The heel spur (or calcaneal spur) is a nail-like growth of calcium around the ligaments and tendons of the foot where they attach to the heel bone. The spur grows from the bone and into the flesh of the foot. A heel spur results from an anatomical change of the calcaneus (heel bone). This involves the area of the heel and occasionally, another disability, such as arthritis. The heel bone forms one end of the two longitudinal arches of the foot. These arches are held together by ligaments and are activated by the muscles of the foot (some of which are attached beneath the arches and run from the front to the back of the foot). These muscles and ligaments, like the other supporting tissues of the body, are attached in two places. Many are attached at the heel bone. The body reacts to the stress at the heel bone by calcifying the soft tissue attachments and creating a spur.
A heel spur usually develops as a result of wear and tear over time, which leads to the degeneration of connective tissue called fascia. Standing for prolonged periods and wearing shoes that do not provide the right type of arch support can also lead to connective tissue damage in the heel. The body attempts to repair the damaged tissue by delivering calcium to the affected region, but sometimes too much calcium begins to accumulate and this results in painful plantar fasciitis.
Although it may take years to become a problem, once it appears, it may cause considerable suffering. Because of proximity to the tendons, the spur is a source of continuous painful aching. The sensation has been described as "a toothache in the foot." When you place your weight on the heel, the pain can be sufficient to immobilize you.
Heel spurs and plantar fasciitis are diagnosed based on the history of pain and tenderness localized to these areas. They are specifically identified when there is point tenderness at the bottom of the heel, which makes it difficult to walk barefoot on tile or wood floors. X-ray examination of the foot is used to identify the bony prominence (spur) of the heel bone (calcaneus).
Non Surgical Treatment
Elevation of the affected foot and leg at rest may diminish the pain. Applying gentle heat to the painful area may ease the pain by dilating local blood vessels. One also can protect the heel by placing a foam rubber pad in the heel of the shoe. A pad about one-half inch thick will raise the heel, shift the weight of the body forward, and protect the irritated muscles attached to the heel bone. The same effect can be achieved by using adhesive tape to turn the foot inward. Additional treatment may consist of a number of physical therapies, such as diathermy, ultrasound waves and whirlpool baths.
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.
You can help prevent heel spur symptoms from returning by wearing the proper shoes. Customized orthotics and insoles can help relieve pressure. It is important to perform your exercises to help keep your foot stretched and relaxed.