A heel spur is a bony growth at the underside of the heel bone. The underlying cause of heel spurs is a common condition called ?Plantar Fasciitis?. This is Latin for inflammation of the plantar
fascia. This tendon forms the arch of the foot, starting at the heel and running to the ball of the foot. Plantar Fasciitis is a persistent and painful condition. Interestingly, in some people a heel
spur has been present for a long time, but no pain is felt for years until one day the pain suddenly appears ?out of nothing?.
Heel spurs are exacerbated by an movements that stretch, twist or impact the plantar ligaments. Running, jumping, standing or walking on hard surfaces with unsupportive shoes, walking barefoot in
sand are all activities that can activate heel spurs and plantar fasciitis. Obesity is another factor that increases stress to the plantar ligaments.
The pain caused by a calcaneal spur is not the result of the pressure of weight on the point of the spur, but results from inflammation around the tendons where they attach to the heel bone. You
might expect the pain to increase as you walk on the spur, but actually it decreases. The pain is most severe when you start to walk after a rest. The nerves and capillaries adapt themselves to the
situation as you walk. When you rest, the nerves and capillaries rest, also. Then, as you begin to move about again, extreme demands are made on the blood vessels and nerves, which will cause pain
until they again adjust to the spur. If excessive strain has been placed on the foot the day before, the pain may also be greater. A sudden strain, as might be produced by leaping or jumping, can
also increase the pain. The pain might be localized at first, but continued walking and standing will soon cause the entire heel to become tender and painful.
Heel spurs and plantar fasciitis are diagnosed based on the history of pain and tenderness localized to these areas. They are specifically identified when there is point tenderness at the bottom of
the heel, which makes it difficult to walk barefoot on tile or wood floors. X-ray examination of the foot is used to identify the bony prominence (spur) of the heel bone (calcaneus).
Non Surgical Treatment
If pain and other symptoms of inflammation-redness, swelling, heat-persist, you should limit normal daily activities and contact a doctor of podiatric medicine. The podiatric physician will examine
the area and may perform diagnostic X-rays to rule out problems of the bone. Early treatment might involve oral or injectable anti-inflammatory medication, exercise and shoe recommendations, taping
or strapping, or use of shoe inserts or orthotic devices. Taping or strapping supports the foot, placing stressed muscles and tendons in a physiologically restful state. Physical therapy may be used
in conjunction with such treatments. A functional orthotic device may be prescribed for correcting biomechanical imbalance, controlling excessive pronation, and supporting of the ligaments and
tendons attaching to the heel bone. It will effectively treat the majority of heel and arch pain without the need for surgery. Only a relatively few cases of heel pain require more advanced
treatments or surgery. If surgery is necessary, it may involve the release of the plantar fascia, removal of a spur, removal of a bursa, or removal of a neuroma or other soft-tissue growth.
Most studies indicate that 95% of those afflicted with heel spurs are able to relieve their heel pain with nonsurgical treatments. If you are one of the few people whose symptoms don?t improve with
other treatments, your doctor may recommend plantar fascia release surgery. Plantar fascia release involves cutting part of the plantar fascia ligament in order to release the tension and relieve the
inflammation of the ligament. Sometimes the bone spur is also removed, if there is a large spur (remember that the bone spur is rarely a cause of pain. Overall, the success rate of surgical release
is 70 to 90 percent in patients with heel spurs. One should always be sure to understand all the risks associated with any surgery they are considering.
To prevent this condition, wearing shoes with proper arches and support is very important. Proper stretching is always a necessity, especially when there is an increase in activities or a change in
running technique. It is not recommended to attempt working through the pain, as this can change a mild case of heel spurs and plantar fascitis into a long lasting and painful episode of this