Heel spurs are small lumps of excess bone that grow and stick out on the calcaneus, aka heel bone. They usually develop in response to friction, tightness, inflammation or injury when the body lays
down extra layers of bone to try and protect itself. There are two areas where heel bone spurs tend to develop. At the back of the heel: these are usually due to conditions such as Achilles
tendonitis, tight calf muscles or wearing tight footwear. These are known as posterior calcaneal spurs. Underneath the heel: these are usually due to conditions such as plantar fasciitis, muscle
imbalance or altered foot biomechanics. These are known as inferior calcaneal spurs.
A heel spur usually develops as a result of wear and tear over time, which leads to the degeneration of connective tissue called fascia. Standing for prolonged periods and wearing shoes that do not
provide the right type of arch support can also lead to connective tissue damage in the heel. The body attempts to repair the damaged tissue by delivering calcium to the affected region, but
sometimes too much calcium begins to accumulate and this results in painful plantar fasciitis.
Pain and discomfort associated with heel spurs does not occur from the spur itself. The bone growth itself has no feeling. However, as you move, this growth digs into sensitive nerves and tissue
along the heel of the foot, resulting in severe pain. Pain can also be generated when pushing off with the toes while walking. Swelling along the heel is also common.
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. The plantar fascia is the
thick, connective tissue that runs from the calcaneus (heel bone) to the ball of the foot. 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. In other words, tremendous stress is placed on the plantar fascia.
Non Surgical Treatment
Podiatric Care for heel spur syndrome may involve keeping the fascia stretched out by performing exercises. Your doctor may also suggest for you to be seen by a physical therapist. You probably will
be advised on the best shoes to wear or some inserts for your shoes. Your podiatrist may suggest that a custom made orthotic be made to allow your foot to function in the most ideal way especially if
you have excessive pronation. A heel lift may be used if you have a leg length discrepancy. Medical treatment may include anti-inflammatory oral medications or an injection of medication and local
anesthetic to reduce the swelling and decrease pain. If a bursitis is present the medication may greatly improve the symptoms. Your podiatric physician may also recommend a surgical procedure to
actually fix the structural problem of your foot.
When chronic heel pain fails to respond to conservative treatment, surgical treatment may be necessary. Heel surgery can provide relief of pain and restore mobility. The type of procedure used is
based on examination and usually consists of releasing the excessive tightness of the plantar fascia, called a plantar fascia release. Depending on the presence of excess bony build up, the procedure
may or may not include removal of heel spurs. Similar to other surgical interventions, there are various modifications and surgical enhancements regarding surgery of the heel.