Heel spurs are new bone that forms in response to stress to the heel. They serve to protect the bone against the development of microfractures. Spurs start out as cartilage and progress to solid
bone. They are present in about 50 percent of the population, yet not everyone has heel pain- that's the first clue that heel spurs don't always cause heel pain.
A strong band of sinew (plantar fascia) stretches across the sole of the foot below the surface of the skin and is attached to a point in the middle of the under surface of the heel bone. With
repeated activity on our feet, the plantar fascia can become tight and cause persistent traction (tugging) on its attachment point into the heel bone, and inflammation and pain may develop at this
site. This painful condition is known as plantar fasciitis. Sometimes a ?spur? develops at the site of this traction on the bone and protrudes into the surrounding tissue. This is a heel spur.
Symptoms of heel spur syndrome often include pain early in the morning or after rest, as you take the first few steps. It may also include severe pain after standing or walking long hours, especially
on hard cement floors. Usually more pain exist while wearing a very flat soled shoe. A higher heel may actually relieve the pain as an arch is created. The pain is usually sharp, but can also be a
dull ache. The pain may only be at the bottom of the heel, or may also travel along the arch of the foot.
Diagnosis of a heel spur can be done with an x-ray, which will be able to reveal the bony spur. Normally, it occurs where the plantar fascia connects to the heel bone. When the plantar fascia
ligament is pulled excessively it begins to pull away from the heel bone. When this excessive pulling occurs, it causes the body to respond by depositing calcium in the injured area, resulting in the
formation of the bone spur. The Plantar fascia ligament is a fibrous band of connective tissue running between the heel bone and the ball of the foot. This structure maintains the arch of the foot
and distributes weight along the foot as we walk. However, due to the stress that this ligament must endure, it can easily become damaged which commonly occurs along with heel spurs.
Non Surgical Treatment
Heel spurs are considered a self-limited condition, which means that by making small alterations in your lifestyle and regular routines you can often control the condition. The goal is to relieve
pain, reduce friction and transfer pressure from your sensitive foot areas. By eliminating the cause of the heel spur and plantar fasciitis (i.e. better shoes, orthotics to fix your gait, losing
weight) will help reduce the pressure put on your fascia and heel and can reduce the inflammation caused by your heel spur. Failure to see improvements after conservative treatments may make surgery
your only option.
In a small number of cases (usually less than 5 percent), patients may not experience relief after trying the recommendations listed above. It is important that conservative treatments (such as those
listed above) be performed for AT LEAST a year before considering surgery. Time is important in curing the pain from heel spurs, and insufficient treatment before surgery may subject you to potential
complications from the procedure. If these treatments fail, your doctor may consider an operation to loosen the plantar fascia, called a plantar fascia release.
Heel spurs and plantar fasciitis can only be prevented by treating any underlying associated inflammatory disease.