Overview
Heel spurs are a condition that usually makes its presence known first thing in the morning via heel pain. Discomfort is typically felt in the front and bottom of the heel (calcaneal). Pain can be constant for several months or intermittent for lengthy periods of time.
Causes
Athletes who participate in sports that involve a significant amount of jumping and running on hard surfaces are most likely to suffer from heel spurs. Some other risk factors include poor form while walking which can lead to undue stress on the heel and its nerves and ligaments. Shoes that are not properly fitted for the wearer?s feet. Poor arch support in footwear. Being overweight. Occupations that require a lot of standing or walking. Reduced flexibility and the thinning of the fat pad along the bottom of the heel, both of which are a typical depreciation that comes with aging.
Symptoms
Bone spurs may cause sudden, severe pain when putting weight on the affected foot. Individuals may try to walk on their toes or ball of the foot to avoid painful pressure on the heel spur. This compensation during walking or running can cause additional problems in the ankle, knee, hip, or back.
Diagnosis
Diagnosis is made using a few different technologies. X-rays are often used first to ensure there is no fracture or tumor in the region. Then ultrasound is used to check the fascia itself to make sure there is no tear and check the level of scar tissue and damage. Neurosensory testing, a non-painful nerve test, can be used to make sure there is not a local nerve problem if the pain is thought to be nerve related. It is important to remember that one can have a very large heel spur and no plantar fasciitis issues or pain at all, or one can have a great deal of pain and virtually no spur at all.
Non Surgical Treatment
There are many ways to treat heel spurs. Some remedies you can even do at home once a podiatrist shows you how. Heel spur treatment is very similar to treatment of plantar fasciitis. Here are a few of the most common treatments. First, your doctor will assess which activities are causing your symptoms and suggest rest and time off from these activities. Ice packs are used to control pain and reduce symptoms. Certain exercises and stretches help you to feel relief quickly. Medications that reduce inflammation and decrease pain are also used. Sometimes cortisone injections are given. Often special shoe orthotics can help to take the pressure off of the plantar fascia and reduce symptoms. Night splints that keep your heel stretched are sometimes recommended. Rarely, surgery is an option. A new treatment called extracorporeal shock wave therapy is being studied.
Surgical Treatment
More than 90 percent of people get better with nonsurgical treatments. If conservative treatment fails to treat symptoms of heel spurs after a period of 9 to 12 months, surgery may be necessary to relieve pain and restore mobility. Surgical techniques include release of the plantar fascia, removal of a spur. Pre-surgical tests or exams are required to identify optimal candidates, and it’s important to observe post-surgical recommendations concerning rest, ice, compression, elevation of the foot, and when to place weight on the operated foot. In some cases, it may be necessary for patients to use bandages, splints, casts, surgical shoes, crutches, or canes after surgery. Possible complications of heel surgery include nerve pain, recurrent heel pain, permanent numbness of the area, infection, and scarring. In addition, with plantar fascia release, there is risk of instability, foot cramps, stress fracture, and tendinitis.
Prevention
There are heel spur prevention methods available in order to prevent the formation of a heel spur. First, proper footwear is imperative. Old shoes or those that do not fit properly fail to absorb pressure and provide the necessary support. Shoes should provide ample cushioning through the heel and the ball of the foot, while also supporting the arch. Wearing an orthotic shoe insert is one of the best ways to stretch the plantar fascia and prevent conditions such as heel spurs. Stretching the foot and calf is also helpful in preventing damage. Athletes in particular should make sure to stretch prior to any physical activity. Stretching helps prevent heel spurs by making tissue stronger as well as more flexible. In addition, easing into a new or increasingly difficult routine should be done to help avoid strain on the heel and surrounding tissue.
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