Heel Spurs Explained

What is a heel spur?

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. About 70 percent of patients with plantar fasciitis have a heel spur that can be seen on an X-ray. A spur may develop when the ligament that connects the heel bone to the bones in the toes (plantar fascia) becomes inflamed.  This strong and tight tissue helps maintain the arch of the foot. It is also one of the major transmitters of weight across the foot as you walk or run. 

What are the symptoms of a heel spur?

Because of proximity to the tendons, the spur is a source of continuous painful aching. The sensation has been described as "a toothache in the foot," usually characterized by a sharp poking and is localized to the heel or under the heel. Aching pain can become very severe and inflammation and bruising can also occur. When taking a step or when putting pressure on the heel, pain can escalate, particularly after prolonged periods of rest like the first step after getting out of bed in the morning. When you place your weight on the heel, the pain can be sufficient to immobilize you.

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.

How can a heel spur be diagnosed?

A heel spur can be diagnosed by looking at an X-ray. A heel spur diagnosis is made when an X-ray shows a hook of bone protruding from the bottom of the foot at the point where the plantar fascia is attached to the heel bone.

Who gets heel spurs?

Heel spurs are common in patients who have a history of foot pain caused by plantar fasciitis. Although heel spurs are most often seen in middle-aged men and women, they can be found in all age groups. Spurs can begin to form as a result of obesity or sudden weight gain, such as during pregnancy, which can place continuous and excessive weight on the heel of the foot. Another common cause of heel spurs is wearing ill-fitting shoes that don’t properly support the heel and other important areas of the foot. Pronation, the abnormal motion and misalignment of the foot, can also contribute to this condition. With excessive pronation, the plantar fascia, which is a bow-like ligament along the bottom of the foot, could be stretched and forced to pull away from the heel bone, contributing to the development of a spur. Other causes of heel spurs may be attributed to gout, and rheumatoid arthritis. 

How can heel spurs be treated?

The first step in the treatment of a heel spur is short-term rest and inflammation control. Here are the steps patients should take in order to cure the symptoms of heel spurs:

• Rest. The first treatment step is avoiding activities that aggravate symptoms. For example, take a few day off jogging or prolonged standing to try to rest the painful foot. Just resting usually helps eliminate the most severe pain, and will allow the inflammation to begin to settle down.

• Apply Ice Packs. Icing will help diminish some of the symptoms and control the heel pain. Icing is especially helpful after an acute exacerbation of symptoms.

• Exercises and stretches are designed to relax the tissues that surround the heel bone. Some simple exercises, performed in the morning and evening, often help patients feel better quickly.
  

• Anti-Inflammatory Medications. Anti-inflammatory medications help control pain and decrease inflammation. Over-the-counter medications are usually sufficient, but prescription options are also available.

• Shoe inserts Heel Seats are often the key to successful treatment of plantar fasciitis. The shoe inserts often permit patients to continue their routine activities without pain.

• Night Splints are worn to keep the heel stretched out when you sleep. They prevent the arch of the foot from becoming contracted at night and thus not as painful in the morning.

• Diathermy treatment uses an electrical current to produce heat that sedates the inflamed tissues. The ultrasound device sends sound waves into the heel and sets up a massaging action that stimulates blood circulation. Treatment with a whirlpool bath involves placing the foot directly into the jetting stream.

• Surgery, which is a more radical treatment, can be a permanent correction to remove the spur itself. If your doctor believes that surgery is indicated, he will recommend an operation - but only after establishing that less drastic methods of treatment are not successful.
  

Heel Seats correct the problem... not just treat the symptoms.
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