A heel spur is a painful condition that is caused by the accumulation of excessive calcium under the heel of the foot. The heel bone is made up of a large structure called the calcaneus, which is
connected to the bottom of the foot by durable connective tissue called fascia. If the layers of connective tissue become damaged or begin to degenerate due to wear and tear, plantar fasciitis may
develop. This causes calcification, which refers to the abnormal buildup of calcium on the heel bone. As the calcium continues to accumulate, a calcified protrusion called a spur may become visible
on an X-ray.
Heel Spurs develop when the plantar fascia is excessively and repetitively pulled away from the heel bone. In many cases, a heel spur can develop along with plantar fasciitis, but can also occur by
itself. Heel spurs often develop in middle-aged patients, but can also occur in younger people as well. Athletes are especially prone to heel spur due to the regular stress on their heels.
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.
Heel spurs and plantar fasciitis is usually diagnosed by your physiotherapist or sports doctor based on your symptoms, history and clinical examination. After confirming your heel spur or plantar
fasciitis they will investigate WHY you are likely to be predisposed to heel spurs and develop a treatment plan to decrease your chance of future bouts. X-rays will show calcification or bone within
the plantar fascia or at its insertion into the calcaneus. This is known as a calcaneal or heel spur. Ultrasound scans and MRI are used to identify any plantar fasciitis tears, inflammation or
calcification. Pathology tests may identify spondyloarthritis, which can cause symptoms similar to plantar fasciitis.
Non Surgical Treatment
The first line of treatment for Heel Spur is to avoid the activities and positions that cause the pain. A physician can evaluate your foot with an X-ray to diagnose Heel Spur and determine a course
of treatment. This condition can often be treated by non-surgical means; however in severe cases surgery may be necessary to relieve the pain. The most common surgical procedures treat the soft
tissues around the Heel Spur, often a tarsal tunnel release or a plantar fascia release. Injections for heel spurs are sometimes controversial as steroids may cause heel pad atrophy or damage the
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.