Heel spur is a thorn-like, bony protrusion of the heel bone, which can become inflamed through irritation, thus causing pain. A heel spur forms at the tendon attachments on the muscles of the heel
bone as a result of micro-injuries to the tissue caused by overstraining. As part of the healing process for these micro-injuries, the body stores bone material in the tendon attachments as a repair
mechanism. Heel spurs can develop over a very long period without causing major complaints. However, irritation of the area surrounding the ossified tendon attachment can cause inflammations. Left
untreated, the inflammations can in turn lead to increased ossification and thus to permanent degradation with a risk of chronic manifestation. The normal rolling procedure that we all use when
walking is then frequently no longer possible.
One common cause of heel spurs and related injuries is due to abnormal mechanics and movement of the foot, also referred to as pronation. Abnormal gait, which is the way our feet hit the ground as we
walk, also stresses the tissue of the foot, leading to conditions such as plantar fasciitis and heel spurs. Pronation can cause the foot to become unstable during movement, affecting the gait and
leading to damage. A sudden increase in weight can also influence the development of a painful heel spur.
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.
Because the diagnosis of heel spurs can be confused with tarsal tunnel syndrome (as described earlier), most surgeons advocate performing a tarsal tunnel release (or at least a partial tarsal tunnel
release) along with the plantar fascia release. This surgery is about 80percent successful in relieving pain in the small group of patients who do not improve with conservative treatments.
Non Surgical Treatment
Elevation of the affected foot and leg at rest may diminish the pain. Applying gentle heat to the painful area may ease the pain by dilating local blood vessels. One also can protect the heel by
placing a foam rubber pad in the heel of the shoe. A pad about one-half inch thick will raise the heel, shift the weight of the body forward, and protect the irritated muscles attached to the heel
bone. The same effect can be achieved by using adhesive tape to turn the foot inward. Additional treatment may consist of a number of physical therapies, such as diathermy, ultrasound waves and
Surgery to correct for heel spur syndrome is a common procedure which releases plantar fascia partially from its attachment to the calcaneous (heel bone). This part of the surgery is called a plantar
fasciotomy due to the fact the fascia is cut. This is most often done through an open procedure as any heel spur or bursa can be removed at the same time. If the spur is not removed during the
surgery, it will probably be just as successful, as the large spur is not the true problem. Some physicians use an endoscopic approach (EPF) where a small camera aids the physician during surgery
with typically smaller incisions on each side of your foot.