A heel spur is a pointed bony outgrowth of the bone of the heel (the calcaneus bone). They are attributed to chronic local inflammation at the insertion of soft tissue tendons or fascia in the area. Heel spurs can be located at the back of the heel or under the heel, beneath the sole of the foot. Heel spurs at the back of the heel are frequently associated with inflammation of the Achilles tendon (tendinitis) and cause tenderness and pain at the back of the heel made worse while pushing off the ball of the foot.
Heel spurs are common in patients who have a history of foot pain caused by plantar fasciitis. In the setting of plantar fasciitis, heel spurs are most often seen in middle-aged men and women, but can be found in all age groups. The heel spur itself is not thought to be the primary cause of pain, rather inflammation and irritation of the plantar fascia is thought to be the primary problem. A heel spur diagnosis is made when an X-ray shows a hook of bone protruding from the bottom of the foot at the point where the plantar fascia is attached to the heel bone.
Some symptoms at the beginning of this condition include pain and swelling, and discomfort when pushing off with the toes during walking. This movement of the foot stretches the fascia that is already irritated and inflamed. If this condition is not treated, pain will be noticed in the heel when a heel spur develops in response to the stress. This is a common condition among athletes and others who run and jump a significant amount.
Heel spurs and plantar fasciitis are diagnosed based on the history of pain and tenderness localized to these areas. They are specifically identified when there is point tenderness at the bottom of the heel, which makes it difficult to walk barefoot on tile or wood floors. X-ray examination of the foot is used to identify the bony prominence (spur) of the heel bone (calcaneus).
Non Surgical Treatment
Rest won?t help you in case of pain from the heel spur. When you get up after sleeping for some time, the pain may get worse. The pain worsens after a period of rest. You will feel pain because the plantar fascia elongates during working which stresses the heel. It is important to see a doctor if you are having consistent pain in you heel. The doctors may advise few or all of the conservative treatments, stretching exercises, shoe recommendations, shoe inserts or orthotic devices, physical therapy, taping or strapping to rest stressed muscles and tendons. There are some over-the-counter medicines available for treatment of heel pain. Acetaminophen (Tylenol), ibuprofen (Advil), or naproxen (Aleve) are some such medicines which can help you to get relief from the pain. In case of biomechanical imbalances causing the pain, a functional orthotic device can help you to get relief. Your doctor may also advise a corticosteroid injection for eliminating the inflammation.
In a small number of cases (usually less than 5 percent), patients may not experience relief after trying the recommendations listed above. It is important that conservative treatments (such as those listed above) be performed for AT LEAST a year before considering surgery. Time is important in curing the pain from heel spurs, and insufficient treatment before surgery may subject you to potential complications from the procedure. If these treatments fail, your doctor may consider an operation to loosen the plantar fascia, called a plantar fascia release.