Heel spurs (calcaneal spurs) are protrusions (bumps) on the forward underside of the heel bone that can occur when the plantar tendon pulls excessively in the area where it attaches to the bone. The
condition is often associated with plantar fasciitis, although it can also occur on its own. Heel spurs typically are not painful unless they intrude into the soft tissue (plantar fascia), where they
can cause irritation that results in heel pain.
These bony protrusions are commonly found in association with a condition called Plantar Fasciitis. Plantar Fasciitis occurs when the plantar fascia ligament, which spans the arch of the foot,
becomes stressed, torn and inflamed. Misalignment and excessive movement of the plantar fascia ligament is most typically the result of an abnormal walking gait. The ligament is designed to stretch
with the bounce of each step you take, but if it stretches too much, the resulting small tears and inflammation can cause mild to extreme discomfort. At the same time, it is believed that heel spurs
are formed as the body attempts to provide some additional support to the over-stretched ligament. In other words, calcium builds up as a prop to the plantar fascia.
Bone spurs may cause sudden, severe pain when putting weight on the affected foot. Individuals may try to walk on their toes or ball of the foot to avoid painful pressure on the heel spur. This
compensation during walking or running can cause additional problems in the ankle, knee, hip, or back.
The proper diagnosis of a heel spur often requires an X-ray. To make this process as convenient for his patients as possible, most clinics have an on-site digital X-ray and diagnostic ultrasound
machines. This can make it unnecessary for patients to visit diagnostic imaging centers, allowing patients to receive more expedient treatment.
Non Surgical Treatment
The key for the proper treatment of heel spurs is determining what is causing the excessive stretching of the plantar fascia. When the cause is over-pronation (flat feet), an orthotic with rear foot
posting and longitudinal arch support is an effective device to reduce the over-pronation, and allow the condition to heal. Other common treatments include stretching exercises, losing weight,
wearing shoes that have a cushioned heel that absorbs shock, and elevating the heel with the use of a heel cradle, heel cup, or orthotic. Heel cradles and heel cups provide extra comfort and cushion
to the heel, and reduce the amount of shock and shear forces experienced from everyday activities.
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.
In order to prevent heel spurs, it?s important that you pay attention to the physical activities you engage in. Running or jogging on hard surfaces, such as cement or blacktop, is typical for
competitive runners, but doing this for too long without breaks can lead to heel spurs and foot pain. Likewise, the shoes you wear can make a big difference in whether or not you develop heel spurs.
Have your shoes and feet checked regularly by our Dallas podiatrist to ensure that you are wearing the proper equipment for the activities. Regular checkups with a foot and ankle specialist can help
avoid the development of heel spurs.