What is a Heel Spur?
A heel spur is an abnormal growth of the heel bone. Patient’s report that the pain is often worse in the morning and the first step out of bed can cause terrible pain.
Heel spurs develop due to calcium deposits that form when the plantar fascia pulls away from the heel.
Heel spurs are commonly misdiagnosed as Plantar Fasciitis and Heel pain. It was originally thought that only 11%-16% of the population suffered with Heel Spurs but more recents studies have associated with a higher prevalence of 55% of the population.
Who develops heel spurs?
Athletes are particularly prone to developing heel spurs due to the stress placed on the plantar fascia. Any activity that causes the plantar fascia to stretch excessively can cause a heel spur to develop.
Women also have a higher incidence of heel spurs due to the type of footwear worn on a regular basis. Flip Flops and flat shoes or slim soles provide no shock absorption.
Heel spurs are more common in people with osteoarthritis and people who are carrying extra weight as this causes more pressure on the arch of the foot to collapse.
Men and women in physically demanding jobs where heavy equipment is lifted are also prone to heel spurs due to the strain placed on the plantar fascia which then causes the fascia to pull away from the heel bone.
The body’s defence mechanism in response to trauma or excessive pressure is to deposit calcium in the heel area resulting in the heel spur. This accelerates the degeneration process of the heel bone.
When excessive pressure is produced on the arch of the foot, this causes the foot to flatten out, causing repetitive traction of the band of plantar fascia which joins into the calcaneus (heel bone). This causes inflammation and reactive ossification (more bone material is laid down).
What will happen if I leave it untreated?
If the heel spur is not addressed patients may experience prolonged periods of pain and discomfort.
The heel pain may become more persistent and begin to affect you when you stand following periods of sitting down or rest.
The fat pad in the heel of the foot may start to degenerate causing increased shock transmission to the spur.
Nerve pain caused by nerve entrapment is common. The heel spur can cause abductor digiti minimi muscle to wear away, causing compression on the inferior calcaneal nerve which will produce a burning sensation in the heel.
Fracture of the spur is also common when the spur becomes enlarged.
What can help?
Stretching exercises, losing weight and wearing shoes that have a cushioned heel thatabsorbs shock can help to relieve the discomfort of a heel spur.
Elevating the heel with the use of a heel cradle, heel cup, or orthotic can also help. 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.
What are the treatment options?
The key for the proper treatment of heel spurs is determining what is causing theexcessive stretching of the plantar fascia. When the cause is over-pronation (flat feet), an orthotic with rearfoot posting and longitudinal arch support is an effective device, and allow the condition to heal.
Acupuncture is commonly used here at Mespil Foot & Ankle Clinic, we have had great results in resolving the pain associated with heel spurs.
Along with this treatment will also provide personalised strengthening exercises to build up the muscles which hold arch of the foot. Orthotics may be prescribed for a short period of time to help alleviate the pain and support the muscles.
If the pain from the heel spur does not respond to conservative treatment your Podiatrist may consider a cortisone injection or shockwave therapy.