03 Jul Everything You Need to Know for Healing a Heel Spur
A heel spur is a protrusion of bone that develops on the bottom of the calcaneus (heel bone).
Heel spurs are often not painful but they can result in heel pain when they lead to inflammation of the thick, fibrous band of connective tissue that covers the calcaneus (plantar fascia). This is a tissue that connects the heel bone to the ball of the foot and when it is inflamed the condition is referred to as plantar fasciitis.
If the heel pain is persistent, X-rays of the anatomy will be performed and the spurs may then be visualized during this investigation which would confirm their presence.
Causes and Risk Factors
Heel spurs are caused by the deposition of calcium on the underside of the calcaneus and this is a process that occurs over many months.
The reasons why calcium deposits on the heel bone include:
- Ligament and muscle strains.
- Stretching of the plantar fascia.
- Repeated tearing of the membrane that covers the calcaneus.
Heel spurs occur most commonly in athletes who participate in physical activities that require large amounts of jumping and running.
Risk factors for developing heel spurs include:
- Jogging or running, especially on hard surfaces.
- Being overweight or obese.
- Wearing badly worn out or poorly fitting shoes, especially if they have no adequate arch support.
- Having gait abnormalities as these place excessive stress onto the nerves and ligaments around the heel and the calcaneus itself.
Risk factors for the development of plantar fasciitis include:
- Advancing age as this results in decreased flexibility of the plantar fascia and the heel’s protective fat pad becomes thinner.
- Standing for long periods of time.
- Having high foot arches or flat feet.
- Performing frequent short bursts of physical exertion.
Heel spurs themselves cause no symptoms but they can irritate the plantar fascia which causes inflammation of the tissue and this lead to symptoms being experienced by the patient.
These may include:
- Stabbing pain over the heel of the foot when walking, running, or jogging.
- Pain that is at its worst when standing on the affected foot in the morning.
- Pain that becomes a dull ache later in the day.
- Sharp pain that returns after standing on the affected foot from a sitting or lying down position.
Patients who complain of heel pain are managed conservatively for the symptom. The measures include:
- Recommending the correct shoes to wear.
- Using orthotic devices or specific shoe inserts.
- Appropriate stretching exercises.
- Strapping or taping stressed tendons and muscles to allow them to relax and rest.
- Physical therapy.
- Using night splints.
- Pain medications such as acetaminophen and anti-inflammatory agents such as ibuprofen and naproxen.
- Steroid medications can be injected into the heel to help reduce inflammation in the affected area.
More than 90 percent of patients will improve with these conservative measures but if they fail to treat the symptoms of heel spurs after a period of nine to 12 months, then heel spur surgery may be indicated.
Surgical options include:
- Making an incision in the plantar fascia to help release some tension in the tissue.
- Removal of a bone spur.
These surgeries are performed as a last resort therapy for affected individuals in order to reduce pain and improve the mobility of the foot.