A heel spur is a bony projection on the sole (bottom) of the heel bone. This condition may accompany or result from severe cases of inflammation to the structure called plantar fascia. The plantar fascia is a fibrous band of connective tissue on the sole of the foot, extending from the heel to the toes. Heel spurs are a common foot problem resulting from excess bone growth on the heel bone. The bone growth is usually located on the underside of the heel bone, and may extend forward toward the toes. A painful tear in the plantar fascia between the toes and heel can produce a heel spur and/or inflammation of the plantar fascia. Because this condition is often correlated to a decrease in the arch of the foot, it is more prevalent after the ages of six to eight years, when the arch is fully developed.
One frequent cause of injury to the plantar fascia is pronation. Pronation is defined as the inward and downward action of the foot that occurs while walking, so that the foot's arch flattens toward the ground (fallen arch). A condition known as excessive pronation creates a mechanical problem in the foot, and the portion of the plantar fascia attached to the heel bone can stretch and pull away from the bone. This damage can occur especially while walking and during athletic activities.
Heel spurs often cause no symptoms. But heel spurs can be associated with intermittent or chronic pain, especially while walking, jogging, or running, if inflammation develops at the point of the spur formation. In general, the cause of the pain is not the heel spur itself but the soft-tissue injury associated with it. Many people describe the pain of heel spurs and plantar fasciitis as a knife or pin sticking into the bottom of their feet when they first stand up in the morning, a pain that later turns into a dull ache. They often complain that the sharp pain returns after they stand up after sitting for a prolonged period of time.
Heel spurs and plantar fasciitis are diagnosed based on the history of pain and tenderness localized to these areas. They are specifically identified when there is point tenderness at the bottom of the heel, which makes it difficult to walk barefoot on tile or wood floors. X-ray examination of the foot is used to identify the bony prominence (spur) of the heel bone (calcaneus).
Non Surgical Treatment
Podiatric Care for heel spur syndrome may involve keeping the fascia stretched out by performing exercises. Your doctor may also suggest for you to be seen by a physical therapist. You probably will be advised on the best shoes to wear or some inserts for your shoes. Your podiatrist may suggest that a custom made orthotic be made to allow your foot to function in the most ideal way especially if you have excessive pronation. A heel lift may be used if you have a leg length discrepancy. Medical treatment may include anti-inflammatory oral medications or an injection of medication and local anesthetic to reduce the swelling and decrease pain. If a bursitis is present the medication may greatly improve the symptoms. Your podiatric physician may also recommend a surgical procedure to actually fix the structural problem of your foot.
When chronic heel pain fails to respond to conservative treatment, surgical treatment may be necessary. Heel surgery can provide pain relief and restore mobility. The type of procedure used is based on examination and usually consists of releasing the excessive tightness of the plantar fascia, called a plantar fascia release. The procedure may also include removal of heel spurs.
In order to prevent heel spurs, it?s important that you pay attention to the physical activities you engage in. Running or jogging on hard surfaces, such as cement or blacktop, is typical for competitive runners, but doing this for too long without breaks can lead to heel spurs and foot pain. Likewise, the shoes you wear can make a big difference in whether or not you develop heel spurs. Have your shoes and feet checked regularly by our Dallas podiatrist to ensure that you are wearing the proper equipment for the activities. Regular checkups with a foot and ankle specialist can help avoid the development of heel spurs.