The term heel spur generally refers more specifically to a heel spur, also known as a calcaneal spur. These calcium growths form around the tendons and ligaments of the foot and eventually become attached to the heel bone. The spurs then continue to grow, piercing the skin of the foot and causing pain and discomfort. When left untreated the spur can continue to grow causing agonizing pain and even immobilizing the patient.
A bone spur forms as the body tries to repair itself by building extra bone. It generally forms in response to pressure, rubbing, or stress that continues over a long period of time. Some bone spurs form as part of the aging process. As we age, the slippery tissue called cartilage that covers the ends of the bones within joints breaks down and eventually wears away (osteoarthritis). Bone spurs due to aging are especially common in the joints of the spine and feet.
Major symptoms consist of pain in the region surrounding the spur, which typically increases in intensity after prolonged periods of rest. Patients may report heel pain to be more severe when waking up in the morning. Patients may not be able to bear weight on the afflicted heel comfortably. Running, walking, or lifting heavy weight may exacerbate the issue.
Diagnosis of a heel spur can be done with an x-ray, which will be able to reveal the bony spur. Normally, it occurs where the plantar fascia connects to the heel bone. When the plantar fascia ligament is pulled excessively it begins to pull away from the heel bone. When this excessive pulling occurs, it causes the body to respond by depositing calcium in the injured area, resulting in the formation of the bone spur. The Plantar fascia ligament is a fibrous band of connective tissue running between the heel bone and the ball of the foot. This structure maintains the arch of the foot and distributes weight along the foot as we walk. However, due to the stress that this ligament must endure, it can easily become damaged which commonly occurs along with heel spurs.
Non Surgical Treatment
Conventional treatment for heel spurs typically includes rest, stretching exercises, icing and anti-inflammatory medications. Many people find it difficult to go through the day without some sort of routine activity or exercise, and this prolongs the heel spur and forces people to rely on anti-inflammatory medications for a longer period of time. This can be detrimental due to the many side effects of these medications, including gastrointestinal problems like leaky gut, bleeding and ulcer symptoms.
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 considered.