Heel Spurs

 

What is a heel spur?

Definition: a heel spur is a bony growth protruding from the calcaneus (heel bone) at the underside of the heel that can make walking quite painful. Heel spurs can be diagnosed through X-Ray examination and are often associated with an underlying condition: Plantar Fasciitis. The bony overgrowth at the heel develops at the attachment location of the plantar fascia to the calcaneus (heel bone). Such abnormal bone overgrowth is often extended and hooked as much as half an inch towards the toes.

heel spurs Heel Spurs

Heel Spurs or calcaneal spurs

Do heel spurs cause pain?

Contrary to popular belief heel spurs do not cause any pain! Many people have spurs under the heel and don’t even know it because there is no pain. If pain is present most likely the person suffers from inflammation of the plantar fascia, the ligament that runs under the foot from the toes to the heel. The spur is merely a symptom of an underlying condition, not the actual cause!

What causes heel spurs?

When a spur grows in the plantar area of the heel (i.e. underside of the heel), it is associated with an inflammatory condition of the ligament of plantar fascia: Plantar Fasciitis.

An estimated 70% of the American population have feet that pronate exessively. Excessive pronation means that when weight is applied during walking, standing or running the ankles roll inwards and the foot arches lower (or collapse). In turn this places a lot of stress and continuous tension on the plantar fascia ligament under the foot. Due to the tissue pulling away from the heel bone the body responds by developing a bony growth at the heel, laying down extra bone upon the heel bone. Essentially the bone is ‘stretching out’ so that soft tissue (the plantar fascia) does not have to stretch as far. This is a very slow process and it may take years to form a heel spur.  Therefore the presence of a heel spur indicates that the plantar fascia have been stretched out for a long period of time, usually because of faulty foot function i.e. over-pronation.

Calcaneal spurs may also occur due to underlying medical conditions like arthritis, joint inflammation, Reiter’s disease, diffuse idiopathic skeletal hyperostosis or ankylosing spondylitis. In most cases,  however, it is Plantar Fasciitis (inflammation of the plantar fascia) that causes the development of a heel spur.

Heel spur symptoms

Heel spurs are often associated with tenderness, redness at the heel or even severe heel pain, disrupting walking, running and sports activities. Heel spurs can affect daily life in a debilitating way. The condition of heel spur is usually characterized by a sharp ripping pain that generates either from the rear or bottom of the heel.

The pain may vary from minor to severe and can even turn worse with bruising and inflammation. Heel spurs occuring at the rear of the heel are often related to inflammation of the Achilles tendon that causes severe pain and tenderness. This condition is called Achilles Tendonitis and should not be confused with Plantar Fasciitis which causes pain under the heel.

The pain can be quite intense during the first hours of the morning or after prolonged period of rest like sitting at a desk behind the computer.

Who is affected most by heel spurs?

Heel spurs can affect people of all ages, however statistically middle-aged people are more likely to develop heel spurs In particular men. Men over 50 years of age have a likelihood of 50% to suffer from this condition at some stage. But this condition can also affect other age groups. Heel spurs can be easily diagnosed through an X-ray that clearly shows the bony hook jutting out from the bottom of the foot at the same position where plantar fascia is linked with the calcaneus bone.

Treatment options

A number of measures can be taken to relieve heel spur pain and reduce the inflammation of the plantar fascia while avoiding any further heel injury. Ice applications done locally can lessen both the inflammation and pain. Patients can also take anti-inflammatory medicines like ibuprofen, sometimes your physician will recommend  cortisone injections.

Patients can also use orthotic shoe inserts or control over-pronation and release the tension on the plantar fascia.  At the same time, sport shoes with soft and cushioned soles can also bring benefit helping to mitigate the irritation caused in the inflamed tissues.

Futhermore, a program of simple daily exercises can be very beneficial to make the muscles and ligament in the lower limb more flexible and less tense. In turn this will reduce the stress on the plantar fascia.

 

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