A heel spur, also called calcaneal spur, is a small bone spur on the heel bone and are detectable by x-ray examination. When a foot bone is constantly exposed to stress, calcium is deposited on the bottom of the heel bone.
- Origin of Heel Spur
- Heel Spur Symptoms
- Medical imaging to detect Heel Spur
- Heel Spur Treatments
- Would surgery take care of a heel spur problem?
- Getting Help for Heel Spur Symptoms
- Relieve Heel Pain Caused by Heel Spurs
- Heel Spur versus Plantar Fasciitis
Origin of Heel Spur
In general, this would not affect an individual’s daily routine but when deposits build up, a deformity is caused known as a calcaneal spur or heel spur. People who are prone to developing heel spurs are women who wear high heels most of the time, obese people and the flat foot.
An inferior calcaneal spur can be found at the interior part of the heel and is usually associated with plantar fasciitis. Another type of heel spur is posterior calcaneal spur which develops on the back of the heel near the Achilles tendon.
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Heel Spur Symptoms
Patients suffering from heel spurs would experience sore foot in the area surrounding the spur, which intensifies after long rest periods. Most patients report the heel pain as severe in the morning upon waking up. Patients would also find it intolerable to put weight on the affected heel. Activities like walking, running and exercising may intensify the pain in the foot. The first signs of heel pain are usually caused by plantar fasciitis. When pain is ignored, inflammation increases stress on the fascia and this may result in formation of the bone on the bottom of the heel.[ssba]
Medical imaging to detect Heel Spur
As previously explained, a heel spur is a calcification that forms under the calcaneus, the largest tarsal bone (bone from back of the foot). Hence the terms “calcaneal spur” or “heel spur” to designate this common problem. Given that heel spurs are often associated with another condition, such as plantar fasciitis, it is important not only to properly treat the condition, but also to prevent the condition. Hence it must be identified and diagnosed.
Medical imaging (or diagnostic imaging) allows to better view anomalies or diseases, and to better understand the causes of pain. Medical imaging refers to the examinations that may be carried out by health professionals on patients in order to see inside their bodies for diagnostic purposes. Included in such technologies are methods such as MRI (Magnetic Resonance Imaging), bone density measurements, x-rays, tomography and angiography among others.
In their study of databases generated from examination results following the use of medical imaging, researchers McMillan, Landorf & Bird have been able to establish that cases of osteophytes on the underside of the calcaneus (heel spur ) correlate significantly with cases of plantar fasciitis, as seen by a thickening (> 4.0 mm) of the plantar fascia, and with cases of chronic pain under the heel. Bear in mind that the plantar fascia attaches to the bone where the heel spur would be located.
Heel Spur Treatments
Usually, heel spur is not the actual cause of pain in the foot and rarely require surgery. general practitioners focus treatment on the removal of symptoms of plantar fasciitis or tendonitis. There are some cases, though, when heel spur can be removed surgically as part of surgical treatment of plantar fasciitis.
Heel spur is treated similarly to plantar fasciitis because both conditions are related. The initial treatment for a heel spur is rest and control of the inflammation. In order to cure heel spur, patients are advised the following:
Avoid activities that can aggravate the symptoms. Take a rest from jogging or long periods of standing to allow the foot to rest.
2) Application of ice packs
Applying ice helps to reduce the symptoms and heel pain.
Anti-inflammatory medicines can be prescribed to relieve inflammation and foot pain . While some over the counter medicines are available, there are also prescription medications .
4) Foot orthotics
Just like in cases of plantar fasciitis, patients with heel spur can use shoe inserts to allow them to move about with less foot pain .
Usually, symptoms of plantar fasciitis can be relieved using a combination of these treatments. However, not all symptoms are easily resolved and recovery can vary from 3 months to a year.
Recommended treatment for plantar fasciitis and heel spur syndromes would vary based on specific symptoms. Heel pain caused by excessive pronation and torquing of the fascia may be treated with an aggressive orthotic device. Orthotics help to stabilize pronation and arch elongation.
It should also be known that heel spurs are more often a consequence rather than a cause. The sting or “shearing” tip felt at the base of the calcaneus is actually a manifestation of tendinitis where the plantar fascia links to the calcaneus.
Through manual interventions, a specialist will measure the tension and stiffness associated with your plantar fasciitis condition. Stretching exercises done at the clinic and at home and could then be prescribed. The goal would be to eliminate the inflammation and thickening of the plantar fascia, and also to eliminate the inflamed tissue around the heel spur. Regarding the latter, physiotherapy may also take the form of ultrasonic or laser treatments. Ultimately, what matters is to increase blood circulation to promote the repair of ligament tissue. Lastly, the specialist will check for joint deficiencies, misalignment or collapsing feet. Accordingly, foot orthoses (flexible or rigid insoles) adapted to your condition (flat feet, pronation, supination, etc.) would be prescribed.
Would surgery take care of a heel spur problem?
Being a rare option and considered a last resort, if for example orthopedic treatment fails after twelve months, this type of surgery is a possible option. Such as in cases where a a foreign body, tumor, etc. must be removed, an excision (ablation) would be involved. Bear in mind that we all have a heel spur “in the making”; this cumulative benign neoplasm progresses slowly. It is when a bony overgrowth has become too large or when tissue damage occurs that a problem arises (i.e.: sharp pain).
