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.
Heel spurs can form as a result of repeated strain placed on foot muscles and ligaments as well as from abnormally stretching the band of tissue connecting the heel and ball of the foot. Repeated
injury to the membrane that lines the heel bone can also cause problems as can repeated tight pressure on the back of the heel. The causes can range from excessive walking (especially if unaccustomed
to walking), running or jumping to improperly fitted or worn-out shoes. Runners, volleyball players, and tennis players, people who do step aerobics or stair climbing for exercise, those with flat
feet, pregnant women, the obese and diabetics and those who wear tight-fitting shoes with a high heel are all prone to developing spurs (and plantar fasciitis) more readily.
More often than not, heel spurs have no signs or symptoms, and you don?t feel any pain. This is because heel spurs aren?t pointy or sharp pieces of bone, contrary to common belief. Heel spurs don?t
cut tissue every time movement occurs; they?re actually deposits of calcium on bone set in place by the body?s normal bone-forming mechanisms. This means they?re smooth and flat, just like all other
bones. Because there?s already tissue present at the site of a heel spur, sometimes that area and the surrounding tissue get inflamed, leading to a number of symptoms, such as chronic heel pain that
occurs when jogging or walking.
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
The key for the proper treatment of heel spurs is determining what is causing the excessive 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 to reduce the over-pronation, and allow the condition to heal. Other common treatments include stretching exercises, losing weight,
wearing shoes that have a cushioned heel that absorbs shock, and elevating the heel with the use of a heel cradle, heel cup, or orthotic. 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.
Most studies indicate that 95% of those afflicted with heel spurs are able to relieve their heel pain with nonsurgical treatments. If you are one of the few people whose symptoms don?t improve with
other treatments, your doctor may recommend plantar fascia release surgery. Plantar fascia release involves cutting part of the plantar fascia ligament in order to release the tension and relieve the
inflammation of the ligament. Sometimes the bone spur is also removed, if there is a large spur (remember that the bone spur is rarely a cause of pain. Overall, the success rate of surgical release
is 70 to 90 percent in patients with heel spurs. One should always be sure to understand all the risks associated with any surgery they are considering.