September 28, 2015
A heel spur also known as a calcaneal spur, is a pointed bony outgrowth of the heel bone (calcaneus). Heel spurs do not always cause pain and often are discovered incidentally on X-rays taken for other problems. Heel spurs can occur at the back of the heel and also under the heel bone on the sole of the foot, where they may be associated with the painful foot condition plantar fasciitis.
A heel spur can develop when there is an abundance of calcium creating a deposit in the calcaneus, or heel bone. Over time, this deposit grows to create an outcropping under the heel that extends into the foot. The result is a protrusion that leads to foot pain when pressure is applied, and in some cases, even during rest.
Heel spurs are most noticeable in the morning when stepping out of bed. It can be described as sharp isolated pain directly below the heel. If left untreated heel spurs can grow and become problematic long-term.
A thorough history and physical exam is always necessary for the proper diagnosis of heel spurs and other foot conditions. X rays of the heel area are helpful, as excess bone production will be visible.
Non Surgical Treatment
Elevation of the affected foot and leg at rest may diminish the pain. Applying gentle heat to the painful area may ease the pain by dilating local blood vessels. One also can protect the heel by placing a foam rubber pad in the heel of the shoe. A pad about one-half inch thick will raise the heel, shift the weight of the body forward, and protect the irritated muscles attached to the heel bone. The same effect can be achieved by using adhesive tape to turn the foot inward. Additional treatment may consist of a number of physical therapies, such as diathermy, ultrasound waves and whirlpool baths.
More than 90 percent of people get better with nonsurgical treatments. If conservative treatment fails to treat symptoms of heel spurs after a period of 9 to 12 months, surgery may be necessary to relieve pain and restore mobility. Surgical techniques include release of the plantar fascia, removal of a spur. Pre-surgical tests or exams are required to identify optimal candidates, and it's important to observe post-surgical recommendations concerning rest, ice, compression, elevation of the foot, and when to place weight on the operated foot. In some cases, it may be necessary for patients to use bandages, splints, casts, surgical shoes, crutches, or canes after surgery. Possible complications of heel surgery include nerve pain, recurrent heel pain, permanent numbness of the area, infection, and scarring. In addition, with plantar fascia release, there is risk of instability, foot cramps, stress fracture, and tendinitis.
The best way to prevent heel spurs is by wearing properly fitted footwear. Shoes should have a shock absorbing tread and soles and should be effective in supporting the heel and arch. Proper warm up and stretching before embarking on any physical activity that will put pressure or impact on the area is highly recommended. Also, just as it?s important for your general health, if you can lose some extra pounds, you will be more likely to avoid heel spurs. If you are starting to feel the onset of pain, it may not be heel spurs, but could be a tendonitis condition that could lead to heel spurs.