Patients and doctors often confuse the terms heel spur and plantar fasciitis. While these two diagnoses are related, they are not the same. Plantar fasciitis refers to the inflammation of the plantar
fascia--the tissue that forms the arch of the foot. A heel spur is a hook of bone that can form on the heel bone (calcaneus) and is associated with plantar fasciitis. About 70 percent of patients
with plantar fasciitis have a heel spur that can be seen on an X-ray. However, many patients without symptoms of pain can have a heel spur. The exact relationship between plantar fasciitis and heel
spurs is not entirely understood. Heel spurs are common in patients who have a history of foot pain caused by plantar fasciitis.
Generally caused by lack of flexibility in the calf muscles and/or excess weight, heel spurs occur when the foot bone is exposed to constant stress and calcium deposit build-up on the bottom of the
heel bone. Repeated damage can cause these deposits to pile up on each other, presenting a spur-shaped deformity.
Heel spurs often do not show any symptoms. If you have intermittent or chronic pain when you walk, run or jog, it may be heel spur. There will be inflammation the point where spur formation happens.
The pain is caused by soft tissue injury in the heel. Patients often describe the pain as a pin or knife sticking to the heel. The pain is more specially in the morning when the patient stands up for
the first time.
A Diagnosis of Heel Spur Syndrome is a very common reason for having heel pain. Heel pain may be due to other types of conditions such as tendonitis, Haglund's Deformity, Stress Fracture, Tarsal
Tunnel Syndrome, or low back problems. A more common condition in children is Sever's Disease. The diagnosis is usually made with a combination of x-ray examination and symptoms.
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.
More than 90 percent of people get better with nonsurgical treatments. If conservative treatment fails to treat symptoms of heel spurs after a period of 9 to 12 months, surgery may be necessary to
relieve pain and restore mobility. Surgical techniques include release of the plantar fascia, removal of a spur. Pre-surgical tests or exams are required to identify optimal candidates, and it's
important to observe post-surgical recommendations concerning rest, ice, compression, elevation of the foot, and when to place weight on the operated foot. In some cases, it may be necessary for
patients to use bandages, splints, casts, surgical shoes, crutches, or canes after surgery. Possible complications of heel surgery include nerve pain, recurrent heel pain, permanent numbness of the
area, infection, and scarring. In addition, with plantar fascia release, there is risk of instability, foot cramps, stress fracture, and tendinitis.
The best way to prevent heel spurs is by wearing properly fitted footwear. Shoes should have a shock absorbing tread and soles and should be effective in supporting the heel and arch. Proper warm up
and stretching before embarking on any physical activity that will put pressure or impact on the area is highly recommended. Also, just as it?s important for your general health, if you can lose some
extra pounds, you will be more likely to avoid heel spurs. If you are starting to feel the onset of pain, it may not be heel spurs, but could be a tendonitis condition that could lead to heel spurs.