A heel spur is a bony growth at the underside of the heel bone. The underlying cause of heel spurs is a common condition called ?Plantar Fasciitis?. This is Latin for inflammation of the plantar
fascia. This tendon forms the arch of the foot, starting at the heel and running to the ball of the foot. Plantar Fasciitis is a persistent and painful condition. Interestingly, in some people a heel
spur has been present for a long time, but no pain is felt for years until one day the pain suddenly appears ?out of nothing?.
Heel spurs are exacerbated by an movements that stretch, twist or impact the plantar ligaments. Running, jumping, standing or walking on hard surfaces with unsupportive shoes, walking barefoot in
sand are all activities that can activate heel spurs and plantar fasciitis. Obesity is another factor that increases stress to the plantar ligaments.
Although it may take years to become a problem, once it appears, it may cause considerable suffering. Because of proximity to the tendons, the spur is a source of continuous painful aching. The
sensation has been described as "a toothache in the foot." When you place your weight on the heel, the pain can be sufficient to immobilize you.
Heel spurs and plantar fasciitis is usually diagnosed by your physiotherapist or sports doctor based on your symptoms, history and clinical examination. After confirming your heel spur or plantar
fasciitis they will investigate WHY you are likely to be predisposed to heel spurs and develop a treatment plan to decrease your chance of future bouts. X-rays will show calcification or bone within
the plantar fascia or at its insertion into the calcaneus. This is known as a calcaneal or heel spur. Ultrasound scans and MRI are used to identify any plantar fasciitis tears, inflammation or
calcification. Pathology tests may identify spondyloarthritis, which can cause symptoms similar to plantar fasciitis.
Non Surgical Treatment
Over-the-counter or prescription-strength anti-inflammatory medications can help temporarily, but can cause side effects with prolonged use - the most significant being gastrointestinal upset,
ulceration and bleeding. Deep tissue massage, taping and other physical therapy modalities can also be helpful. Arch support is highly recommended, either with shoe inserts or custom orthotics made
by podiatrists. If pain continues, a steroid injection at the site of pain may be recommended; however, many physicians do not like injecting around the heel. The side effects of steroids injected in
this area can be serious and worsen symptoms. Complications can include fat necrosis (death of fatty tissue) of the heel and rupture of the plantar fascia.
Usually, heel spurs are curable with conservative treatment. If not, heel spurs are curable with surgery, although there is the possibility of them growing back. About 10% of those who continue to
see a physician for plantar fascitis have it for more than a year. If there is limited success after approximately one year of conservative treatment, patients are often advised to have surgery.