As a patient, you have the right to be informed and ask questions of your healthcare provider. Below are 5 things patients should question when undergoing tests or treatments for foot and ankle conditions. Before moving forward with any treatment, consult with a foot and ankle orthopaedic surgeon in your area.


1. Don't undergo surgery for a bunion or hammertoes without symptoms.

Foot surgery for cosmetic reasons is not supported by medical research. Symptoms such as pain and limitations of activity are the most common reasons to pursue bunion or hammertoe surgery. Patients having surgery for bunions and hammertoes are at risk for a wide range of complications such as nerve damage, infection, bone healing problems and toe stiffness.

2. Don't use shoe inserts for symmetric flat feet or high arches in patients without symptoms.

Symmetric flat feet or high arches are common conditions, and generally they are asymptomatic. The development of the arch is not related to external supports, and no evidence exists that any support is needed in asymptomatic patients.

3. Don't undergo surgery for plantar fasciitis before trying at least 6 months of non-operative care.

With 6 months of consistent, non-operative treatment, plantar fasciitis will resolve up to 97% of the time. Surgery has the possibility of post-operative complications with continued pain.

4. Don't get a non-weightbearing X-ray evaluation of your foot and ankle if you are able to stand.

The functional position of the foot and ankle is one of weightbearing (putting weight on the foot and ankle). Foot and ankle disorders including flatfeet, ligamentous injuries of the midfoot, ankle arthritis, bunions, and hammertoes that are well-demonstrated on weightbearing X-rays may be underestimated or not appreciated at all on non-weightbearing X-rays. Therefore, when possible, weightbearing X-rays of the foot and ankle are preferred in order to give the most accurate assessment of the functional bony anatomy of the foot and ankle.

5. Don't use orthopaedic therapeutic biologics, including platelet rich plasma and stem cell treatment, for foot and ankle problems without first considering established, conventional treatment options.

Orthopaedic therapeutic biologics (orthobiologics) comprise a variety of tissue grafts and autologous blood products that include platelet rich plasma (PRP) and mesenchymal stem cell treatment. Surgeons bear responsibility to offer their patients efficacious, safe, and cost-effective treatments. Orthobiologic treatment can be costly and may not be covered by insurance. Patients can become financially vulnerable especially when pursuing orthobiologic treatment that extends beyond its intended use, scientific support, or regulatory approval. Surgeons should be well-versed in the scientific basis, techniques, potential risks, and regulatory status of orthobiologic treatments. Furthermore, surgeons should review the risks, benefits, and anticipated efficacy of orthobiologic therapy with patients in advance. Orthobiologic treatment options represent a rapidly expanding area of interest for both patients and providers, but remain relatively new and understudied. There is ongoing need for investigative research.


This list was created in conjunction with Choosing Wisely, an initiative of the ABIM Foundation. These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their foot and ankle orthopaedic surgeon.

The American Orthopaedic Foot & Ankle Society (AOFAS) offers information on this site as an educational service. The content of FootCareMD, including text, images, and graphics, is for informational purposes only. The content is not intended to substitute for professional medical advice, diagnoses or treatments. If you need medical advice, use the "Find a Surgeon " search to locate a foot and ankle orthopaedic surgeon in your area.