Heel Spurs are deposits of calcium in the heel area of the foot that are the typically the result of tension, abrasion and/or inflammation in the plantar fascia attachment to the heel. The heel spur
itself is said not to be painful. The pain likely arises from the inflammation of the plantar fascia. The plantar fascia encapsulates muscles in the sole of the foot. It supports the arch of the foot
by acting as a bowstring to connect the ball of the foot to the heel. Common causes of heel spurs include excessive load on the foot from obesity or a sudden increase in weight, a sudden increase in
walking or sports activities.
Heel spurs under the sole of the foot (plantar area) are associated with inflammation of the plantar fascia (fasciitis), the "bowstring-like" tissue stretching underneath the sole that attaches at
the heel. Plantar heel spurs cause localized tenderness and pain made worse when stepping down on the heel. Heel spurs and plantar fasciitis can occur alone or be related to underlying diseases that
cause arthritis (inflammation of the joints), such as reactive arthritis (formerly called Reiter's disease), ankylosing spondylitis, and diffuse idiopathic skeletal hyperostosis. It is important to
note that heel spurs may cause no symptoms at all and may be incidentally discovered during X-ray exams taken for other purposes.
Most people think that a bone "spur" is sharp and produces pain by pressing on tissue, when in fact, these bony growths are usually smooth and flat. Although they rarely cause pain on their own, bone
spurs in the feet can lead to callus formation as tissue builds up to provide added cushion over the area of stress. Over time, wear and tear on joints may cause these spurs to compress neighboring
ligaments, tendons or nerves, thus injuring tissue and causing swelling, pain and tearing.
Sharp pain localized to the heel may be all a doctor needs to understand in order to diagnose the presence of heel spurs. However, you may also be sent to a radiologist for X-rays to confirm the
presence of heel spurs.
Non Surgical Treatment
Only in rare cases do the symptoms of heel spurs fail to be resolved through conservative treatment. Conservative treatment, although not 100% effective, is successful in most cases and should be
given ample time to work. In many cases, conservative methods should be utilized as long as a year depending on the rate at which your body responds to the treatment. When treatment is unsuccessful,
surgery may be considered. A common surgical procedure for this condition is plantar fascia release surgery. In this procedure, the tension of the plantar fascia ligament is released, lessening
tension in the heel and helping to prevent damage.
Surgery to correct for heel spur syndrome is a common procedure which releases plantar fascia partially from its attachment to the calcaneous (heel bone). This part of the surgery is called a plantar
fasciotomy due to the fact the fascia is cut. This is most often done through an open procedure as any heel spur or bursa can be removed at the same time. If the spur is not removed during the
surgery, it will probably be just as successful, as the large spur is not the true problem. Some physicians use an endoscopic approach (EPF) where a small camera aids the physician during surgery
with typically smaller incisions on each side of your foot.
If you have not yet developed this condition, you can take steps to protect yourself from it. Most importantly, make it a rule to wear properly fitted footwear. Avoid shoes that have become worn down
in the heel, and don't choose shoes that cause you to walk in an abnormal fashion. Maintaining a healthy weight will ensure that undue pressure isn't being put on the ligaments, tendons and bones of
your feet. If your job requires a great deal of time on your feet, or if you exercise regularly, be sure to balance periods of activity with periods of rest for your feet.