Overview
Heel spur is a hook of bone that forms on the heel bone. The condition itself is not the most painful; it is the inflammation and irritation that cause the heel pain. Often times, plantar fasciitis is a cause of heel spurs. When the ligaments are pulled away, calcium deposits form on the hooked bone. An orthotic will help relieve the pain associated with heel spurs.
Causes
The cause of heel spurs is excessive strain placed on the plantar fascia over a long period of time, as a result of different factors. These factors include incorrect gait, being overweight, ageing or being in a job that requires a lot of standing on hard floors. It is usually a combination of any of these factors that will bring on the development of heel spurs.
Symptoms
The following symptoms are typical of heel spur. Stabbing pain when treading on the area affected. Dull, irregularly occurring pains in the heel area also without exerting pressure (e.g. in a reclining position) Pain when taking the first steps in the morning (after lying or sitting down for an extended period, especially in the morning) Occasional swelling in the ankle area. For the lower heel spur, extreme sensitivity at the tendon attachment (laterally in the lower heel area) For the upper heel spur, extreme pressure sensitivity of the Achilles tendon, primarily at approximately ankle height.
Diagnosis
Heel spurs and plantar fasciitis is usually diagnosed by your physiotherapist or sports doctor based on your symptoms, history and clinical examination. After confirming your heel spur or plantar fasciitis they will investigate WHY you are likely to be predisposed to heel spurs and develop a treatment plan to decrease your chance of future bouts. X-rays will show calcification or bone within the plantar fascia or at its insertion into the calcaneus. This is known as a calcaneal or heel spur. Ultrasound scans and MRI are used to identify any plantar fasciitis tears, inflammation or calcification. Pathology tests may identify spondyloarthritis, which can cause symptoms similar to plantar fasciitis.
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.
Surgical Treatment
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.
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