A heel spur is an overgrowth of bone that resembles a hook on the bottom of the foot. It is a reaction to stress placed on the thick connective tissue on the bottom of the foot (plantar fascia) that
helps maintain the arches of the foot. Over-stress can stem from improper support of the feet. A heel spur is often accompanied by a bursitis that is a major contributor to pain.
Heel spurs are common in patients who have a history of foot pain caused by plantar fasciitis. In the setting of plantar fasciitis, heel spurs are most often seen in middle-aged men and women, but
can be found in all age groups. The heel spur itself is not thought to be the primary cause of pain, rather inflammation and irritation of the plantar fascia is thought to be the primary problem. 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.
Most bone spurs cause no signs or symptoms. You might not realize you have bone spurs until an X-ray for another condition reveals the growths. In some cases, though, bone spurs can cause pain and
loss of motion in your joints.
Because the diagnosis of heel spurs can be confused with tarsal tunnel syndrome (as described earlier), most surgeons advocate performing a tarsal tunnel release (or at least a partial tarsal tunnel
release) along with the plantar fascia release. This surgery is about 80percent successful in relieving pain in the small group of patients who do not improve with conservative treatments.
Non Surgical Treatment
Heel spurs and plantar fasciitis are treated by measures that decrease the associated inflammation and avoid reinjury. Local ice applications both reduce pain and inflammation. Physical therapy
methods, including stretching exercises, are used to treat and prevent plantar fasciitis. Anti-inflammatory medications, such as ibuprofen or injections of cortisone, are often helpful. Orthotic
devices or shoe inserts are used to take pressure off plantar spurs (donut-shaped insert), and heel lifts can reduce stress on the Achilles tendon to relieve painful spurs at the back of the heel.
Similarly, sports running shoes with soft, cushioned soles can be helpful in reducing irritation of inflamed tissues from both plantar fasciitis and heel spurs. Infrequently, surgery is performed on
chronically inflamed spurs.
When chronic heel pain fails to respond to conservative treatment, surgical treatment may be necessary. Heel surgery can provide pain relief 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. The procedure may also include removal of heel spurs.
Walk around before you buy shoes. Before you purchase your shoes, do the following. Re-lace the shoes if you're trying on athletic shoes. Start at the farthest eyelets and apply even pressure to the
laces as you come closer to the tongue of the shoe. Make sure that you can wiggle your toes freely inside of the shoe. Also, make sure that you have at enough space between your tallest toe and the
end of the shoe. You should have room equal to about the width of your thumb in the tip of your shoe. Walk around to make sure that the shoe has a firm grip on your heel without sliding up and down.
Walk or run a few steps to make sure your shoes are comfortable. Shoes that fit properly require no break-in period.