A heel spur is a bony projection on the sole (bottom) of the heel bone. This condition may accompany or result from severe cases of inflammation to the structure called plantar fascia. The plantar fascia is a fibrous band of connective tissue on the sole of the foot, extending from the heel to the toes. Heel spurs are a common foot problem resulting from excess bone growth on the heel bone. The bone growth is usually located on the underside of the heel bone, and may extend forward toward the toes. A painful tear in the plantar fascia between the toes and heel can produce a heel spur and/or inflammation of the plantar fascia. Because this condition is often correlated to a decrease in the arch of the foot, it is more prevalent after the ages of six to eight years, when the arch is fully developed.
Generally caused by lack of flexibility in the calf muscles and/or excess weight, heel spurs occur when the foot bone is exposed to constant stress and calcium deposit build-up on the bottom of the heel bone. Repeated damage can cause these deposits to pile up on each other, presenting a spur-shaped deformity.
An individual with the lower legs turning inward, a condition called genu valgus or “knock knees,” can have a tendency toward excessive pronation. This can lead to a fallen arch and problems with the plantar fascia and heel spurs. Women tend to suffer from this condition more than men. Heel spurs can also result from an abnormally high arch. Other factors leading to heel spurs include a sudden increase in daily activities, an increase in weight, or a thinner cushion on the bottom of the heel due to old age. A significant increase in training intensity or duration may cause inflammation of the plantar fascia. High-heeled shoes, improperly fitted shoes, and shoes that are too flexible in the middle of the arch or bend before the toe joints will cause problems with the plantar fascia and possibly lead to heel spurs.
A thorough history and physical exam is always necessary for the proper diagnosis of heel spurs and other foot conditions. X rays of the heel area are helpful, as excess bone production will be visible.
Non Surgical Treatment
Some heel spurs do require surgery, however surgery is a last resort. In most cases the patients underlying foot problem needs to be addressed, such as Over Pronation and Over Supination and Heel Pain Treatment Options need to be implemented if Plantar Fasciitis and Achilles Tendonitis are still an ongoing concern. Your best treatment is always prevention.
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.