Heel spur is a hook of bone that protrudes from the bottom of the foot where plantar fascia connects to the heel bone. Pain associated with heel spurs is usually pain from plantar fasciitis, not the
actual bone. Heel spurs are most often diagnosed when a patient has visited a pain specialist or podiatrist for on-going foot pain related to plantar fasciitis; spurs are diagnosed via X-ray of the
foot. Heel spurs are most commonly diagnosed in middle-aged men and women. As noted, most patients with this condition have other podiatry-related pain. This condition is a result of plantar
fasciitis (when the fascia, a thick connective tissue that connects the heel bone and ball of the foot) becomes inflamed. Some 70% of plantar fasciitis patients have a bone spur. Bone spurs are soft
calcium deposits caused from tension in the plantar fascia. When found on an X-ray, they are used as evidence that a patient is suffering from plantar fasciitis. Plantar fasciitis is typically caused
from repetitive stress disorder. Walking, running, and dancing can cause this with time.
The plantar fascia is a thick, ligamentous 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. That's why tremendous stress is placed on the plantar fascia.
Symptoms of heel spur syndrome often include pain early in the morning or after rest, as you take the first few steps. It may also include severe pain after standing or walking long hours, especially
on hard cement floors. Usually more pain exist while wearing a very flat soled shoe. A higher heel may actually relieve the pain as an arch is created. The pain is usually sharp, but can also be a
dull ache. The pain may only be at the bottom of the heel, or may also travel along the arch of the foot.
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
If pain and other symptoms of inflammation-redness, swelling, heat-persist, you should limit normal daily activities and contact a doctor of podiatric medicine. The podiatric physician will examine
the area and may perform diagnostic X-rays to rule out problems of the bone. Early treatment might involve oral or injectable anti-inflammatory medication, exercise and shoe recommendations, taping
or strapping, or use of shoe inserts or orthotic devices. Taping or strapping supports the foot, placing stressed muscles and tendons in a physiologically restful state. Physical therapy may be used
in conjunction with such treatments. A functional orthotic device may be prescribed for correcting biomechanical imbalance, controlling excessive pronation, and supporting of the ligaments and
tendons attaching to the heel bone. It will effectively treat the majority of heel and arch pain without the need for surgery. Only a relatively few cases of heel pain require more advanced
treatments or surgery. If surgery is necessary, it may involve the release of the plantar fascia, removal of a spur, removal of a bursa, or removal of a neuroma or other soft-tissue growth.
Heel spur surgery should only be considered after less invasive treatment methods have been explored and ruled insufficient. The traditional surgical approach to treating heel spurs requires a
scalpel cut to the bottom of the food which allows the surgeon to access the bone spur. Endoscopic plantar fasciotomies (EPF) involve one or two small incisions in the foot which allow the surgeon to
access and operate on the bone spur endoscopically. Taking a surgical approach to heel spur treatment is a topic to explore with a foot and ankle specialist.