Heel spurs are a condition that usually makes its presence known first thing in the morning via heel pain. Discomfort is typically felt in the front and bottom of the heel (calcaneal). Pain can be
constant for several months or intermittent for lengthy periods of time.
Heel spurs are bony outgrowths positioned where the plantar fascia tissue attaches to the heel bone (the calcaneus). Heel spurs seldom cause pain. It is the inflamed tissue surrounding the spur that
causes the pain. The Latin meaning of Plantar Fasciitis is, ?Inflammation of Plantar Fascia.? The plantar fascia is a long, thick and very tough band of tissue beneath your foot that provides arch
support. It also connects your toes to your heel bone. Each time you take a step, the arch slightly flattens to absorb impact. This band of tissue is normally quite strong and flexible but
unfortunately, circumstances such as undue stress, being overweight, getting older or having irregularities in your foot dynamics can lead to unnatural stretching and micro-tearing of the plantar
fascia. This causes pain and swelling at the location where the plantar fascia attaches to the heel bone. As the fascia continually pulls at the heel bone, the constant irritation eventually creates
a bony growth on the heel. This is called a heel spur.
Heel spurs can be quite painful, but can just as likely occur with no symptoms at all. Plantar fasciitis is a contributing condition to heel spurs. The cause of the pain is not the heel spur itself
but the soft-tissue injury associated with it. The feeling has been described as a knife or pin sticking into the bottom of your feet when you first stand up after sitting or laying down for a long
period of time - a pain that later turns into a dull ache.
Your doctor, when diagnosing and treating this condition will need an x-ray and sometimes a gait analysis to ascertain the exact cause of this condition. If you have pain in the bottom of your foot
and you do not have diabetes or a vascular problem, some of the over-the-counter anti-inflammatory products such as Advil or Ibuprofin are helpful in eradicating the pain. Pain creams, such as
Neuro-eze, BioFreeze & Boswella Cream can help to relieve pain and help increase circulation.
Non Surgical Treatment
To aid in the reduction of inflammation, applying ice for 10-15 minutes after activities and the use of anti-inflammatory medications, such as aspirin or ibuprofen, can be helpful. Corticosteroid
injections may also be used to reduce pain and inflammation. Physical therapy can be beneficial with the use of heat modalities, such as ultrasound, that create a deep heat and reduce inflammation.
If the pain caused by inflammation is constant, keeping the foot raised above the heart and/or compressed by wrapping with a bandage will help. Taping can help speed the healing process by protecting
the fascia from reinjury, especially during stretching and walking.
Surgery involves releasing a part of the plantar fascia from its insertion in the heel bone, as well as removing the spur. Many times during the procedure, pinched nerves (neuromas), adding to the
pain, are found and removed. Often, an inflamed sac of fluid call an accessory or adventitious bursa is found under the heel spur, and it is removed as well. Postoperative recovery is usually a
slipper cast and minimal weight bearing for a period of 3-4 weeks. On some occasions, a removable short-leg walking boot is used or a below knee cast applied.
Heel spurs and plantar fasciitis can only be prevented by treating any underlying associated inflammatory disease.