Does the operation involve the “removal of the heel spur” from the foot? Not necessarily. There isn’t only one type of procedure and opinions from the medical community differ with respect to which procedure is best. However, in the case of such a removal, the surgeon would insert a tiny camera to help with the complete removal of the bone spur. Alternatively, an endoscopic plantar fasciotomy could be performed. This would involve detaching or removing (depending on cases and techniques) part of the plantar fascia (at the heel) so as to allow the development of new fascial tissue where the incision was made. The result in a reduction in tension which was causing the pain and originated from plantar fasciitis. That tension had also been increased by the sub-calcaneal overgrowth.
Getting Help for Heel Spur Symptoms
Do you wake up in the morning feeling heel pain? Does your heel hurt after sitting down for a long time or after exercising? These symptoms may be due to a heel spur. Heel spurs don’t go away by themselves and the foot pain can only worsen unless you do something about it.
A heel spur is a tiny bone growth from calcium deposits developed at the base of the heel. Repeated stress from activities like running, intense walking, dancing or a condition called Plantar Fasciitis may cause a ligament located at the bottom of the foot (plantar fascia) to become inflamed. This ligament tightens and as a result, pulls on the heel’s bone, causing you heel pain. Some of the other symptoms of heel spurs are swollen and inflamed Achilles tendon or plantar fascia. These symptoms can spread pain to the legs and back if ignored or left untreated.
How did you get a heel spur? Heel spurs are often associated with another foot problem called Plantar Fasciitis. It is one of the most common causes of heel pain and most people who get this condition cannot specifically identify what caused it. In most cases, however, a change in activity occurred prior to the heel pain which could involve running more than usual, intensified work outs, barefoot walking, on standing on one’s feet for long periods of time. It can also occur as an effect of aging. Rather than worry about how heel pain developed, it is more important to concentrate on the correction of factors that contribute to heel pain like inappropriate footwear, incorrect orthotics or biomechanical problems.
Some heel spurs are asymptomatic. If you start feeling pain, however, you will need to seek treatment.
One of the most important steps in treating heel pain and heel spurs is correct diagnosis of the foot condition that causes the pain and getting the right treatment for it. The most effective way to treat heel pain correctly is to get professional help. Podiatrists are most qualified to examine, diagnose and recommend treatment of foot conditions and their symptoms.
Relieve Heel Pain Caused by Heel Spurs
There are many treatment methods for curing heel spur or plantar fasciitis which would involve simple rest or surgery, when needed. It is difficult to stop routine activities to allow the foot to heal but unfortunately, resting the foot is the most basic requirement of treating heel spur.
You will need to give ample time for the foot to heel by reducing the amount of time you stand on your feet. Exercise should temporarily be cut down. The usual chores you do around the house can be delegated in the meantime to a spouse or other family members in order to cut down on the time you spend on your feet.
A podiatrist would recommend other courses of action depending on the severity of your symptoms. To relieve pain, anti-inflammatory medications and pain relievers can be prescribed to you. Stretching exercises would also be recommended to strengthen and heal the plantar fascia. In addition to these, the use of foot orthotic devices is also a popular option among heel pain patients. Your podiatrist would determine the type of foot orthotic device suitable to your case and custom order it based on your individual foot specifications. Examples of these devices are night splint, braces, shoe inserts and foot supports.
Given the location of the calcaneus, an area exposed to impacts and which supports most of the body weight, heel spurs can bring about complications with age and depending on the physical activity. That being said, since surgery is a more aggressive and non-definitive treatment, and knowing that heel spurs are benign conditions (despite the pain), many individuals prefer to control their heel spur problem in a less invasive or aggressive manner.
Here are other options:
- Foods with natural anti-inflammatory properties have the advantage of producing very few side effects compared to medication such as nonsteroidal anti-inflammatory drugs (NSAIDs). Relatively effective, such foods can be easily integrated into current eating habits. Ginger, turmeric and some herbal teas are examples.
- Additional B12 vitamin intake through supplements is beneficial for your bones, and foods rich in Omega-3s such as flax seeds and cabbages can help relieve pain due to inflammation.
- Herbal poultices, wrappings (i.e.: flax seed oil) and hot plasters (apple cider vinegar, molasses and baking soda) are also used to reduce pain.
Heel Spur versus Plantar Fasciitis
The good news is that heel spurs and plantar fasciitis can be treated at home. Other proven techniques to curing heel pain include ice application and change of footwear that provide more heel support and protection.
The time for recovery from heel pain and how fast it gets cured vary from one person to the next. Simply ignoring these symptoms will only result in persistent pain. If you commit to treating your heel pain properly and make necessary modifications to correct the factors that cause your heel pain, you can eliminate most or all of the symptoms in a few weeks. If your tissue is more severely damaged, complete healing and recovery can take months. This means the earlier you start taking care of your foot problem, the faster it can heal.
According to experts, heel spurs do not cause plantar fasciitis contrary to what some people think. The truth is that heel spurs often are a result of plantar fasciitis but the treatment for both conditions are similar. A patient with plantar fasciitis would not necessarily develop a heel spur. Surgery for removing a heel spur is rare as podiatrists prefer to treat heel spurs with non-invasive methods. Only when a patient’s condition does not improve despite diligent treatment with rest, exercise, medication and foot orthotics is surgery considered an option.
Most podiatrists would only recommend surgery if a patient fails to improve after diligent use of all other non-invasive methods such as rest, stretch exercises, medication and foot orthotic devices.
Get help from a podiatrist or kinesiologist today to start treatment of your heel pain now.