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.
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.
A thorough medical history and physical exam by a physician is always necessary for the proper diagnosis of heel spurs and other foot conditions. X rays of the heel area are helpful, as excess bone
production will be visible.
Non Surgical Treatment
Acupuncture and acupressure can used to address the pain of heel spurs, in addition to using friction massage to help break up scar tissue and delay the onset of bony formations. Physical therapy may
help relieve pain and improve movement. The Feldenkrais method could be especially helpful for retraining some of the compensation movements caused by the pain from the spur. Guided imagery or a
light massage on the foot may help to relieve some of the pain. Other treatments include low-gear cycling, and pool running. Some chiropractors approve of moderate use of aspirin or ibuprofen, or
other appropriate anti-inflammatory drugs. Chiropractic manipulation is not recommended, although chiropractors may offer custom-fitted shoe orthotics and other allopathic-type treatments.
Have surgery if no other treatments work. Before performing surgery, doctors usually give home treatments and improved footwear about a year to work. When nothing else eases the pain, here's what you
need to know about surgical options. Instep plantar fasciotomy. Doctors remove part of the plantar fascia to ease pressure on the nerves in your foot. Endoscopy. This surgery performs the same
function as an instep plantar fasciotomy but uses smaller incisions so that you'll heal faster. However, endoscopy has a higher rate of nerve damage, so consider this before you opt for this option.
Be prepared to wear a below-the-knee walking cast to ease the pain of surgery and to speed the healing process. These casts, or "boots," usually work better than crutches to speed up your recovery
Use orthotic inserts. You can purchase orthotics over the counter, or you can have orthotics specially fitted by your podiatrist. Try 1 of these options. Heel cups. These inserts will help to align
the bones in your foot and to cushion your heel. Check your skin for blisters when you first start using heel cups. Also, your feet may sweat more with a heel cup, so change your socks and shoes
often. Insoles. While you can pick up generic insoles at a drugstore, you may have more luck if you go to a store that sells athletic shoes. Push on the arch to make sure that it doesn't collapse. If
your insoles help but could use a little work, you can take them to a podiatrist to get them customized. Custom orthotics. A podiatrist can make a cast of your foot and provide you with custom-made
orthotics. These may be more expensive, but they are made of materials specifically designed for your needs, and they can last up to 5 years if your podiatrist refurbishes them every 1 or 2 years. To
find a podiatrist near you, look at the Web page for the American Academy of Podiatric Sports Medicine. Dynamic Insoles. Lack of elasticity in plantar fascia in the foot is for most people the real
problem. If there is poor elasticity in the lengthwise tendons in the foot (plantar fascia) in relation to a person's general condition, only a small additional strain is required for the pull on the
tendons to cause damage to the tissues connecting the tendons to the heel bone. This will generate an inflamed condition called Plantar Fasciitis.