A heel spur is a bony projection on the sole (bottom) of the heel bone. This condition may accompany or result from severe cases of inflammation to the structure called plantar fascia. The plantar
fascia is a fibrous band of connective tissue on the sole of the foot, extending from the heel to the toes. Heel spurs are a common foot problem resulting from excess bone growth on the heel bone.
The bone growth is usually located on the underside of the heel bone, and may extend forward toward the toes. A painful tear in the plantar fascia between the toes and heel can produce a heel spur
and/or inflammation of the plantar fascia. Because this condition is often correlated to a decrease in the arch of the foot, it is more prevalent after the ages of six to eight years, when the arch
is fully developed.
Bone spurs form in the feet in response to tight ligaments, to activities such as dancing and running that put stress on the feet, and to pressure from being overweight or from poorly fitting shoes.
For example, the long ligament on the bottom of the foot (plantar fascia) can become stressed or tight and pull on the heel, causing the ligament to become inflamed (plantar fasciitis). As the bone
tries to mend itself, a bone spur can form on the bottom of the heel (known as a ?heel spur?). Pressure at the back of the heel from frequently wearing shoes that are too tight can cause a bone spur
on the back of the heel. This is sometimes called a ?pump bump,? because it is often seen in women who wear high heels.
Most of the time heel spurs present as pain in the region surrounding the spur, which typically increases in intensity after prolonged periods of rest. Patients may not be able to bear weight on the
afflicted heel comfortably. Running, walking, or lifting heavy weight may exacerbate the issue.
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
Heel spurs are considered a self-limited condition, which means that by making small alterations in your lifestyle and regular routines you can often control the condition. The goal is to relieve
pain, reduce friction and transfer pressure from your sensitive foot areas. By eliminating the cause of the heel spur and plantar fasciitis (i.e. better shoes, orthotics to fix your gait, losing
weight) will help reduce the pressure put on your fascia and heel and can reduce the inflammation caused by your heel spur. Failure to see improvements after conservative treatments may make surgery
your only option.
Sometimes bone spurs can be surgically removed or an operation to loosen the fascia, called a plantar fascia release can be performed. This surgery is about 80 percent effective in the small group of
individuals who do not have relief with conservative treatment, but symptoms may return if preventative measures (wearing proper footwear, shoe inserts, stretching, etc) are not maintained.