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.
Some causes of heel spurs include abnormal or lopsided walking, which places excessive stress on the heel bone, ligaments and nerves Running, jogging or jumping, especially on hard surfaces. Poorly
fitted or badly worn shoes, especially those lacking appropriate arch support, excess weight and obesity.
It is important to be aware that heel spurs may or may not cause symptoms. Symptoms are usually related to the plantar fasciitis. You may experience significant pain and it may be worse in the
morning when you first wake up or during certain physical activities such as, walking, jogging, or running.
A Heel Spur diagnosis is made when an X-ray shows a hook of bone protruding from the bottom of the foot at the point where the plantar fascia is attached to the heel bone. The plantar fascia is the
thick, 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. In other words, tremendous stress is placed on the plantar fascia.
Non Surgical Treatment
Heel spurs and plantar fascitis are usually controlled with conservative treatment. Early intervention includes stretching the calf muscles while avoiding re-injuring the plantar fascia. Decreasing
or changing activities, losing excess weight, and improving the proper fitting of shoes are all important measures to decrease this common source of foot pain. Modification of footwear includes shoes
with a raised heel and better arch support. Shoe orthotics recommended by a healthcare professional are often very helpful in conjunction with exercises to increase strength of the foot muscles and
arch. The orthotic prevents excess pronation and lengthening of the plantar fascia and continued tearing of this structure. To aid in this reduction of inflammation, applying ice for 10-15 minutes
after activities and use of anti-inflammatory medication can be helpful. Physical therapy can be beneficial with the use of heat modalities, such as ultrasound that creates a deep heat and reduces
inflammation. If the pain caused by inflammation is constant, keeping the foot raised above the heart and/or compressed by wrapping with an ace bandage will help. Corticosteroid injections are also
frequently used to reduce pain and inflammation. Taping can help speed the healing process by protecting the fascia from reinjury, especially during stretching and walking.
Most studies indicate that 95% of those afflicted with heel spurs are able to relieve their heel pain with nonsurgical treatments. If you are one of the few people whose symptoms don?t improve with
other treatments, your doctor may recommend plantar fascia release surgery. Plantar fascia release involves cutting part of the plantar fascia ligament in order to release the tension and relieve the
inflammation of the ligament. Sometimes the bone spur is also removed, if there is a large spur (remember that the bone spur is rarely a cause of pain. Overall, the success rate of surgical release
is 70 to 90 percent in patients with heel spurs. One should always be sure to understand all the risks associated with any surgery they are considering.