Overview
Heel spur is a hook of bone that protrudes from the bottom of the foot where plantar fascia connects to the heel bone. Pain associated with heel spurs is usually pain from plantar fasciitis, not the actual bone. Heel spurs are most often diagnosed when a patient has visited a pain specialist or podiatrist for on-going foot pain related to plantar fasciitis; spurs are diagnosed via X-ray of the foot. Heel spurs are most commonly diagnosed in middle-aged men and women. As noted, most patients with this condition have other podiatry-related pain. This condition is a result of plantar fasciitis (when the fascia, a thick connective tissue that connects the heel bone and ball of the foot) becomes inflamed. Some 70% of plantar fasciitis patients have a bone spur. Bone spurs are soft calcium deposits caused from tension in the plantar fascia. When found on an X-ray, they are used as evidence that a patient is suffering from plantar fasciitis. Plantar fasciitis is typically caused from repetitive stress disorder. Walking, running, and dancing can cause this with time.
Causes
One frequent cause of injury to the plantar fascia is pronation. Pronation is defined as the inward and downward action of the foot that occurs while walking, so that the foot's arch flattens toward the ground (fallen arch). A condition known as excessive pronation creates a mechanical problem in the foot, and the portion of the plantar fascia attached to the heel bone can stretch and pull away from the bone. This damage can occur especially while walking and during athletic activities.
Symptoms
You'll typically first notice early heel spur pain under your heel in the morning or after resting. Your heel pain will be worse with the first steps and improves with activity as it warms up. When you palpate the tender area you may feel a tender bony lump. As your plantar fasciitis deteriorates and your heel spur grows, the pain will be present more often.
Diagnosis
The proper diagnosis of a heel spur often requires an X-ray. To make this process as convenient for his patients as possible, most clinics have an on-site digital X-ray and diagnostic ultrasound machines. This can make it unnecessary for patients to visit diagnostic imaging centers, allowing patients to receive more expedient treatment.
Non Surgical Treatment
Heel spurs can be treated by wearing orthotic insoles inside the shoe. Orthotics are designed to correct incorrect gait, in particular over-pronation (rolling in of the foot and collapsing of the arches). Over-pronation is a very common foot condition, affecting at least half of the population. It is a major contributing cause of heel spurs. Orthotics are very effective in that the device corrects the foot to its natural position. By supporting the arches properly and preventing excess rolling in of the foot, the plantar fascia is placed under much less strain and stress compared to an unsupported foot. Less strain on the ligament means less pulling away from the heel bone, allowing the inflammation to heal faster. In addition to orthotic treatment, most podiatrists and physiotherapists recommend a series of exercises to help make the ligaments in the feet and legs longer and more flexible. In turn this will help reduce strain on the plantar fascia.
Surgical Treatment
In some cases, heel spurs are removed by surgery after an X-ray. While the surgery is typically effective, it?s a timely and expensive procedure. Even after surgery, heel spurs can re-form if the patient continues the lifestyle that led to the problem. These reasons are why most people who develop painful heel spurs begin looking for natural remedies for joint and bone pain. Surgery isn?t required to cure a heel spur. In fact, more than 90 percent of people get better with nonsurgical treatments. If nonsurgical methods fail to treat symptoms of heel spurs after 12 months, surgery may be necessary to alleviate pain and restore mobility.