Heel spurs are a condition that usually makes its presence known first thing in the morning via heel pain. Discomfort is typically felt in the front and bottom of the heel (calcaneal). Pain can be
constant for several months or intermittent for lengthy periods of time.
The plantar fascia is a big strong ligament on the bottom of the foot, starting at the bottom of the heel bone and running into the ball of the foot. As the arch of the foot becomes weak, it sags
slightly with each step and this causes the plantar fascia to tug and pull at the heel bone with each step. Over a period of time, a spur forms where this big strong ligament tugs and pulls at the
heel bone. Soon, inflammation (swelling) starts around this spur and the pain becomes almost unbearable. (Sometimes heel spurs may be present without being painful if no inflammation is
Symptoms may be similar to those of plantar fasciitis and include pain and tenderness at the base of the heel, pain on weight bearing and in severe cases difficulty walking. The main diagnosis of a
heel spur is made by X-ray where a bony growth on the heel can be seen. A heel spur can occur without any symptoms at all and the athlete would never know they have the bony growth on the heel.
Likewise, Plantar fasciitis can occur without the bone growth present.
Your doctor will discuss your medical history and will examine your foot and heel for any deformities and inflammation (swelling, redness, heat, pain). He/she will analyze your flexibility,
stability, and gait (the way you walk). Occasionally an x-ray or blood tests (to rule out diseases or infections) may be requested.
Non Surgical Treatment
The key is to identify what is causing excessive stretching of the plantar fascia. When the cause is over-pronation (flat feet), an orthotic with rearfoot posting and longitudinal arch support will
help reduce the over-pronation and thus allow the condition to heal. Other common treatments for heel spurs include Stretching exercises. Losing weight. Wearing shoes that have a cushioned heel that
absorbs shock. Elevating the heel with the use of a heel cradle, heel cup, or orthotics. For example, heel cradles and heel cups provide extra comfort and cushion to the heel, reducing the amount of
shock and shear forces experienced from everyday activities.
Surgery is used a very small percentage of the time. It is usually considered after trying non-surgical treatments for at least a year. Plantar fascia release surgery is use to relax the plantar
fascia. This surgery is commonly paired with tarsal tunnel release surgery. Surgery is successful for the majority of people.