Heel Spurs: Diagnosis and Treatment

Do you feel a sharp, knife-like pain in your heel on waking up in the morning or after prolonged standing/walking? Does this pain increase in intensity after long-drawn-out periods of rest or after some kind of an activity/exercise? Do you find it painful to take even a step? If yes, then you may have a heel spur.

What is a heel spur?

Heel spur is a calcaneal or a small bone spur that is located on the heel bone or calcaneus and common in patients with a history of foot pain. They are tiny calcium deposits that can form near the base of the heel bone and jut out causing pain whenever pressure is applied on the heel.

How does it form?

Constant stress on the foot bone leads to building up of calcium deposits on the underside of the heel bone. This happens over a period of many months. Other reasons are ill-fitted shoes or shoes with poor shock absorption, strain on foot muscles and ligaments due to running frequently on hard surfaces like concrete and tight calf muscles.

Plantar fasciitis

Plantar fasciitis could also be a cause for heel spurs and in 70% of heel spur cases, it is the underlying reason. Often heel spur is confused with plantar fasciitis. But the latter is inflammation of the band of tissue that runs from the heel along the arch of the foot while a heel spur is a hook of bone that can form on the heel bone.

Those who have heel spurs will not always feel symptoms of pain. And the pain that is felt is not because of the heel spur but due to inflammation and irritation of the plantar fascia. A person with plantar fasciitis finds it worse early in the morning when the plantar fascia is contracted causing pain with every little step. It gradually loosens up and the pain subsides.

The treatment

Treatment for heel spurs is simple and if followed then this condition can be rid of easily. Surgery is the last resort but more than 90% of the people are cured with non-surgical treatments.

Non-surgical treatment

Rest: Give your foot a good deal of rest for at least a week. Take yourself off from vigorous exercises. This will allow the inflammation to subside.

Icepack: Apply an icepack on the heel twice a day for at least 10 to 15 minutes. It will help bring down the pain.

Shoe inserts: They have a good effect on lessening the pain and inflammation. A good shoe insert or orthotic devices will help you carry on normal activities without any pain. Silicone heel cups and Silipos heel spurs with removable plug are good examples of devices that provide lasting support and comfort.

Change your footwear: Get yourself fitted into comfortable shoes. Often, heel spurs occur because of ill-fitted shoes therefore, the right size and right fit is important here. Wear the shoes you want to buy and walk about in it before settling for it.

Stretch exercise: This aids in loosening up the tissues that surround the heel bone and provide relief from the pain. Calf stretch is also quite helpful.

Medications: Try over-the-counter anti-inflammatory drugs for the pain.

Night splints: Wearing night splints will stretch the plantar fascia when you are sleeping.

Corticosteroid injection: Your doctor may advise taking this injection to reduce the inflammation.

ESWT: This is a new kind of treatment. Extracorporeal Shock Wave Therapy uses sound waves to injure the tissue around the heel spur which triggers tissue repair process by the body.

Surgical treatment

The last option should be surgery to loosen up the plantar fascia. Generally, less than 5% of the sufferers need to go for it because they did not find relief from any of the above. But one should wait a year and try out all other treatments before surgery because this in itself could have complications.

Prevention

After the heel spurs have healed, one needs to ensure that they do not return by regular stretch exercises and wearing the right shoes or custom orthotics.

 

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