The calcaneus is the largest bone in the foot. Pain in the heel region can sometimes be related to Plantar Fasciitis, inflammation of the plantar fascia ligament in the heel area. A heel spur is a
hook of bone that forms on the calcaneus where the plantar fascia attaches. Heel spurs can be identified with an X-ray. A heel spur can occur with or without Plantar Fasciitis.
Causes for heel spurs (and related plantar fasciitis) include increase or change in activity, lack of arch support or poor shoe choice, injury, inflexibility in Achilles tendon and calf muscles, and
spending hours daily on the feet. Also, arthritis from aging is often a common cause of bone loss and natural cushioning under the heel. Tarsal tunnel syndrome can also be to blame. Ultimately, in
the United States, the most likely cause of this pain is being overweight. With more than 60% of the nation obese or morbidly obese, foot pain related to excessive weight is most likely. Dietary
changes are most likely to cause long-term relief for bone spurs and plantar fasciitis.
More often than not, heel spurs have no signs or symptoms, and you don?t feel any pain. This is because heel spurs aren?t pointy or sharp pieces of bone, contrary to common belief. Heel spurs don?t
cut tissue every time movement occurs; they?re actually deposits of calcium on bone set in place by the body?s normal bone-forming mechanisms. This means they?re smooth and flat, just like all other
bones. Because there?s already tissue present at the site of a heel spur, sometimes that area and the surrounding tissue get inflamed, leading to a number of symptoms, such as chronic heel pain that
occurs when jogging or walking.
Your doctor will discuss your medical history and will examine your foot and heel for any deformities and inflammation (swelling, redness, heat, pain). He/she will analyze your flexibility,
stability, and gait (the way you walk). Occasionally an x-ray or blood tests (to rule out diseases or infections) may be requested.
Non Surgical Treatment
The most important part of treatment is to rest. Do not undertake activities which hurt the foot or aggravate symptoms as will only cause painful symptoms to persist. Apply an ice pack regularly for
10 minutes at a time every hour initially to reduce pain and inflammation of the surrounding tissues. As symptoms subside frequency of application can reduce to 2 or 3 times per day. Exercises and
stretches to keep the foot and ankle strong and mobile are important as long as pain allows. Stretching the plantar fascia is important, especially if symptoms are worse in the morning. A plantar
fasciitis night splint is excellent for stretching and preventing the plantar fascia tightening up over night. Anti-Inflammatory medicine (e.g. ibuprofen) may be prescribed by a doctor but always
check with a medical professional first as taking some medications such as ibuprofen should not be done if the patient has asthma. Shoe inserts can help to take the pressure off of the spur and
reduce pain. If these treatments do not significantly ease the symptoms then surgery may be an option.
More than 90 percent of people get better with nonsurgical treatments. If conservative treatment fails to treat symptoms of heel spurs after a period of 9 to 12 months, surgery may be necessary to
relieve pain and restore mobility. Surgical techniques include release of the plantar fascia, removal of a spur. Pre-surgical tests or exams are required to identify optimal candidates, and it's
important to observe post-surgical recommendations concerning rest, ice, compression, elevation of the foot, and when to place weight on the operated foot. In some cases, it may be necessary for
patients to use bandages, splints, casts, surgical shoes, crutches, or canes after surgery. Possible complications of heel surgery include nerve pain, recurrent heel pain, permanent numbness of the
area, infection, and scarring. In addition, with plantar fascia release, there is risk of instability, foot cramps, stress fracture, and tendinitis.