What Are The Leading Causes Of Posterior Calcaneal Spur

Heel Spur

Overview

Bone spurs including heel spurs occur as a natural response of the body to wear and tear. Heel spur in particular, can cause pain when it rubs against soft tissues including the Achilles tendon. When that happens movement can become restricted. Spurs can also appear in other joint areas such as under the toenail where it would lead to pain and nail deformation.

Causes

Heel spurs are bony outgrowths positioned where the plantar fascia tissue attaches to the heel bone (the calcaneus). Heel spurs seldom cause pain. It is the inflamed tissue surrounding the spur that causes the pain. The Latin meaning of Plantar Fasciitis is, ?Inflammation of Plantar Fascia.? The plantar fascia is a long, thick and very tough band of tissue beneath your foot that provides arch support. It also connects your toes to your heel bone. Each time you take a step, the arch slightly flattens to absorb impact. This band of tissue is normally quite strong and flexible but unfortunately, circumstances such as undue stress, being overweight, getting older or having irregularities in your foot dynamics can lead to unnatural stretching and micro-tearing of the plantar fascia. This causes pain and swelling at the location where the plantar fascia attaches to the heel bone. As the fascia continually pulls at the heel bone, the constant irritation eventually creates a bony growth on the heel. This is called a heel spur.

Calcaneal Spur

Symptoms

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.

Diagnosis

A thorough medical history and physical exam by a physician 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

FIRST, Reduce the acute pain. This is done by a combination of several things; injection of a synthetic relative of cortisone into the heel, a prescription of anti-inflammatory pills to reduce inflammation, physical therapy and a special heel pad. About 50% of the time, these treatments will permanently relieve the pain. In the other 50%, the pain becomes recurrent, and the treatment proceeds to Stage II. SECOND, Recurrent, painful heel spur is caused by the tug and pull of the plantar fascia ligament on the heel bone with each step. When the pain is recurrent, arch supports are made to prevent sagging of the arch. The arch supports are custom-made according to the size and shape of the feet. This prevents the arch from sagging and the ligament from tugging and pulling on the heel bone. The inflammation and pain eventually go away as the first phase of treatment is continued along with the arch supports, although the spur itself remains. THIRD, Surgery to remove the spur is possible and is usually done as Day Surgery.

Surgical Treatment

Surgery to correct for heel spur syndrome is a common procedure which releases plantar fascia partially from its attachment to the calcaneous (heel bone). This part of the surgery is called a plantar fasciotomy due to the fact the fascia is cut. This is most often done through an open procedure as any heel spur or bursa can be removed at the same time. If the spur is not removed during the surgery, it will probably be just as successful, as the large spur is not the true problem. Some physicians use an endoscopic approach (EPF) where a small camera aids the physician during surgery with typically smaller incisions on each side of your foot.

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