The heel spur (or calcaneal spur) is a nail-like growth of calcium around the ligaments and tendons of the foot where they attach to the heel bone. The spur grows from the bone and into the flesh of
the foot. A heel spur results from an anatomical change of the calcaneus (heel bone). This involves the area of the heel and occasionally, another disability, such as arthritis. The heel bone forms
one end of the two longitudinal arches of the foot. These arches are held together by ligaments and are activated by the muscles of the foot (some of which are attached beneath the arches and run
from the front to the back of the foot). These muscles and ligaments, like the other supporting tissues of the body, are attached in two places. Many are attached at the heel bone. The body reacts to
the stress at the heel bone by calcifying the soft tissue attachments and creating a spur.
Common causes of this bone spur in the heel are repetitive trauma to the base of the heel, obesity, poor walking/running technique, poorly fitting shoes, or hereditary conditions.
Heel spurs result in a jabbing or aching sensation on or under the heel bone. The pain is often worst when you first arise in the morning and get to your feet. You may also experience pain when
standing up after prolonged periods of sitting, such as work sessions at a desk or car rides. The discomfort may lessen after you spend several minutes walking, only to return later. Heel spurs can
cause intermittent or chronic pain.
Heel spurs and plantar fasciitis is usually diagnosed by your physiotherapist or sports doctor based on your symptoms, history and clinical examination. After confirming your heel spur or plantar
fasciitis they will investigate WHY you are likely to be predisposed to heel spurs and develop a treatment plan to decrease your chance of future bouts. X-rays will show calcification or bone within
the plantar fascia or at its insertion into the calcaneus. This is known as a calcaneal or heel spur. Ultrasound scans and MRI are used to identify any plantar fasciitis tears, inflammation or
calcification. Pathology tests may identify spondyloarthritis, which can cause symptoms similar to plantar fasciitis.
Non Surgical Treatment
Heel spurs and plantar fascitis (inflammation of the plantar fascia) are usually controlled with conservative treatment. Early intervention includes stretching the calf muscles while avoiding
reinjury to the plantar fascia. Decreasing or changing activities, losing excess weight, and improving the fit of shoes are all important measures to decrease foot pain. Modification of footwear
includes well-padded shoes with a raised heel and better arch support. Shoe inserts recommended by a healthcare professional are often very helpful when used with exercises to increase the strength
of the foot muscles and arch. The inserts prevent excessive pronation and continued tearing of the plantar fascia.
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