A heel spur is caused by the displacement of calcium on the bone that forms on the underside of the heel, it may be one small bony protrusion or a collection of tiny, irregularly shaped growths on the bone of the heel, which is called the calcaneum. Heel spurs are sometimes painful, described as a knife digging into the heel and other times, a heel spur goes unnoticed and is only detected by an X-ray.
At the onset of this condition, pain and swelling become present, with discomfort particularly noted as pushing off with the toes occurs during walking. This movement of the foot stretches the fascia that is already irritated and inflamed. If this condition is allowed to continue, pain is noticed around the heel region because of the newly formed bone, in response to the stress. This results in the development of the heel spur. It is common among athletes and others who run and jump a significant amount.
Symptoms may be similar to those of plantar fasciitis and include pain and tenderness at the base of the heel, pain on weight bearing and in severe cases difficulty walking. The main diagnosis of a heel spur is made by X-ray where a bony growth on the heel can be seen. A heel spur can occur without any symptoms at all and the athlete would never know they have the bony growth on the heel. Likewise, Plantar fasciitis can occur without the bone growth present.
Your doctor will discuss your medical history and will examine your foot and heel for any deformities and inflammation (swelling, redness, heat, pain). He/she will analyze your flexibility, stability, and gait (the way you walk). Occasionally an x-ray or blood tests (to rule out diseases or infections) may be requested.
Non Surgical Treatment
FIRST, Reduce the acute pain. This is done by a combination of several things; injection of a synthetic relative of cortisone into the heel, a prescription of anti-inflammatory pills to reduce inflammation, physical therapy and a special heel pad. About 50% of the time, these treatments will permanently relieve the pain. In the other 50%, the pain becomes recurrent, and the treatment proceeds to Stage II. SECOND, Recurrent, painful heel spur is caused by the tug and pull of the plantar fascia ligament on the heel bone with each step. When the pain is recurrent, arch supports are made to prevent sagging of the arch. The arch supports are custom-made according to the size and shape of the feet. This prevents the arch from sagging and the ligament from tugging and pulling on the heel bone. The inflammation and pain eventually go away as the first phase of treatment is continued along with the arch supports, although the spur itself remains. THIRD, Surgery to remove the spur is possible and is usually done as Day Surgery.
Sometimes bone spurs can be surgically removed or an operation to loosen the fascia, called a plantar fascia release can be performed. This surgery is about 80 percent effective in the small group of individuals who do not have relief with conservative treatment, but symptoms may return if preventative measures (wearing proper footwear, shoe inserts, stretching, etc) are not maintained.
Heel spurs and plantar fasciitis can only be prevented by treating any underlying associated inflammatory disease.