a clearer understanding of your condition and a plan for moving forward
How Long Does the Consultation Take?
You should plan on being at the office for about an hour to allow time for check-in, the consultation itself, and any follow-up discussion with the care team.
Schedule Your Consultation
If you’re ready to explore whether plantar fasciitis embolization is right for you, contact Fox Vein & Vascular to schedule a consultation with Dr. Fox.
Dr. Fox and his team will review your imaging, discuss your treatment history, and help you understand whether PFE could be the right next step toward lasting relief from chronic heel pain.
Schedule a Consultation
We’re here to help you take the next step with confidence.