A heel spur is a hook of bone that can form on the heel bone of the foot. Heel spurs are associated with plantar fasciitis. Heel spurs can cause extreme pain in the rearfoot. The pain is most intense
while standing or walking. What Causes Heel Spurs? Heel spurs develop as an abnormal growth in the heel bone due to calcium deposits that form when the plantar fascia stretches and pulls away from
the heel. The plantar fascia is a ligament located at the bottom of your foot. This stretching of the plantar fascia is usually the result of flat feet or unusually high arches.
This condition is a constellation of many causes; overweight, ill fitting shoes, bio-mechanical problems (mal-alignment of the heel), gout, pronation (a complex motion including outward rotation of
the heel and inward rotation of the ankle) and rheumatoid arthritis are some of the causes of heel pain.
The pain caused by a calcaneal spur is not the result of the pressure of weight on the point of the spur, but results from inflammation around the tendons where they attach to the heel bone. You
might expect the pain to increase as you walk on the spur, but actually it decreases. The pain is most severe when you start to walk after a rest. The nerves and capillaries adapt themselves to the
situation as you walk. When you rest, the nerves and capillaries rest, also. Then, as you begin to move about again, extreme demands are made on the blood vessels and nerves, which will cause pain
until they again adjust to the spur. If excessive strain has been placed on the foot the day before, the pain may also be greater. A sudden strain, as might be produced by leaping or jumping, can
also increase the pain. The pain might be localized at first, but continued walking and standing will soon cause the entire heel to become tender and painful.
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
Non Surgical Treatment
Treatment of heel spurs is the same as treatment of plantar fasciitis. Because these problems are related, the treatment is the same. The first step in the treatment of a heel spur is short-term rest
and inflammation control. Here are the steps patients should take in order to cure the symptoms of plantar fasciitis and heel spurs. Avoiding the activity that caused the symptoms is the first step
in treatment. For example, take a few day off jogging or prolonged standing/walking. Just resting usually helps to eliminate the most severe pain, and will allow the inflammation to begin to cool
down. Icing will help to diminish some of the symptoms and control the heel pain. Icing is especially helpful after a sudden flare up of symptoms. Exercises and stretches are designed to relax the
tissues that surround the heel bone. Some simple exercises, performed in the morning and evening, often help patients feel better quickly. Many patients will work with a physical therapist, or you
can try some simple activities on your own. If you need some help, meet with a therapist for a few sessions to learn a program you can continue on your own.
Sometimes bone spurs can be surgically removed or an operation to loosen the fascia, called a plantar fascia release can be performed. This surgery is about 80 percent effective in the small group of
individuals who do not have relief with conservative treatment, but symptoms may return if preventative measures (wearing proper footwear, shoe inserts, stretching, etc) are not maintained.
Heel spurs and plantar fasciitis can only be prevented by treating any underlying associated inflammatory disease.