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, extending forward to the toes. One explanation for this excess production of bone is a painful tearing of the plantar fascia connected between the toes and heel. This can result in either a heel spur or an inflammation of the plantar fascia, medically termed plantar fascitis. Because this condition is often correlated to a decrease in the arch of the foot, it is more prevalent after the age of six to eight years, when the arch is fully developed.
Causes of Heel Spur Syndrome are mostly due to your foot structure. Foot structure is due to hereditary for the most part, meaning it was the way you were when born. Other factors such as increase in weight, injury, improper shoes, or different activities may change the way your foot functions as well. If one leg is longer or shorter than the other, this may make your foot function improperly and be the cause of the heel spur syndrome. Improper shoes may be ones that are new or ones that are worn out and do not give good support. The higher priced shoes do not mean it's a better shoe. Pronation is a term used to describe a foot which allows the arch to fall more than normal and allows for the fascia along the bottom of the foot to put a tighter pull or a different angle of pull on the heel bone. Over time, this constant pull of the tight fascia can force the bone to enlarge and form a spur. It is not the heel spur that causes the pain directly. The spur may cause pressure against a nearby nerve causing a neuritis, or a bursa causing a bursitis.
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.
The diagnosis of heel pain and heel spurs is made by a through history of the course of the condition and by physical exam. Weight bearing x-rays are useful in determining if a heel spur is present and to rule out rare causes of heel pain such as a stress fracture of the heel bone, the presence of bone tumors or evidence of soft tissue damage caused by certain connective tissue disorders.
Non Surgical Treatment
Heel spurs can be treated by wearing orthotic insoles inside the shoe. Orthotics are designed to correct incorrect gait, in particular over-pronation (rolling in of the foot and collapsing of the arches). Over-pronation is a very common foot condition, affecting at least half of the population. It is a major contributing cause of heel spurs. Orthotics are very effective in that the device corrects the foot to its natural position. By supporting the arches properly and preventing excess rolling in of the foot, the plantar fascia is placed under much less strain and stress compared to an unsupported foot. Less strain on the ligament means less pulling away from the heel bone, allowing the inflammation to heal faster. In addition to orthotic treatment, most podiatrists and physiotherapists recommend a series of exercises to help make the ligaments in the feet and legs longer and more flexible. In turn this will help reduce strain on the plantar fascia.
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.
Walk around before you buy shoes. Before you purchase your shoes, do the following. Re-lace the shoes if you're trying on athletic shoes. Start at the farthest eyelets and apply even pressure to the laces as you come closer to the tongue of the shoe. Make sure that you can wiggle your toes freely inside of the shoe. Also, make sure that you have at enough space between your tallest toe and the end of the shoe. You should have room equal to about the width of your thumb in the tip of your shoe. Walk around to make sure that the shoe has a firm grip on your heel without sliding up and down. Walk or run a few steps to make sure your shoes are comfortable. Shoes that fit properly require no break-in period.