A heel spur is a calcium deposit on the underside of the heel bone, often caused by strain on foot muscles and ligaments. Heel spurs are common among athletes but also tend to develop as we age, as flexibility decreases. Heel spurs can be painful when associated with plantar fasciitis, an inflammation of the connective tissue that runs along the bottom of the foot and connects the heel bone to the ball of the foot.
If left untreated, the mild aches associated with this condition can evolve into chronic pain. And as you try to compensate for the pain, your gait may change, which could impact your knee, hip and back.
One frequent cause of heel spurs is an abnormal motion and mal-alignment of the foot called pronation. For the foot to function properly, a certain degree of pronation is required. This motion is defined as an inward action of the foot, with dropping of the inside arch as one plants the heel and advances the weight distribution to the toes during walking. When foot pronation becomes extreme from the foot turning in and dropping beyond the normal limit, a condition known as excessive pronation creates a mechanical problem in the foot. In some cases the sole or bottom of the foot flattens and becomes unstable because of this excess pronation, especially during critical times of walking and athletic activities. The portion of the plantar fascia attached into the heel bone or calcaneous begins to stretch and pull away from the heel bone.
The vast majority of people who have heel spurs feel the asscociated pain during their first steps in the morning. The pain is quite intense and felt either the bottom or front of the heel bone. Typically, the sharp pain diminishes after being up for a while but continues as a dull ache. The pain characteristically returns when first standing up after sitting for long periods.
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
If pain and other symptoms of inflammation-redness, swelling, heat-persist, you should limit normal daily activities and contact a doctor of podiatric medicine. The podiatric physician will examine the area and may perform diagnostic X-rays to rule out problems of the bone. Early treatment might involve oral or injectable anti-inflammatory medication, exercise and shoe recommendations, taping or strapping, or use of shoe inserts or orthotic devices. Taping or strapping supports the foot, placing stressed muscles and tendons in a physiologically restful state. Physical therapy may be used in conjunction with such treatments. A functional orthotic device may be prescribed for correcting biomechanical imbalance, controlling excessive pronation, and supporting of the ligaments and tendons attaching to the heel bone. It will effectively treat the majority of heel and arch pain without the need for surgery. Only a relatively few cases of heel pain require more advanced treatments or surgery. If surgery is necessary, it may involve the release of the plantar fascia, removal of a spur, removal of a bursa, or removal of a neuroma or other soft-tissue growth.
Though conservative treatments for heel spurs work most of the time, there are some cases where we need to take your treatment to the next level. Luckily, with today?s technologies, you can still often avoid surgery. Some of the advanced technologies to treat a Heel Spur are Platelet Rich Plasma Therapy. Platelet Rich Plasma Therapy (also known as PRP) is one of several regenerative medicine techniques that University Foot and Ankle Institute has helped bring to foot and ankle care. This amazing in-office procedure allows the growth factors in the blood to be used to actually begin the healing process again long after your body has given up on healing the area. Heel Pain Shockwave Therapy. Shockwave therapy is a non-invasive procedure done in the office that allows for new blood to get to the region of fascia damage and help with healing. Results have been excellent with more than 70 percent of patients getting relief with only one treatment. Topaz for Heal Spurs and pain. Another minimally invasive technology technique is called Coblation Surgery using a Topaz probe. This minimally invasive procedure involves controlled heating of multiple tiny needles that are inserted through the skin and into the plantar fascia. This process, like PRP and Shockwave therapy, irritates the fascia enough to turn a chronic problem back into an acute problem, greatly increasing the chances of healing. Heel Spur Surgery. Endoscopic Plantar Fasciotomy is one surgical procedure that we consider to release the tight fascia. University Foot and Ankle Institute has perfected an endoscopic (camera guided) approach for fascia release to allow rapid healing and limited downtime with minimal pain.