The heel bone is the largest bone in the foot and absorbs the most shock and pressure. A heel spur develops as an abnormal growth of the heel bone. Most commonly, calcium deposits form when the
plantar fascia pulls away from the heel area, causing a bony protrusion, or heel spur to develop. While bone spurs can develop in other locations such as the rear of the heel bone, this is the most
common location for development. The plantar fascia is a broad band of fibrous tissue located along the bottom surface of the foot that runs from the heel to the forefoot. Heel spurs can cause
extreme pain in the rearfoot, especially while standing or walking.
One frequent cause of heel spurs is an abnormal motion and mal-alignment of the foot called pronation. For the foot to function properly, a certain degree of pronation is required. This motion is
defined as an inward action of the foot, with dropping of the inside arch as one plants the heel and advances the weight distribution to the toes during walking. When foot pronation becomes extreme
from the foot turning in and dropping beyond the normal limit, a condition known as excessive pronation creates a mechanical problem in the foot. In some cases the sole or bottom of the foot flattens
and becomes unstable because of this excess pronation, especially during critical times of walking and athletic activities. The portion of the plantar fascia attached into the heel bone or calcaneous
begins to stretch and pull away from the heel bone.
If your body has created calcium build-ups in an effort to support your plantar fascia ligament, each time you step down with your foot, the heel spur is being driven into the soft, fatty tissue
which lines the bottom of your heel. Heel spur sufferers experience stabbing sensations because the hard protrusion is literally being jabbed into the heel pad. If left untreated, Plantar Fasciitis
and heel spurs can erode the fatty pad of the heel and cause permanent damage to the foot. Fortunately, most cases can be resolved without medications or surgeries.
A heel spur is often seen on X-ray as a bony protrusion, which can vary in size. However, because a Heel Spur only indicates increased load on the plantar fascia, and not pain, an ultra sound may be
required to assess other actual cause of the heel pain such and may include checking to see if the plantar fascia is inflamed or degenerated.
Non Surgical Treatment
In case of heel spurs rest is most important. Active sports, running, long walks etc should be avoided to start with. If you?re in a job that requires a lot of standing, take a few days off work.
Rest (or reduced activity) is essential to allow the inflammation from becoming aggrevated. Furthermore, you can use ice packs (placed on the heel for 5-10 minutes) to ?cool down? the inflamed area.
You may take anti-inflammatory medication or apply a topical inflammatory (i.e. a cream) to help reduce inflammation. In addition, there are some simple exercises that should be done daily to help
relieve heel spur pain.
Most studies indicate that 95% of those afflicted with heel spurs are able to relieve their heel pain with nonsurgical treatments. If you are one of the few people whose symptoms don?t improve with
other treatments, your doctor may recommend plantar fascia release surgery. Plantar fascia release involves cutting part of the plantar fascia ligament in order to release the tension and relieve the
inflammation of the ligament. Sometimes the bone spur is also removed, if there is a large spur (remember that the bone spur is rarely a cause of pain. Overall, the success rate of surgical release
is 70 to 90 percent in patients with heel spurs. One should always be sure to understand all the risks associated with any surgery they are considering.
The best way to prevent heel spurs is by wearing properly fitted footwear. Shoes should have a shock absorbing tread and soles and should be effective in supporting the heel and arch. Proper warm up
and stretching before embarking on any physical activity that will put pressure or impact on the area is highly recommended. Also, just as it?s important for your general health, if you can lose some
extra pounds, you will be more likely to avoid heel spurs. If you are starting to feel the onset of pain, it may not be heel spurs, but could be a tendonitis condition that could lead to heel spurs.