A heel spur is a hook of bone that can form on the heel bone of the foot. Heel spurs are associated with plantar fasciitis. Heel spurs can cause extreme pain in the rearfoot. The pain is most intense while standing or walking. What Causes Heel Spurs? Heel spurs develop as an abnormal growth in the heel bone due to calcium deposits that form when the plantar fascia stretches and pulls away from the heel. The plantar fascia is a ligament located at the bottom of your foot. This stretching of the plantar fascia is usually the result of flat feet or unusually high arches.
Heel spurs are exacerbated by an movements that stretch, twist or impact the plantar ligaments. Running, jumping, standing or walking on hard surfaces with unsupportive shoes, walking barefoot in sand are all activities that can activate heel spurs and plantar fasciitis. Obesity is another factor that increases stress to the plantar ligaments.
Most people think that a bone "spur" is sharp and produces pain by pressing on tissue, when in fact, these bony growths are usually smooth and flat. Although they rarely cause pain on their own, bone spurs in the feet can lead to callus formation as tissue builds up to provide added cushion over the area of stress. Over time, wear and tear on joints may cause these spurs to compress neighboring ligaments, tendons or nerves, thus injuring tissue and causing swelling, pain and tearing.
A heel spur is often seen on X-ray as a bony protrusion, which can vary in size. However, because a Heel Spur only indicates increased load on the plantar fascia, and not pain, an ultra sound may be required to assess other actual cause of the heel pain such and may include checking to see if the plantar fascia is inflamed or degenerated.
Non Surgical Treatment
In some cases, heel spur pain may not be resolved through conservative treatment options. In those cases, cortisone injections may be used to reduce inflammation associated with the condition, helping to reduce discomfort. However, treatment options such as these must be discussed in detail with your physician, since more serious forms of treatment could yield negative side effects, such as atrophy of the heel's fat pad, or the rupture of the plantar fascia ligament. Although such side effects are rare, they are potential problems that could deliver added heel pain.
Have surgery if no other treatments work. Before performing surgery, doctors usually give home treatments and improved footwear about a year to work. When nothing else eases the pain, here's what you need to know about surgical options. Instep plantar fasciotomy. Doctors remove part of the plantar fascia to ease pressure on the nerves in your foot. Endoscopy. This surgery performs the same function as an instep plantar fasciotomy but uses smaller incisions so that you'll heal faster. However, endoscopy has a higher rate of nerve damage, so consider this before you opt for this option. Be prepared to wear a below-the-knee walking cast to ease the pain of surgery and to speed the healing process. These casts, or "boots," usually work better than crutches to speed up your recovery time.