The term heel spur generally refers more specifically to a heel spur, also known as a calcaneal spur. These calcium growths form around the tendons and ligaments of the foot and eventually become
attached to the heel bone. The spurs then continue to grow, piercing the skin of the foot and causing pain and discomfort. When left untreated the spur can continue to grow causing agonizing pain and
even immobilizing the patient.
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.
The vast majority of people who have heel spurs feel the asscociated pain during their first steps in the morning. The pain is quite intense and felt either the bottom or front of the heel bone.
Typically, the sharp pain diminishes after being up for a while but continues as a dull ache. The pain characteristically returns when first standing up after sitting for long periods.
Diagnosis is made using a few different technologies. X-rays are often used first to ensure there is no fracture or tumor in the region. Then ultrasound is used to check the fascia itself to make
sure there is no tear and check the level of scar tissue and damage. Neurosensory testing, a non-painful nerve test, can be used to make sure there is not a local nerve problem if the pain is thought
to be nerve related. It is important to remember that one can have a very large heel spur and no plantar fasciitis issues or pain at all, or one can have a great deal of pain and virtually no spur at
Non Surgical Treatment
Ice compresses, stretching exercises, night splint for traction of the leg muscles to stretch the muscle in the back of the leg, and massage of the back of the leg, along with padding and heel
cushions are also things that you can do at home. The number one recommendation for relief of heel pain is wearing good shoe gear. Good shoe gear usually consists of a sturdy, solid shoe. Heel pain
is not relieved by a soft, ill supported shoe. Shoes such as Nike, K-Swiss, and Avia are the best shoes for this condition. Custom orthotics are highly recommended. Physical therapy is another way
physicians treat this condition. Ice packs, muscle stimulation, ultra sound, paraffin baths, and the new Plantar Fascitis Night Splint are also helpful. If all these conservative measures fail to
relieve the pain, then surgery is indicated. The newer minimal incision surgeries such as the Endoscopic plantar fasciotomy surgery is extremely beneficial for this condition, and for earlier
ambulation, the use of the newer Cast Walking Boot is recommended.
Approximately 2% of people with painful heel spurs need surgery, meaning that 98 out of 100 people do well with the non-surgical treatments previously described. However, these treatments can
sometimes be rather long and drawn out, and may become considerably expensive. Surgery should be considered when conservative treatment is unable to control and prevent the pain. If the pain goes
away for a while, and continues to come back off and on, despite conservative treatments, surgery should be considered. If the pain really never goes away, but reaches a plateau, beyond which it does
not improve despite conservative treatments, surgery should be considered. If the pain requires three or more injections of "cortisone" into the heel within a twelve month period, surgery should be
In 2002, researchers attempted to compare the effects of various running techniques on pronation and resulting injuries like stress fractures and heel spurs. They suggested that it is possible to
teach runners to stride in such a way as to minimize impact forces. One way is to lower running speed. Another is to take longer rest periods following a run.