Heel spurs are a small calcification, which extends into the attachment of the connective tissues from the calcaneus (heel bone). This is easily observed on X-Ray and is very commonly misdiagnosed as
the cause of your pain. Why? Because the wrong type of scan is used and only one foot is examined. Do you know if you have a spur on the other heel, the heel without the pain? Probably? and the heel
spur would have been there long before you had the pain, and will still be there long after the pain is gone. Heel spurs are not the actual cause of heel pain, and are virtually always a secondary
observation or symptom caused by long term pulling on the heel bone.
Bone spurs can form anywhere in the feet in response to tight ligaments, repetitive stress injuries (typically from sports), obesity, even poorly fitting shoes. For instance, when the plantar fascia
on the bottom of the foot pulls repeatedly on the heel, the ligament becomes inflamed, causing plantar fasciitis. As the bone tries to mend itself, a bone spur forms on the bottom of the heel,
typically referred to as a heel spur. This is a common source of heel pain.
The pain caused by a calcaneal spur is not the result of the pressure of weight on the point of the spur, but results from inflammation around the tendons where they attach to the heel bone. You
might expect the pain to increase as you walk on the spur, but actually it decreases. The pain is most severe when you start to walk after a rest. The nerves and capillaries adapt themselves to the
situation as you walk. When you rest, the nerves and capillaries rest, also. Then, as you begin to move about again, extreme demands are made on the blood vessels and nerves, which will cause pain
until they again adjust to the spur. If excessive strain has been placed on the foot the day before, the pain may also be greater. A sudden strain, as might be produced by leaping or jumping, can
also increase the pain. The pain might be localized at first, but continued walking and standing will soon cause the entire heel to become tender and painful.
Because the diagnosis of heel spurs can be confused with tarsal tunnel syndrome (as described earlier), most surgeons advocate performing a tarsal tunnel release (or at least a partial tarsal tunnel
release) along with the plantar fascia release. This surgery is about 80percent successful in relieving pain in the small group of patients who do not improve with conservative treatments.
Non Surgical Treatment
Heel spurs and plantar fascitis (inflammation of the plantar fascia) are usually controlled with conservative treatment. Early intervention includes stretching the calf muscles while avoiding
reinjury to the plantar fascia. Decreasing or changing activities, losing excess weight, and improving the fit of shoes are all important measures to decrease foot pain. Modification of footwear
includes well-padded shoes with a raised heel and better arch support. Shoe inserts recommended by a healthcare professional are often very helpful when used with exercises to increase the strength
of the foot muscles and arch. The inserts prevent excessive pronation and continued tearing of the plantar fascia.
When chronic heel pain fails to respond to conservative treatment, surgical treatment may be necessary. Heel surgery can provide pain relief and restore mobility. The type of procedure used is based
on examination and usually consists of releasing the excessive tightness of the plantar fascia, called a plantar fascia release. The procedure may also include removal of heel spurs.