Heel spur is a thorn-like, bony protrusion of the heel bone, which can become inflamed through irritation, thus causing pain. A heel spur forms at the tendon attachments on the muscles of the heel
bone as a result of micro-injuries to the tissue caused by overstraining. As part of the healing process for these micro-injuries, the body stores bone material in the tendon attachments as a repair
mechanism. Heel spurs can develop over a very long period without causing major complaints. However, irritation of the area surrounding the ossified tendon attachment can cause inflammations. Left
untreated, the inflammations can in turn lead to increased ossification and thus to permanent degradation with a risk of chronic manifestation. The normal rolling procedure that we all use when
walking is then frequently no longer possible.
Heel spurs form in some patients who have plantar fasciitis (PLAN-tar fash-ee-I-tis), and tend to occur in patients who have had the problem for a prolonged period of time. While about 70 percent of
patients with plantar fasciitis have a heel spur, X-rays also show about 50 percent of patients with no symptoms of plantar fasciitis also have a heel spur.
Most heel spurs cause no symptoms and may go undetected for years. If they cause no pain or discomfort, they require no treatment. Occasionally, a bone spur will break off from the larger bone,
becoming a ?loose body?, floating in a joint or embedding itself in the lining of the joint. This can cause pain and intermittent locking of the joint. In the case of heel spurs, sharp pain and
discomfort is felt on the bottom of the foot or heel.
A Heel Spur diagnosis is made when an X-ray shows a hook of bone protruding from the bottom of the foot at the point where the plantar fascia is attached to the heel bone. The plantar fascia is the
thick, connective tissue that runs from the calcaneus (heel bone) to the ball of the foot. This strong and tight tissue helps maintain the arch of the foot. It is also one of the major transmitters
of weight across the foot as you walk or run. In other words, tremendous stress is placed on the plantar fascia.
Non Surgical Treatment
The most important part of treatment is to rest. Do not undertake activities which hurt the foot or aggravate symptoms as will only cause painful symptoms to persist. Apply an ice pack regularly for
10 minutes at a time every hour initially to reduce pain and inflammation of the surrounding tissues. As symptoms subside frequency of application can reduce to 2 or 3 times per day. Exercises and
stretches to keep the foot and ankle strong and mobile are important as long as pain allows. Stretching the plantar fascia is important, especially if symptoms are worse in the morning. A plantar
fasciitis night splint is excellent for stretching and preventing the plantar fascia tightening up over night. Anti-Inflammatory medicine (e.g. ibuprofen) may be prescribed by a doctor but always
check with a medical professional first as taking some medications such as ibuprofen should not be done if the patient has asthma. Shoe inserts can help to take the pressure off of the spur and
reduce pain. If these treatments do not significantly ease the symptoms then surgery may be an option.
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.
Prevention of heel spur syndrome may be best by finding a good supportive shoe. Never go barefoot or wear a flat soled shoe. There are many over the counter arch supports that give increased support
for your feet. Usually when there is excessive pronation the Achilles Tendon contracts or becomes shortened over time since it is not being used fully. The shortened Achilles Tendon is called an
equinus deformity. By keeping this tendon stretched it may decrease some of the tension in the foot. Some theories believe the Achilles Tendon and plantar fascia is continuous. Before you get up from
rest, stretch out your Achilles and the plantar fascia. You may attempt to spell the alphabet with your foot and ankle, use a towel against pressure on your foot, or roll a can of soup or sodapop on
the ground. Ice may work well at the times of severe pain. For a chronic pain, or longer lasting pain heat therapy may improve the condition.