While the term heel spur may create the impression of a sharp bony projection on the bottom of the heel that pokes the bottom of our foot causing our pain. Painful heel spurs are actually a result of
damage to the soft tissue at the bottom of the foot. While this may be confusing, we'll try to explain. Heel spurs is the more common name for a condition that is medically referred to as plantar
fascitiis or heel spur syndrome. Plantar fasciitis is a location oriented term that refers to the bottom of the foot(i.e. plantar warts). Fascia is a tough, inelastic band. 'itis'is a term used to
describe something that is inflamed (i.e. tendonitis, bursitis).
There exists a membrane that covers most of the bone along the heel. When this membrane gets torn repeatedly due to straining of the muscles in the foot, the calcium deposits that lead to heel spurs
are more likely to occur.
An individual with the lower legs turning inward, a condition called genu valgus or "knock knees," can have a tendency toward excessive pronation. This can lead to a fallen arch and problems with the
plantar fascia and heel spurs. Women tend to suffer from this condition more than men. Heel spurs can also result from an abnormally high arch. Other factors leading to heel spurs include a sudden
increase in daily activities, an increase in weight, or a thinner cushion on the bottom of the heel due to old age. A significant increase in training intensity or duration may cause inflammation of
the plantar fascia. High-heeled shoes, improperly fitted shoes, and shoes that are too flexible in the middle of the arch or bend before the toe joints will cause problems with the plantar fascia and
possibly lead to heel spurs.
Diagnosis of a heel spur can be done with an x-ray, which will be able to reveal the bony spur. Normally, it occurs where the plantar fascia connects to the heel bone. When the plantar fascia
ligament is pulled excessively it begins to pull away from the heel bone. When this excessive pulling occurs, it causes the body to respond by depositing calcium in the injured area, resulting in the
formation of the bone spur. The Plantar fascia ligament is a fibrous band of connective tissue running between the heel bone and the ball of the foot. This structure maintains the arch of the foot
and distributes weight along the foot as we walk. However, due to the stress that this ligament must endure, it can easily become damaged which commonly occurs along with heel spurs.
Non Surgical Treatment
Get some rest. You need to stay off of your aching foot as much as possible for at least a week. Think about possible causes of the problem while you're resting and figure out how you can make some
changes. Some actions that can contribute to heel spurs include running too often or running on hard surfaces such as concrete, tight calf muscles, shoes with poor shock absorption. Ease back into
your activities. In many cases, you'll be in too much pain to go ahead with a strenuous exercise routine that puts pressure or impact on your heel. Listen to your body and switch to different
activities such as swimming or riding a bike until your heel spurs improve.
Surgery involves releasing a part of the plantar fascia from its insertion in the heel bone, as well as removing the spur. Many times during the procedure, pinched nerves (neuromas), adding to the
pain, are found and removed. Often, an inflamed sac of fluid call an accessory or adventitious bursa is found under the heel spur, and it is removed as well. Postoperative recovery is usually a
slipper cast and minimal weight bearing for a period of 3-4 weeks. On some occasions, a removable short-leg walking boot is used or a below knee cast applied.