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.
Everyone can be affected by heel spurs, however, certain groups of people have an increased risk. For example, Plantar Fasciitis is a common running injury. People who walk a lot are much more likely
to have heel spurs or people who play golf or play tennis. Over-weight people are also more at risk for heel bone spurs as our feet are not designed to carry around extra weight. As a result the
ligaments under the foot are placed under constant stress, which inevitably will lead to foot problems.
The Heel Spur itself is not thought to be painful. Patients who experience pain with Plantar Fasciitis are suffering from inflammation and irritation of the plantar fascia. This the primary cause of
pain and not the Heel Spur. Heel Spurs form in some patients who have plantar fasciitis, and tend to occur in patients who have had the problem for a prolonged period of time. While about 70 % of
patients with plantar fasciitis have a heel spur, X-rays also show about 50 % of patients with no symptoms of plantar fasciitis also have a heel spur.
Your doctor, when diagnosing and treating this condition will need an x-ray and sometimes a gait analysis to ascertain the exact cause of this condition. If you have pain in the bottom of your foot
and you do not have diabetes or a vascular problem, some of the over-the-counter anti-inflammatory products such as Advil or Ibuprofin are helpful in eradicating the pain. Pain creams, such as
Neuro-eze, BioFreeze & Boswella Cream can help to relieve pain and help increase circulation.
Non Surgical Treatment
Heel spurs are considered a self-limited condition, which means that by making small alterations in your lifestyle and regular routines you can often control the condition. The goal is to relieve
pain, reduce friction and transfer pressure from your sensitive foot areas. By eliminating the cause of the heel spur and plantar fasciitis (i.e. better shoes, orthotics to fix your gait, losing
weight) will help reduce the pressure put on your fascia and heel and can reduce the inflammation caused by your heel spur. Failure to see improvements after conservative treatments may make surgery
your only option.
Surgery to correct for heel spur syndrome is a common procedure which releases plantar fascia partially from its attachment to the calcaneous (heel bone). This part of the surgery is called a plantar
fasciotomy due to the fact the fascia is cut. This is most often done through an open procedure as any heel spur or bursa can be removed at the same time. If the spur is not removed during the
surgery, it will probably be just as successful, as the large spur is not the true problem. Some physicians use an endoscopic approach (EPF) where a small camera aids the physician during surgery
with typically smaller incisions on each side of your foot.