A bone spur (osteophyte) is a bony growth that forms along the edge of normal bone in response to wear and tear, most frequently in the joints. A heel spur is a bone spur of the heel bone, which
causes heel pain by rubbing on the achilles tendon or other soft tissues.
A strong band of sinew (plantar fascia) stretches across the sole of the foot below the surface of the skin and is attached to a point in the middle of the under surface of the heel bone. With
repeated activity on our feet, the plantar fascia can become tight and cause persistent traction (tugging) on its attachment point into the heel bone, and inflammation and pain may develop at this
site. This painful condition is known as plantar fasciitis. Sometimes a ?spur? develops at the site of this traction on the bone and protrudes into the surrounding tissue. This is a heel spur.
Most heel spurs cause no symptoms and may go undetected for years. If they cause no pain or discomfort, they require no treatment. Occasionally, a bone spur will break off from the larger bone,
becoming a ?loose body?, floating in a joint or embedding itself in the lining of the joint. This can cause pain and intermittent locking of the joint. In the case of heel spurs, sharp pain and
discomfort is felt on the bottom of the foot or heel.
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
Rest won?t help you in case of pain from the heel spur. When you get up after sleeping for some time, the pain may get worse. The pain worsens after a period of rest. You will feel pain because the
plantar fascia elongates during working which stresses the heel. It is important to see a doctor if you are having consistent pain in you heel. The doctors may advise few or all of the conservative
treatments, stretching exercises, shoe recommendations, shoe inserts or orthotic devices, physical therapy, taping or strapping to rest stressed muscles and tendons. There are some over-the-counter
medicines available for treatment of heel pain. Acetaminophen (Tylenol), ibuprofen (Advil), or naproxen (Aleve) are some such medicines which can help you to get relief from the pain. In case of
biomechanical imbalances causing the pain, a functional orthotic device can help you to get relief. Your doctor may also advise a corticosteroid injection for eliminating the inflammation.
When chronic heel pain fails to respond to conservative treatment, surgical treatment may be necessary. Heel surgery can provide relief of pain and restore mobility. The type of procedure used is
based on examination and usually consists of releasing the excessive tightness of the plantar fascia, called a plantar fascia release. Depending on the presence of excess bony build up, the procedure
may or may not include removal of heel spurs. Similar to other surgical interventions, there are various modifications and surgical enhancements regarding surgery of the heel.