A heel spur is a bony projection on the sole (bottom) of the heel bone. This condition may accompany or result from severe cases of inflammation to the structure called plantar fascia. The plantar
fascia is a fibrous band of connective tissue on the sole of the foot, extending from the heel to the toes. Heel spurs are a common foot problem resulting from excess bone growth on the heel bone.
The bone growth is usually located on the underside of the heel bone, and may extend forward toward the toes. A painful tear in the plantar fascia between the toes and heel can produce a heel spur
and/or inflammation of the plantar fascia. Because this condition is often correlated to a decrease in the arch of the foot, it is more prevalent after the ages of six to eight years, when the arch
is fully developed.
Early signs of heel pain are usually due to plantar fasciitis, the inflammation of the plantar fascia. It is probably the most common cause of heel pain seen by the podiatrist. It is seen in all
groups of people; runners, athletes, weekend warriors, people who have jobs requiring a fair amount of standing, walking, or lifting, and those who have recently gained weight. The pain most often
manifests itself after periods of non-weight bearing when the plantar fascia is given a chance to rest, so your first steps cause a sudden strain to the tissue. Pain is most common with the first
steps in the morning and after periods of rest. Fortunately, upwards of 80 percent of those treated early do remarkably well with conservative therapy.
If your body has created calcium build-ups in an effort to support your plantar fascia ligament, each time you step down with your foot, the heel spur is being driven into the soft, fatty tissue
which lines the bottom of your heel. Heel spur sufferers experience stabbing sensations because the hard protrusion is literally being jabbed into the heel pad. If left untreated, Plantar Fasciitis
and heel spurs can erode the fatty pad of the heel and cause permanent damage to the foot. Fortunately, most cases can be resolved without medications or surgeries.
A Diagnosis of Heel Spur Syndrome is a very common reason for having heel pain. Heel pain may be due to other types of conditions such as tendonitis, Haglund's Deformity, Stress Fracture, Tarsal
Tunnel Syndrome, or low back problems. A more common condition in children is Sever's Disease. The diagnosis is usually made with a combination of x-ray examination and symptoms.
Non Surgical Treatment
Acupuncture and acupressure can used to address the pain of heel spurs, in addition to using friction massage to help break up scar tissue and delay the onset of bony formations. Physical therapy may
help relieve pain and improve movement. The Feldenkrais method could be especially helpful for retraining some of the compensation movements caused by the pain from the spur. Guided imagery or a
light massage on the foot may help to relieve some of the pain. Other treatments include low-gear cycling, and pool running. Some chiropractors approve of moderate use of aspirin or ibuprofen, or
other appropriate anti-inflammatory drugs. Chiropractic manipulation is not recommended, although chiropractors may offer custom-fitted shoe orthotics and other allopathic-type treatments.
Surgery involves releasing a part of the plantar fascia from its insertion in the heel bone, as well as removing the spur. Many times during the procedure, pinched nerves (neuromas), adding to the
pain, are found and removed. Often, an inflamed sac of fluid call an accessory or adventitious bursa is found under the heel spur, and it is removed as well. Postoperative recovery is usually a
slipper cast and minimal weight bearing for a period of 3-4 weeks. On some occasions, a removable short-leg walking boot is used or a below knee cast applied.
If you have not yet developed this condition, you can take steps to protect yourself from it. Most importantly, make it a rule to wear properly fitted footwear. Avoid shoes that have become worn down
in the heel, and don't choose shoes that cause you to walk in an abnormal fashion. Maintaining a healthy weight will ensure that undue pressure isn't being put on the ligaments, tendons and bones of
your feet. If your job requires a great deal of time on your feet, or if you exercise regularly, be sure to balance periods of activity with periods of rest for your feet.