The heel bone is the largest bone in the foot and absorbs the most amount of shock and pressure. A heel spur develops as an abnormal growth of the heel bone. Calcium deposits form when the plantar
fascia pulls away from the heel area, causing a bony protrusion, or heel spur to develop. The plantar fascia is a broad band of fibrous tissue located along the bottom surface of the foot that runs
from the heel to the forefoot. Heel spurs can cause extreme pain in the rearfoot, especially while standing or walking.
A heel spur usually develops as a result of wear and tear over time, which leads to the degeneration of connective tissue called fascia. Standing for prolonged periods and wearing shoes that do not
provide the right type of arch support can also lead to connective tissue damage in the heel. The body attempts to repair the damaged tissue by delivering calcium to the affected region, but
sometimes too much calcium begins to accumulate and this results in painful plantar fasciitis.
Heel spur and plantar fasciitis pain usually begins in the bottom of the heel, and frequently radiates into the arch. At times, however, the pain may be felt only in the arch. The pain is most
intense when first standing, after any period of rest. Most people with this problem experience their greatest pain in the morning, with the first few steps after sleeping. After several minutes of
walking, the pain usually becomes less intense and may disappear completely, only to return later with prolonged walking or standing. If a nerve is irritated due to the swollen plantar fascia, this
pain may radiate into the ankle. In the early stages of Heel Spurs and Plantar Fasciitis, the pain will usually subside quickly with getting off of the foot and resting. As the disease progresses, it
may take longer periods of time for the pain to subside.
A thorough medical history and physical exam by a physician is always necessary for the proper diagnosis of heel spurs and other foot conditions. X rays of the heel area are helpful, as excess bone
production will be visible.
Non Surgical Treatment
Bone spurs rarely require treatment unless they are causing frequent pain or damaging other tissues. Because heel spurs and plantar fasciitis are so closely related, they are usually treated the same
way. Symptomatic treatment involves rest, especially from the activity that is contributing to the condition and making symptoms worse (although this may not be easy to discover, as problems can
manifest several hours or days after the harmful activity has occurred). If you identify the offending activity, ice is recommended immediately following it. Stretching of the calf muscles after a
short warm up is also a good idea and can be helpful. Stretching exercises that gently lengthen the calm muscle will relax the tissue surrounding the heel and should be done several times a day,
especially in the morning and after prolonged sitting.
In a small number of cases (usually less than 5 percent), patients may not experience relief after trying the recommendations listed above. It is important that conservative treatments (such as those
listed above) be performed for AT LEAST a year before considering surgery. Time is important in curing the pain from heel spurs, and insufficient treatment before surgery may subject you to potential
complications from the procedure. If these treatments fail, your doctor may consider an operation to loosen the plantar fascia, called a plantar fascia release.