Overview
Bone spurs usually form around joints that have arthritis, in the vertebrae of the spine, and on the heel. When they form on the heel, they may form on the back of the heel but usually form on the bottom of the heel. Of course, this is where all of the body weight comes down with each step. Spurs on the bottom of the heel are usually most painful the first few steps out of bed each morning. The pain may lessen somewhat after walking for a few minutes, but may be intense again after sitting for a half hour or so, such as after lunch. The pain usually gets worse throughout the day as you are up on your feet more. Often the pain feels like a nail being driven through the heel into the ankle and leg.
Causes
Some causes of heel spurs include abnormal or lopsided walking, which places excessive stress on the heel bone, ligaments and nerves Running, jogging or jumping, especially on hard surfaces. Poorly fitted or badly worn shoes, especially those lacking appropriate arch support, excess weight and obesity.
Symptoms
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.
Diagnosis
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
Treatments for bone spurs and plantar fasciitis include Stretching the calf muscles several times daily is critical in providing tension relief for the plantar fascia. Some physicians may recommend using a step to stretch, while others may encourage yoga or pushing against a wall to stretch. Icing after activity. A frozen tennis ball can provide specific relief. Rolling the tennis ball under the arch of the foot after exercise can lessen pain in the area. Taping is also recommended at times. Several manufacturers of sports tape have plantar fascia specific lines. Orthotics are a good idea for those on their feet during the day. Orthotics can provide cushioning and relief. Cortisone shots in the fascia can provide temporary anti-inflammatory relief. Losing weight is perhaps the most effective method of improving heel and foot pain. Those who are overweight are far more likely to report these syndromes.
Surgical Treatment
More than 90 percent of people get better with nonsurgical treatments. If conservative treatment fails to treat symptoms of heel spurs after a period of 9 to 12 months, surgery may be necessary to relieve pain and restore mobility. Surgical techniques include release of the plantar fascia, removal of a spur. Pre-surgical tests or exams are required to identify optimal candidates, and it’s important to observe post-surgical recommendations concerning rest, ice, compression, elevation of the foot, and when to place weight on the operated foot. In some cases, it may be necessary for patients to use bandages, splints, casts, surgical shoes, crutches, or canes after surgery. Possible complications of heel surgery include nerve pain, recurrent heel pain, permanent numbness of the area, infection, and scarring. In addition, with plantar fascia release, there is risk of instability, foot cramps, stress fracture, and tendinitis.