If you suffer from heel pain, you know that it affects every step you take. And by the time you take off your shoes in the evening, your feet are really suffering. The pain you?re feeling could be
caused by heel bone spurs. Heel bone spurs are common in people who walk, stand or run on hard surfaces such as concrete or tile floors-and that?s most of us! This kind of frequent, intense impact on
hard surfaces overstretches and can even tear the ligaments on the bottom of the foot, a condition known as plantar fasciitis. In extreme cases, these ligaments begin to pull away from the bone. Heel
bone spurs are created because of this injury to the foot. They are not painful by themselves, but they do irritate surrounding tissues, which causes heel pain.
A heel spur is caused by chronic plantar fasciitis. Your plantar fascia is a thick fibrous band of connective tissue originating on the bottom surface of the calcaneus (heel bone) and extending along
the sole of the foot towards the toes.Your plantar fascia acts as a passive limitation to the over flattening of you arch. When your plantar fascia develops micro tears or becomes inflamed it is
known as plantar fasciitis. When plantar fasciitis healing is delayed or injury persists, your body repairs the weak and injured soft tissue with bone. Usually your injured fascia will be healed via
fibroblastic activity. They'll operate for at least six weeks. If your injury persists beyond this time, osteoblasts are recruited to the area. Osteoblasts form bone and the end result is bone (or
calcification) within the plantar fascia or at the calcaneal insertion. These bone formations are known as heel spurs. This scenario is most common in the traction type injury. The additional bone
growth is known as a heel spur or calcaneal spur.
The following symptoms are typical of heel spur. Stabbing pain when treading on the area affected. Dull, irregularly occurring pains in the heel area also without exerting pressure (e.g. in a
reclining position) Pain when taking the first steps in the morning (after lying or sitting down for an extended period, especially in the morning) Occasional swelling in the ankle area. For the
lower heel spur, extreme sensitivity at the tendon attachment (laterally in the lower heel area) For the upper heel spur, extreme pressure sensitivity of the Achilles tendon, primarily at
approximately ankle height.
A heel spur is often seen on X-ray as a bony protrusion, which can vary in size. However, because a Heel Spur only indicates increased load on the plantar fascia, and not pain, an ultra sound may be
required to assess other actual cause of the heel pain such and may include checking to see if the plantar fascia is inflamed or degenerated.
Non Surgical Treatment
If pain and other symptoms of inflammation-redness, swelling, heat-persist, you should limit normal daily activities and contact a doctor of podiatric medicine. The podiatric physician will examine
the area and may perform diagnostic X-rays to rule out problems of the bone. Early treatment might involve oral or injectable anti-inflammatory medication, exercise and shoe recommendations, taping
or strapping, or use of shoe inserts or orthotic devices. Taping or strapping supports the foot, placing stressed muscles and tendons in a physiologically restful state. Physical therapy may be used
in conjunction with such treatments. A functional orthotic device may be prescribed for correcting biomechanical imbalance, controlling excessive pronation, and supporting of the ligaments and
tendons attaching to the heel bone. It will effectively treat the majority of heel and arch pain without the need for surgery. Only a relatively few cases of heel pain require more advanced
treatments or surgery. If surgery is necessary, it may involve the release of the plantar fascia, removal of a spur, removal of a bursa, or removal of a neuroma or other soft-tissue growth.
When chronic heel pain fails to respond to conservative treatment, surgical treatment may be necessary. Heel surgery can provide relief of pain 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. Depending on the presence of excess bony build up, the procedure
may or may not include removal of heel spurs. Similar to other surgical interventions, there are various modifications and surgical enhancements regarding surgery of the heel.