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A heel spur is a painful condition that is caused by the accumulation of excessive calcium under the heel of the foot. The heel bone is made up of a large structure called the calcaneus, which is connected to the bottom of the foot by durable connective tissue called fascia. If the layers of connective tissue become damaged or begin to degenerate due to wear and tear, plantar fasciitis may develop. This causes calcification, which refers to the abnormal buildup of calcium on the heel bone. As the calcium continues to accumulate, a calcified protrusion called a spur may become visible on an X-ray.
Faulty foot structures such as abnormal growths, different leg lengths, and unhealed injuries and haveinf flat feet or high arches. Muscle imbalances tight, weak or shortened muscles in your foot, plantar fascia, ankle, calf and hamstring. Over pronation can cause imbalance in foot mechanics which puts excess pressure on the plantar fascia. Poor biomechanics affect the way your foot hits the ground. If you overpronate (feet roll inward) you tend to have flat feet (pes planus), which increases stress on the heel bone. Regular shoes or high heels that are too tight or don't support your heel or arch affect the distribution of your body weight on your foot. Health conditions such as obesity, inflammatory diseases (rheumatoid arthritis, ankylosing spondylitis), bursitis, neuroma (nerve growths), gout, diabetes, Haglund's deformity, and Achilles tendinitis can also instigate the problem. Running or jogging on hard surfaces, repetative striking of the heel bone.
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.
Because the diagnosis of heel spurs can be confused with tarsal tunnel syndrome (as described earlier), most surgeons advocate performing a tarsal tunnel release (or at least a partial tarsal tunnel release) along with the plantar fascia release. This surgery is about 80percent successful in relieving pain in the small group of patients who do not improve with conservative treatments.
Non Surgical Treatment
Many treatment options exist, and good results are often observed. Generally, a calcaneal spur develops when proper care is not given to the foot and heels. It is often seen as a repetitive stress injury, and thus lifestyle modification is typically the basic course of management strategies. To alleviate heel spur pain, a person should begin doing foot and calf workouts. Strong muscles in the calves and lower legs will help take the stress off the bone and thus help cure or prevent heel spurs. Icing the area is an effective way to get immediate pain relief.
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.
Heel Spur symptoms can be prevented from returning by wearing proper shoes and using customized orthotics and insoles to relieve pressure. It is important to perform your exercises to help keep your foot stretched and relaxed.
Patients and doctors often confuse the terms heel spur and plantar fasciitis. While these two diagnoses are related, they are not the same. Plantar fasciitis refers to the inflammation of the plantar fascia--the tissue that forms the arch of the foot. A heel spur is a hook of bone that can form on the heel bone (calcaneus) and is associated with plantar fasciitis. About 70 percent of patients with plantar fasciitis have a heel spur that can be seen on an X-ray. However, many patients without symptoms of pain can have a heel spur. The exact relationship between plantar fasciitis and heel spurs is not entirely understood. Heel spurs are common in patients who have a history of foot pain caused by plantar fasciitis.
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.
With heel spurs, people often talk about a dull ache which is felt most of the time with episodes of a sharp pain in the center of the heel or on the inside margin of the heel. Often the pain is worse on first rising in the morning and after rest and is aggravated by prolonged weight bearing and thin-soled shoes.
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
Ice and use arch support . If you can localize the spur, cut a hole in a pad of felt and lay the hole over the spur. This supports the area around the spur and reduces pressure on it. Massage the spur. Start gently with your thumb and gradually increase the pressure until you?re pushing hard directly on the spur with your knuckle or another firm object. Even it if hurts, it should help. Arch support. Build up an arch support system in your shoes. Try to equalize the pressure of your body weight throughout your arch and away from the plantar area. Use a ?cobra pad? or other device that supports the arch but releases pressure on the painful area. If homemade supports do not work, see a podiatrist about custom orthotics.
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.
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