Heel spurs are a relatively common cause of heel pain. A heel spur is a pointed bone fragment that extends forward from the bottom of the heel from the heel bone, also referred to as a calcaneous.
Serious pain and discomfort often develops with this condition. In many cases, a heel spur develops along with plantar fasciitis which occurs when the plantar fascia ligament becomes inflamed.
Heel Spur typically occurs in people who have a history of foot pain, and is most often seen in middle-aged men and women. The bony growth itself is not what causes the pain associated with heel
spur. The pain is typically caused by inflammation and irritation of the surrounding tissues. Approximately 50% of patients with a heel spur also experience Plantar Fasciitis.
If your body has created calcium build-ups in an effort to support your plantar fascia ligament, each time you step down with your foot, the heel spur is being driven into the soft, fatty tissue
which lines the bottom of your heel. Heel spur sufferers experience stabbing sensations because the hard protrusion is literally being jabbed into the heel pad. If left untreated, Plantar Fasciitis
and heel spurs can erode the fatty pad of the heel and cause permanent damage to the foot. Fortunately, most cases can be resolved without medications or surgeries.
Because the diagnosis of heel spurs can be confused with tarsal tunnel syndrome (as described earlier), most surgeons advocate performing a tarsal tunnel release (or at least a partial tarsal tunnel
release) along with the plantar fascia release. This surgery is about 80percent successful in relieving pain in the small group of patients who do not improve with conservative treatments.
Non Surgical Treatment
There are various ways to treat heel spurs. The first is to rest and apply ice to the afflicted area. Shoe inserts and night splints can also treat plantar fasciitis, and in turn, heels spurs. Unless
you have stomach sensitivities, you may want to consider taking over-the-counter anti-inflammatory medication such as naprosyn to lower the swelling. A physical therapist can recommend gentle
exercises and stretches to relax the tissue around the heel bone to relieve the tension. Even with these treatments, a stubborn heel spur may not go away. A physical therapist may decide to inject
cortisone into the area to decrease inflammation, but that can cause other problems such as plantar fascial rupture and fat pad atrophy. Extracorporeal shock wave therapy is also an option, which
uses energy pulses to apply microtrauma around the heel spur. Surgery is also an option but is not suggested unless the heel spur lasts more than a year. To prevent heel spurs from returning, shoe
inserts can relieve the pressure on the plantar fascia. Also continue the recommended stretches and exercises.
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.