Heel Spurs are deposits of calcium in the heel area of the foot that are the typically the result of tension, abrasion and/or inflammation in the plantar fascia attachment to the heel. The heel spur
itself is said not to be painful. The pain likely arises from the inflammation of the plantar fascia. The plantar fascia encapsulates muscles in the sole of the foot. It supports the arch of the foot
by acting as a bowstring to connect the ball of the foot to the heel. Common causes of heel spurs include excessive load on the foot from obesity or a sudden increase in weight, a sudden increase in
walking or sports activities.
Each time we take a step forward, all of our body weight first rests on the heel of one foot. As our weight moves forward, the entire foot begins to bear the body's weight, and the foot flattens and
this places a great deal of pressure and strain on the plantar fascia. There is very little ?give? to the plantar fascia, so as it stretches only slightly, it pulls on its attachment to the heel. If
the foot is properly aligned this pull causes no problems. However, if the foot is ?pronated?(the foot rolls outward at the ankle, causing a break down of the inner side of the shoe), the arch falls
excessively, and this causes an abnormal stretching of the relatively inflexible plantar fascia, which in turn pulls abnormally hard on the heel. The same pathology occurs with ?supination? (the
rolling inward of the foot, causing a break down of the outer side of the shoe). Supinated feet are relatively inflexible; usually have a high arch, and a short or tight plantar fascia. Thus as
weight is transferred from the heel to the remainder of the foot, the tight plantar fascia hardly stretches at all, and pulls with great force on its attachment to the heel. In both cases, the
abnormal stress placed on the attachment of the plantar fascia to the heel usually causes pain, inflammation, and possibly swelling. If this process continues, the plantar fascia partially tears away
from the heel. The body will fill in this torn area with calcium; eventually it becomes bone, and a heel spur results.
More often than not, heel spurs have no signs or symptoms, and you don?t feel any pain. This is because heel spurs aren?t pointy or sharp pieces of bone, contrary to common belief. Heel spurs don?t
cut tissue every time movement occurs; they?re actually deposits of calcium on bone set in place by the body?s normal bone-forming mechanisms. This means they?re smooth and flat, just like all other
bones. Because there?s already tissue present at the site of a heel spur, sometimes that area and the surrounding tissue get inflamed, leading to a number of symptoms, such as chronic heel pain that
occurs when jogging or walking.
The proper diagnosis of a heel spur often requires an X-ray. To make this process as convenient for his patients as possible, most clinics have an on-site digital X-ray and diagnostic ultrasound
machines. This can make it unnecessary for patients to visit diagnostic imaging centers, allowing patients to receive more expedient treatment.
Non Surgical Treatment
Heel spurs and plantar fascitis are usually controlled with conservative treatment. Early intervention includes stretching the calf muscles while avoiding re-injuring the plantar fascia. Decreasing
or changing activities, losing excess weight, and improving the proper fitting of shoes are all important measures to decrease this common source of foot pain. Modification of footwear includes shoes
with a raised heel and better arch support. Shoe orthotics recommended by a healthcare professional are often very helpful in conjunction with exercises to increase strength of the foot muscles and
arch. The orthotic prevents excess pronation and lengthening of the plantar fascia and continued tearing of this structure. To aid in this reduction of inflammation, applying ice for 10-15 minutes
after activities and use of anti-inflammatory medication can be helpful. Physical therapy can be beneficial with the use of heat modalities, such as ultrasound that creates a deep heat and reduces
inflammation. If the pain caused by inflammation is constant, keeping the foot raised above the heart and/or compressed by wrapping with an ace bandage will help. Corticosteroid injections are also
frequently used to reduce pain and inflammation. Taping can help speed the healing process by protecting the fascia from reinjury, especially during stretching and walking.
Surgery is used a very small percentage of the time. It is usually considered after trying non-surgical treatments for at least a year. Plantar fascia release surgery is use to relax the plantar
fascia. This surgery is commonly paired with tarsal tunnel release surgery. Surgery is successful for the majority of people.