A heel spur is a calcium deposit causing a bony protrusion on the underside of the heel bone. On an X-ray, a heel spur can extend forward by as much as a half-inch. Without visible X-ray evidence, the condition is sometimes known as "heel spur syndrome." Although heel spurs are often painless, they can cause heel pain. They are frequently associated with plantar fasciitis, a painful inflammation of the fibrous band of connective tissue (plantar fascia) that runs along the bottom of the foot and connects the heel bone to the ball of the foot. Treatments for heel spurs and associated conditions include exercise, custom-made orthotics, anti-inflammatory medications, and cortisone injections. If conservative treatments fail, surgery may be necessary.
Heel spurs can be caused by several things. Anything that can cause the body to rebuild itself can lead to a bone spur. A heel spur is a natural reaction of the body to correct a weakness by building extra bone. One of the most common causes for the development of heel spurs is the wearing of shoes that are too tight. That?s why more women suffer from heel spurs more than men. Athletes who tend to stress their feet a lot, people are overweight who have more pressure on their lower extremities and the elderly also tend to suffer more from heel spurs.
Most of the time heel spurs present as pain in the region surrounding the spur, which typically increases in intensity after prolonged periods of rest. Patients may not be able to bear weight on the afflicted heel comfortably. Running, walking, or lifting heavy weight may exacerbate the issue.
Diagnosis of a heel spur can be done with an x-ray, which will be able to reveal the bony spur. Normally, it occurs where the plantar fascia connects to the heel bone. When the plantar fascia ligament is pulled excessively it begins to pull away from the heel bone. When this excessive pulling occurs, it causes the body to respond by depositing calcium in the injured area, resulting in the formation of the bone spur. The Plantar fascia ligament is a fibrous band of connective tissue running between the heel bone and the ball of the foot. This structure maintains the arch of the foot and distributes weight along the foot as we walk. However, due to the stress that this ligament must endure, it can easily become damaged which commonly occurs along with heel spurs.
Non Surgical Treatment
The most important part of treatment is to rest. Do not undertake activities which hurt the foot or aggravate symptoms as will only cause painful symptoms to persist. Apply an ice pack regularly for 10 minutes at a time every hour initially to reduce pain and inflammation of the surrounding tissues. As symptoms subside frequency of application can reduce to 2 or 3 times per day. Exercises and stretches to keep the foot and ankle strong and mobile are important as long as pain allows. Stretching the plantar fascia is important, especially if symptoms are worse in the morning. A plantar fasciitis night splint is excellent for stretching and preventing the plantar fascia tightening up over night. Anti-Inflammatory medicine (e.g. ibuprofen) may be prescribed by a doctor but always check with a medical professional first as taking some medications such as ibuprofen should not be done if the patient has asthma. Shoe inserts can help to take the pressure off of the spur and reduce pain. If these treatments do not significantly ease the symptoms then surgery may be an option.
When chronic heel pain fails to respond to conservative treatment, surgical treatment may be necessary. Heel surgery can provide relief of pain and restore mobility. The type of procedure used is based on examination and usually consists of releasing the excessive tightness of the plantar fascia, called a plantar fascia release. Depending on the presence of excess bony build up, the procedure may or may not include removal of heel spurs. Similar to other surgical interventions, there are various modifications and surgical enhancements regarding surgery of the heel.
There are heel spur prevention methods available in order to prevent the formation of a heel spur. First, proper footwear is imperative. Old shoes or those that do not fit properly fail to absorb pressure and provide the necessary support. Shoes should provide ample cushioning through the heel and the ball of the foot, while also supporting the arch. Wearing an orthotic shoe insert is one of the best ways to stretch the plantar fascia and prevent conditions such as heel spurs. Stretching the foot and calf is also helpful in preventing damage. Athletes in particular should make sure to stretch prior to any physical activity. Stretching helps prevent heel spurs by making tissue stronger as well as more flexible. In addition, easing into a new or increasingly difficult routine should be done to help avoid strain on the heel and surrounding tissue.