Heel spurs are a relatively common cause of heel pain. A heel spur is a pointed bone fragment that extends forward from the bottom of the heel from the heel bone, also referred to as a calcaneous.
Serious pain and discomfort often develops with this condition. In many cases, a heel spur develops along with plantar fasciitis which occurs when the plantar fascia ligament becomes inflamed.
These bony protrusions are commonly found in association with a condition called Plantar Fasciitis. Plantar Fasciitis occurs when the plantar fascia ligament, which spans the arch of the foot,
becomes stressed, torn and inflamed. Misalignment and excessive movement of the plantar fascia ligament is most typically the result of an abnormal walking gait. The ligament is designed to stretch
with the bounce of each step you take, but if it stretches too much, the resulting small tears and inflammation can cause mild to extreme discomfort. At the same time, it is believed that heel spurs
are formed as the body attempts to provide some additional support to the over-stretched ligament. In other words, calcium builds up as a prop to the plantar fascia.
An individual with the lower legs turning inward, a condition called genu valgus or "knock knees," can have a tendency toward excessive pronation. This can lead to a fallen arch and problems with the
plantar fascia and heel spurs. Women tend to suffer from this condition more than men. Heel spurs can also result from an abnormally high arch. Other factors leading to heel spurs include a sudden
increase in daily activities, an increase in weight, or a thinner cushion on the bottom of the heel due to old age. A significant increase in training intensity or duration may cause inflammation of
the plantar fascia. High-heeled shoes, improperly fitted shoes, and shoes that are too flexible in the middle of the arch or bend before the toe joints will cause problems with the plantar fascia and
possibly lead to heel spurs.
Diagnosis is made using a few different technologies. X-rays are often used first to ensure there is no fracture or tumor in the region. Then ultrasound is used to check the fascia itself to make
sure there is no tear and check the level of scar tissue and damage. Neurosensory testing, a non-painful nerve test, can be used to make sure there is not a local nerve problem if the pain is thought
to be nerve related. It is important to remember that one can have a very large heel spur and no plantar fasciitis issues or pain at all, or one can have a great deal of pain and virtually no spur at
Non Surgical Treatment
In case of heel spurs rest is most important. Active sports, running, long walks etc should be avoided to start with. If you?re in a job that requires a lot of standing, take a few days off work.
Rest (or reduced activity) is essential to allow the inflammation from becoming aggrevated. Furthermore, you can use ice packs (placed on the heel for 5-10 minutes) to ?cool down? the inflamed area.
You may take anti-inflammatory medication or apply a topical inflammatory (i.e. a cream) to help reduce inflammation. In addition, there are some simple exercises that should be done daily to help
relieve heel spur pain.
Heel spur surgery should only be considered after less invasive treatment methods have been explored and ruled insufficient. The traditional surgical approach to treating heel spurs requires a
scalpel cut to the bottom of the food which allows the surgeon to access the bone spur. Endoscopic plantar fasciotomies (EPF) involve one or two small incisions in the foot which allow the surgeon to
access and operate on the bone spur endoscopically. Taking a surgical approach to heel spur treatment is a topic to explore with a foot and ankle specialist.