Heel spurs are a bone growth that extends from the heel bone, particularly on the bottom front of the heel bone and sometimes slightly to the side. Usually, a heel spur forms where the plantar fascia
ligament attaches to the bottom of the heel bone. Those who overuse, or put heavy stress on the plantar fascia, are at risk of developing heel spurs.
When a patient has plantar fasciitis, the plantar fascia becomes inflamed and degenerative (worn out)--these abnormalities can make normal activities quite painful. Symptoms typically worsen early in
the morning after sleep. At that time, the plantar fascia is tight so even simple movements stretch the contracted plantar fascia. As you begin to loosen the plantar fascia, the pain usually
subsides, but often returns with prolonged standing or walking.
It is important to be aware that heel spurs may or may not cause symptoms. Symptoms are usually related to the plantar fasciitis. You may experience significant pain and it may be worse in the
morning when you first wake up or during certain physical activities such as, walking, jogging, or running.
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. The plantar fascia is the
thick, connective tissue that runs from the calcaneus (heel bone) to the ball of the foot. This strong and tight tissue helps maintain the arch of the foot. It is also one of the major transmitters
of weight across the foot as you walk or run. In other words, tremendous stress is placed on the plantar fascia.
Non Surgical Treatment
Heel spurs and plantar fasciitis are treated by measures that decrease the associated inflammation and avoid reinjury. Local ice applications both reduce pain and inflammation. Physical therapy
methods, including stretching exercises, are used to treat and prevent plantar fasciitis. Anti-inflammatory medications, such as ibuprofen or injections of cortisone, are often helpful. Orthotic
devices or shoe inserts are used to take pressure off plantar spurs (donut-shaped insert), and heel lifts can reduce stress on the Achilles tendon to relieve painful spurs at the back of the heel.
Similarly, sports running shoes with soft, cushioned soles can be helpful in reducing irritation of inflamed tissues from both plantar fasciitis and heel spurs. Infrequently, surgery is performed on
chronically inflamed spurs.
Approximately 2% of people with painful heel spurs need surgery, meaning that 98 out of 100 people do well with the non-surgical treatments previously described. However, these treatments can
sometimes be rather long and drawn out, and may become considerably expensive. Surgery should be considered when conservative treatment is unable to control and prevent the pain. If the pain goes
away for a while, and continues to come back off and on, despite conservative treatments, surgery should be considered. If the pain really never goes away, but reaches a plateau, beyond which it does
not improve despite conservative treatments, surgery should be considered. If the pain requires three or more injections of "cortisone" into the heel within a twelve month period, surgery should be