A heel spur occurs when calcium deposits build up on the underside of the heel bone, a process that usually occurs over a period of many months. Heel spurs are often caused by strains on foot muscles
and ligaments, stretching of the plantar fascia, and repeated tearing of the membrane that covers the heel bone. Heel spurs are especially common among athletes whose activities include large amounts
of running and jumping. Heel spurs often cause no symptoms but can be associated with intermittent pain, especially while walking, jogging, or running. Sharp pain in the heel can also be experienced
when standing after sitting for a long period of time. Heel spurs can be a result of plantar fasciitis.
At the onset of this condition, pain and swelling become present, with discomfort particularly noted as pushing off with the toes occurs during walking. This movement of the foot stretches the fascia
that is already irritated and inflamed. If this condition is allowed to continue, pain is noticed around the heel region because of the newly formed bone, in response to the stress. This results in
the development of the heel spur. It is common among athletes and others who run and jump a significant amount.
An individual with the lower legs turning inward, a condition called genu valgus or "knock knees," can have a tendency toward excessive pronation. This can lead to a fallen arch and problems with the
plantar fascia and heel spurs. Women tend to suffer from this condition more than men. Heel spurs can also result from an abnormally high arch. Other factors leading to heel spurs include a sudden
increase in daily activities, an increase in weight, or a thinner cushion on the bottom of the heel due to old age. A significant increase in training intensity or duration may cause inflammation of
the plantar fascia. High-heeled shoes, improperly fitted shoes, and shoes that are too flexible in the middle of the arch or bend before the toe joints will cause problems with the plantar fascia and
possibly lead to heel spurs.
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
The majority of heel spurs are treated with non-surgical interventions. These can relieve pain, but may take from about 3 months to up to a year for symptoms to resolve. Rest, icing, and
over-the-counter anti-inflammatory or prescription medications can help ease symptoms. Cortisone injections may also be used. Physical therapists may instruct you to perform stretching exercises to
help relax the tissues in the heel. Your doctor may recommend custom orthotics or shoe inserts to position and cushion your heel. Night splints can help position the heel and arch of the foot while
you sleep. Some doctors may recommend extracorporeal shock wave therapy (ESWT). This treatment uses energy pulses to start the repair process in the heel tissues. ESWT is recommend when other
non-surgical treatments have failed.
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.