Heel spurs are a bone growth that extends from the heel bone, particularly on the bottom front of the heel bone and sometimes slightly to the side. Usually, a heel spur forms where the plantar fascia
ligament attaches to the bottom of the heel bone. Those who overuse, or put heavy stress on the plantar fascia, are at risk of developing heel spurs.
When a patient has plantar fasciitis, the plantar fascia becomes inflamed and degenerative (worn out)--these abnormalities can make normal activities quite painful. Symptoms typically worsen early in
the morning after sleep. At that time, the plantar fascia is tight so even simple movements stretch the contracted plantar fascia. As you begin to loosen the plantar fascia, the pain usually
subsides, but often returns with prolonged standing or walking.
Heel spurs often cause no symptoms. But heel spurs can be associated with intermittent or chronic pain, especially while walking, jogging, or running, if inflammation develops at the point of the
spur formation. In general, the cause of the pain is not the heel spur itself but the soft-tissue injury associated with it. Many people describe the pain of heel spurs and plantar fasciitis as a
knife or pin sticking into the bottom of their feet when they first stand up in the morning, a pain that later turns into a dull ache. They often complain that the sharp pain returns after they stand
up after sitting for a prolonged period of time.
Diagnosis is made using a few different technologies. X-rays are often used first to ensure there is no fracture or tumor in the region. Then ultrasound is used to check the fascia itself to make
sure there is no tear and check the level of scar tissue and damage. Neurosensory testing, a non-painful nerve test, can be used to make sure there is not a local nerve problem if the pain is thought
to be nerve related. It is important to remember that one can have a very large heel spur and no plantar fasciitis issues or pain at all, or one can have a great deal of pain and virtually no spur at
Non Surgical Treatment
Ice and use arch support . If you can localize the spur, cut a hole in a pad of felt and lay the hole over the spur. This supports the area around the spur and reduces pressure on it. Massage the
spur. Start gently with your thumb and gradually increase the pressure until you?re pushing hard directly on the spur with your knuckle or another firm object. Even it if hurts, it should help. Arch
support. Build up an arch support system in your shoes. Try to equalize the pressure of your body weight throughout your arch and away from the plantar area. Use a ?cobra pad? or other device that
supports the arch but releases pressure on the painful area. If homemade supports do not work, see a podiatrist about custom orthotics.
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.